The two prime reasons I found were 1) “One-size-fits-all” procedures. For example, according to my age and my specific injury I fit into a high fall risk category. That meant that nurses wanted dog my every move – even being with me in the bathroom. I was not to move from my bed without a nurse being present. It didn’t matter whether I needed this level of attention or not. The importance of avoiding falls meant that my highly rated hospital was willing to go to any length to achieve this. It meant there were three nurses on duty for me night and day: a chief nurse, a nurse, and a technical assistant. It also meant taking vital signs and blood tests all through the night, even though some of this was clearly superfluous. Again, under a one-size-fits all precaution the patient with the lowest risk had to take precautions tailored to the highest risk case.

Did all this reduce the frequency of iproblems? Undoubtedly – for the hospital. But if elderly patients get used to movements only with nurses assistance – what happens when they LEAVE the hospital? It was a perceptive nurse that alerted me to this important point.

In Sweden, instead of all these routine and excessice safety margins, the nurses have the responsibility of evaluating the risk for each patient individually, and also training them to do things themselvces. Result: dramatically reduced staffing needs. Staffing is one of the biggest hospital costs.

2) The second major source of costs is excessively elaborate preparation for medical procedures, extremely detailed checking and confirmation of data and background information and tests. Again, emphasis on nursing and other staff being trained to evaluate patient conditions independently, :”worst case” safeguards are routinely applied to all patients. This delays produres, taking high-priced physician time as well as other staff.