'To Touch the Spirit' is goal of Arizona hospital's initiative
'It's amazing what people are willing to do,' says organizer
When some of the leaders at Mt. Graham Regional Medical Center in Safford, AZ, got together in 2001 to talk about fostering a more caring, holistic environment for patients, visitors, and employees, it took a while to get a firm grasp on "exactly what we wanted to do," says Julie Johnson, CHAM, director of health information management (HIM) and communications and HIPAA privacy officer.
"Each person came up with something," she recalls. "It was, 'How about this? What about this?'" Suggestions ranged from putting movies and a VCR player in the waiting area to having music piped in to creating curtains with garden designs for patient rooms, Johnson adds.
The initiative, she says, began with the suggestion of a couple of the hospital's board members, who had been inspired by the patient-centered Planetree model — the concepts espoused by futurist Leland Kaiser — and other innovative health care philosophies, and said, "Wouldn't it be nice if we had an environment like that here?"
After a few meetings, the members of the informal group began to refer to themselves as a committee on "Care of the Whole Person," Johnson says. While members had a sense of where they wanted to go with the idea, continues John Nichols, director of food and nutrition, "it was hard to put into words and a process that employees would buy into. It was nice to have visions, thoughts, but to get them moving in one direction we needed something tangible."
It was when committee members decided on a new name — Toccare Lo Spirito, an Italian phrase meaning "To Touch the Spirit" — that the effort gained real focus, Nichols recalls. "That put some direction to where we were going. It really embodies what we are doing here."
Notes from committee meetings around that time indicate that board President John Ratje had suggested that a foreign name be used — to pique employees' curiosity — and that Mt. Graham board members and administrators visiting San Diego came up with Toccare Lo Spirito during a conversation with an Italian man in a restaurant, he says.
The group expanded from department heads and some other employees to "everyone who wanted to join," Johnson says. Now, she adds, there are fewer representatives from hospital leadership and "more hands-on people."
Four years later, the program has blossomed into an organizational movement that seemingly has taken on a life of its own, she says, and captured the imagination of the staff in a way that no one had anticipated.
"At every meeting we have a 'Toccare moment,' where people can share stories that came up during the month," Johnson notes. "It helps with the buy-in when we hear how [a staff member] gave a patient a ride home, or drove two hours to take medication to someone. It's amazing what people are willing to do."
"We are trying to touch everybody from visitors to patients to employees," adds Nichols, who has served as chairman of the Toccare committee since late 2004. "When people walk in here, we want them to feel there is something different about what we do — that it's not just talk, but the way [the hospital] looks and smells, that they are using all their senses to enjoy everything we try to do."
One of the earliest Toccare initiatives came about in the midst of a remodeling project at the 59-bed nonprofit hospital, when the committee was given the task of deciding on artwork for hallways, waiting areas, and patient rooms, he says.
Next came the fountain and landscaping outside, referred to internally as "Toccare Café" — a name that conveys the atmosphere and quality of the food service provided for patients and employees, Nichols says. The term "cafeteria" simply doesn't fit, he notes. "There is a garden area with nice tables and umbrellas and vibrant desert flowers."
More recently the art initiative has become more formalized, Nichols says, with a children's artwork program overseen by a Toccare volunteer. Each month that employee coordinates with different schools to provide paintings or drawings inspired by a particular theme.
"High school students came in and painted a mural of dolphins in the CT scanning rooms," adds Johnson.
One of the most popular Toccare touches, she says, is the playing of chimes throughout the hospital when a baby is born — an idea contributed by a former chief nursing officer.
Focus is threefold
The Toccare Lo Spirito committee is now broken down into three groups — enhanced versions of pre-existing employee services and customer service committees, and a new "therapeutic environment" committee, Nichols explains.
In addition to such programs as the children's artwork and new baby arrival music, that committee has instituted a prayer list that members are very enthusiastic about, he says.
Those interested in participating give the first name of the person they would like to add to the list — which changes every week — to the committee member in charge, Nichols says. "Every patient who is admitted has the option."
Employees volunteer to pray for the names on the list, which is placed on the wall in the hospital chapel, he adds. The list is shared with a local senior care center, where residents also pray for the names.
If there is a death in the hospital, sympathy cards are sent to the family at the time, and also at the one-year anniversary of the death, notes Sherry Larson, vice chair of the Toccare committee. If a patient is nearing the end of life, a comfort box — containing cookies, fruit, and drinks — "is delivered to the family members, so they don't have to leave the bedside," Nichols adds. "It's available to them when they need it."
On the celebratory side, pizza parties and ice cream socials are common occurrences, he says, and there is a haunted house at Halloween, and gifts and a visit from Santa Claus at Christmas time.
"We do all kinds of things for National Hospital Week," adds Johnson, "and during the holidays we give turkeys or gift certificates to stores, and donate canned goods and gift baskets to those in need."
In addition to these visible manifestations of Toccare, buy-in has been further ensured by a program in which employees are rewarded for "doing something great for someone else" with pins in the shape of a helping hand and letters of recognition for the employee and his or her supervisor, she notes.
"We've also instituted an 'immediate recognition' program," Johnson says, wherein hospital directors can present certificates on the spot to employees — not necessarily in their own departments — who are practicing outstanding customer service.
The certificates go toward purchases in the gift shop or from food services, Johnson notes. "If I see somebody in radiology doing something marvelous, I can give that person a certificate. The employees love it. It makes them work harder to please, and it has also been helpful in interdepartmental relations."
Other employee initiatives give recognition for five, 10 or 20 years of service, and provide flowers or plants when the employee is ill or has a death in the family, she says. Johnson, who formerly had the title of director of customer service, is recognized as the driving force in that facet of Toccare, Nichols notes, and has been instrumental in planning and coordinating the hospital's ongoing "Together to the Top" customer service classes and the more recently instituted "Survivor Series" for continuing employee education.
This year the focus of the Toccare Lo Spirito committee is on more efficiently turning ideas into "action plans," he says. "Once we ask questions and are sold on an idea, we will put it on paper and involve the whole group in the activity. We will put it on a [schedule], so that in addition to good ideas, we have great results."
Another benefit of the action plan, Nichols notes, is that members of the Mt. Graham staff who otherwise might never interact may find themselves collaborating on a project. "We may ask an employee of housekeeping to have a conversation with the director of another department, which gives each of them an opportunity to find out what the other person is really like. It builds a bond."
It takes only a brief time on the Toccare committee, he points out, for members to become devoted to the cause
"There is probably nothing better, as a Toccare member, than seeing people use or enjoy something you helped [implement], and it's everything you thought it would be and more," Nichols adds. "That's how people get bought in. That's Toccare."
(Editor's note: Julie Johnson can be reached at [email protected]. John Nichols can be reached at [email protected].)
When some of the leaders at Mt. Graham Regional Medical Center in Safford, AZ, got together in 2001 to talk about fostering a more caring, holistic environment for patients, visitors, and employees, it took a while to get a firm grasp ...You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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