Ravi Patel, a member of the IHI Open School Chapter network, received a kidney from his professor, Lynda Bernhardt.
Ravi Patel has seen the health care system from the inside, and now he aspires to change it. Patel, a health administration student at Valdosta State University, joined the IHI Open School Chapter there after suffering from a chronic kidney condition. We asked him about how his disease and treatment have influenced his career goals to improve the quality of health care.
Tell me about your kidney condition. How did it start, and how was it affecting your life before the transplant?
In the fall of 2012, I was taking classes at Valdosta State University when I started feeling very weak and tired. I would hardly be able to walk from one classroom to the other. My body would have intense jolts that I had no control over. One week I couldn’t even get out of bed.
My father had enough and said, “We are taking you to the hospital, no matter what.” I hated hospitals because as a child I was in and out of hospitals continuously, with appendicitis and allergies. On our way there, my father received a call about bloodwork that had been taken earlier in the week. His face turned white. I knew something was terribly wrong because I had never seen my father like that.
We arrived at Coffee Regional Medical Center, and doctors were already waiting for me at the front entrance. A nurse put me on a stretcher and took me all the way to the top floor — to the intensive care unit. That’s when the doctors told me that I was in stage 5 kidney failure — they never figured out why, exactly, other than telling me it was probably caused by high blood pressure. They had to perform emergency surgery to put a central venous catheter in my neck to clean out my blood. I had to receive about four liters of blood because my blood was just too far gone.
Once I became stable, I had to be transferred to Emory University in Atlanta to do some more lab work and tests. After about 30 days at Emory, I was released to go home. Then I had to undergo dialysis three times a week, for four hours a session, for two years — until a donor gave me a kidney.
At IHI, we talk about how quality and safety issues are rarely the fault of people with bad intentions, but rather, flawed systems and processes. What quality problems did you see in your care?
I recognized many flaws and imperfections in the medical system throughout my years in and out of hospitals.
At one point, I got sick with the flu and had to go to the hospital. I had been receiving dialysis at home, where I had never had a problem with cleanliness myself. But when I was admitted to the hospital, my catheter got infected, and what was supposed to be a two-day stay ended up being a three-week stay.
I also saw problems in a dialysis unit where I was being dialyzed every Tuesday, Thursday, and Saturday. Tuesdays and Thursdays were fine, but as soon as Saturday came, all the nurses seemed rushed to put us on and take us off the dialysis machine. There were usually about 11 patients and only one or two nurses to manage all of these patients. When one patient was in pain, he or she would have to wait patiently if the nurse was helping another patient. I couldn’t take this anymore, so I switched to dialysis on Mondays, Wednesdays, and Fridays, when it was calmer and the nurses weren’t in such a hurry to leave.
What inspired you to study health care administration?
One day in dialysis, I saw an elderly Indian lady being wheeled on a stretcher into the dialysis unit. I could see she had just gotten out of the hospital because she still had the armband on. The nurses and doctors were hooking her lines up, and she seemed scared and confused — like she didn’t know what was going on. Luckily, I spoke Gujarati and was able to walk her through the procedure of dialysis. She thanked me for my help and told me she wouldn’t have known what was going on or what to do. From then on, I knew that I wanted to get into health care administration and make patient care my top priority.
Tell me about your experience trying to get a kidney transplant. Do you have any thoughts about how to improve that process?
My experience trying to get a kidney was very tedious. Right now, there are more than 93,000 people on the waiting list, and it could be five or 10 years before those people actually receive a kidney from a deceased donor. I was registered in three different states — Georgia, Florida, and Alabama — to increase the chances of receiving a transplant sooner.
My guardian angel appeared before me in an environmental science class I was enrolled in. I didn’t know it then, but that professor, Lynda Bernhardt, would be donating a kidney to me in the coming months. Lynda had to jump through so many hoops just to donate. She would say, “It’s as if they don’t want me to give you the kidney.”
On May 21, 2015, we both underwent the operation for her to give me one of her kidneys; I had a new family member and lifelong friend.
What has this experience taught you about how health care should work?
This experience has taught me to be informed as a patient. If you feel left out of the circle, always ask questions — whether you’re not sure what a medication is for or you simply want to know the impact of a surgery. After going through so much, I’ve learned it’s always good to ask questions, because doctors will use language you’re not familiar with,; a lot of people just agree without actually knowing what it means. It’s best to stay informed. After all, it’s not the doctor’s body that will face the repercussions. Heath care should focus on patient awareness, not just patient satisfaction.
How has being a patient influenced your decision to get involved with the IHI Open School?
Being a dialysis patient, I saw day-to-day activities in the facilities that needed to be changed. I knew I had to do something when I saw patients coming day in and day out who were sad and complaining. I got in contact with James Powell, who is an IHI Open School Chapter Leader at Valdosta State University. James told me that the Chapter needed someone with my expertise — someone familiar with being a patient. I attended one meeting, and I was hooked.
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