Tigers, Scotsmen, and hospitals

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Last night I watched a re-run of ‘Lost Land of the Tiger’ – this is a nature documentary with Steve Backshall, Scottish Wildlife Cameraman Gordon Buchanan, Scottish Entomologist George McGavin and others wandering about the highlands and lowlands of Bhutan in search of evidence of tigers.

The programme focuses on the creation of a ‘tiger corridor’ between India and China, via Bhutan to support the ongoing preservation of tigers in the wild. This in itself if something quite exciting and a few years ago when the programme first aired, I was keen to develop some sort of tiger corridor in my hospital – alas, the metaphor was too stretched and it never happened.

Nevertheless, one of the themes within the Lost Land relates to the importance of balance and diversity within the ecosystem; this is something that I identified with.

Maintaining tigers in the wild isn’t just a matter of stopping them being poached for the Chinese herbal market, it is also about ensuring that the tigers have adequate access to prey, shelter and territory – to achieve this, they need enough room to roam, as does their prey – Sikka deer in the main, according to the programme. To maintain a healthy population of deer, the entire ecosystem needs to be sound – the water clean – free of toxins and pollution, the trees, plans and flowers able to provide shelter, nutrition and pollen. Thus, the dung beetle scraping about in a pile of elephant dung has significance to the survival of the tiger.

This all translates, for me, to the ecosystem of a hospital – (you could argue, the entire health economy, but I’ll focus here on the hospital)

The goal of modern healthcare, as described by the American Institute for Healthcare Improvement within the ‘triple aim’ is to provide care to the whole population – allowing no one to be excluded, provide the most excellent and high quality care feasible, all within an economy that is experiencing profound financial pressures.

How then do we maintain the health of the hospital – (the tiger, in my world, threatened either by privatization, closure or wholesale deconstruction)?

We ensure the safety and health of all within the ecosystem – we protect those operating at every level, ensuring their health and happiness, through providing a safe, stimulating, caring environment.

We value the staff – we don’t sell them off to zero-hours contracts and reorganisations, we don’t turn their worlds upside down to create a more perfect system – they are the system. We support them through training, education and development, we offer physical and psychological support when they are struggling, we provide care when they are sick, celebrate their successes and support them through failures.

Bhutan is well known as having the happiest society on earth; and I don’t mean superficial happiness – cheap laughs and humor, but the more profound joy that comes from mutual respect and satisfaction, in healthcare, this is seeing recovery, supporting through difficult times, advising, guiding, collaborating, understanding and respecting, and, caring.

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