Massages, reiki, oh my! Make patients feel at home
Northern Westchester Hospital caters to patients
Who would ever believe that one could enter a hospital and confuse it for a spa? The two seem utterly at odds, yet according to Maria Hale, vice president of patient advocacy and service excellence at Northern Westchester Hospital in Mount Kisco, NY a 233-bed designated Planetree patient-centered hospital they have more in common than at first glance. And they seek the same ends comforting and healing the guest.
According to the hospital's Press Ganey reports, which show patient satisfaction in the 90th percentile, it's doing a pretty good job.
According to Hale, who spent many years at the Four Seasons and the Ritz Carlton as director of human resources and training, many similarities exist between the hotel and hospital industries. Upon arriving at the hospital, customers (just like hotel guests) have certain expectations "that there's a seamlessness to the process," Hale says, "that there's someone there to greet them, there's someone there to help them with whatever issues they have when they arrive."
The main difference between a hotel and a hospital visit obviously is "that people coming to our institution are not coming for pleasure," Hale says. "And when they come, they're highly anxious about what's going to happen to them."
Relieving that anxiety is Hale's charge. She is responsible for running the patient advocacy department, working closely with managers of different departments to review patient satisfaction surveys and any other patient data received from surveys, letters, comments during their stay, and making any relevant changes.
"The primary goal of a patient advocate," Hale says, "is to be there to let these patients and families know that there's a person in the building who can really be there to help remove any obstacles they might perceive, remove barriers, listen to concerns and complaints, act as a liaison between staff and physicians when they feel that maybe there's additional information that they need explanation of things of that nature.
"As soon as you enter the building, you can feel that it's different," says Hale. Music plays in public areas, and a grand piano even graces the lobby.
When patients go up to their rooms, a nurse greets them and offers any amenities they might need or might have left at home, such as toothbrush, toothpaste, lip balm, a nail file, ear plugs, socks, or hand lotion.
The caregiver lobby, right outside the main lobby, is "one innovative approach that we have at the hospital that helps the family caregiver," Hale says.
"From the minute you open the the doors and walk in, you almost feel like you're in a spa environment," she adds. Volunteer caregiver coaches meet with caregivers to help them with any issues or concerns they might have. It also provides time and quiet for caregivers to replenish before they return to their caregiving role.
Hale emphasizes empowering patients with choice and customized care and preserving their dignity while in the hospital. Basic things can have a big impact, she says, such as gowns that cover the patient entirely and are not open on the back.
Room service is available on the hospital's maternity ward, and plans are in place to take it hospitalwide by the end of the year. The service was put in place as a response to patients' feedback that they wanted to be able to order food when they were ready to eat. "This was a big need on the maternity ward because you're delivering at different times, and when you're done delivering you want to be able to get a meal that you want to eat, whether it's chicken Caesar salad or a nice burger," Hale says. The service goes a long way to empowering patients, giving them something they can control "in an environment, where at a lot of times, you lose control."
Integrative medicine approach
Northern Westchester provides different modalities of integrative medicine to patients free of charge including massage, reiki (energy healing), guided imagery, and aromatherapy. Patients can request the service, or providers can refer them.
Trained holistic nurses manage the program and have made it a part of the nurses' practice. Now classes are expanding the program to include volunteers and other staff members, and it also is available to staff caregivers. "We're an organization that feels very strongly that in order for our caregivers to give the quality care and service that we expect our patients to receive, you need to be able to decrease the stresses that professional caregivers deal with every day," says Hale.
Staff incentives also include a "healing cart" that travels the hospital offering things such as healthy snacks.
Hale emphasizes communication as part of the patient-centered model. In each room is a white communication board where each nurse writes his or her name and the patient's plan of care for the day. For instance, Hale says, the board might read: "Hi, my name is Kate. I'm your nurse today. Let me tell you what's going on for you today. Today, at 10 a.m. you're going to have a CAT scan, and then at 2 you're going to have a Doppler study."
This involves the patient and "also invites conversation between the nurse and the caregiver to talk about concerns do they understand what is happening, preparing them for what they have to do," Hale says. The board also helps family members stay in the know.
At the bedside, there is a pad of paper and a pen, and guests are encouraged to record any questions or concerns they have to discuss with doctors and nurses. There is even a sign on the wall that says, "Just ask. If you're thinking it, ask it." It also prompts them with example questions such as: Did you know you could ask for a different meal selection? Did you know that your blood work and vitals could be drawn at a more convenient time for you? How can you arrange for a complimentary relaxation session?
Patient response
According to Hale, patients are most impressed by the level of interaction they have with their professional caregivers at Northern Winchester. "Our patients tell us all the time, 'I can't believe how compassionate your staff is, that they took the time to make sure I was comfortable before they wheeled me down to X-ray, that I was completely covered...
"Those types of comments," she adds, "when we get those back are very reassuring to us because we want to empower our patients. We want to give them as much information as we can while they're here about what's happening to them so that they can be actively involved in their care and really feel comfortable about what the process is. To us, that's the most important thing that dialogue."
Patients also write about the decor, the environment, the noise level. Hale says they have eliminated any overhead paging in the hospital. Patients respond favorably to the massage and other modalities also, commenting that their pain or nausea post-procedure was curtailed by the therapy.
Hale says some projects took a longer time to gain acceptance. For instance, the pet therapy initiative. The initial reaction, she says, was "you can't have dogs in a hospital." Now the program is housewide.
For hospitals looking to adopt some or all of the Planetree methods, Hale says, "I think you have to look at patient- and family-centered care as a journey. It can be done regardless of the size of institution you're in. The first thing is to do a little self-evaluation. Where are you on these different dimensions? What are the things you can tackle first? What's the low-hanging fruit?"
She suggests convening a multidisciplinary committee with people who are ready to lead change. "You need to identify what it is you're trying to achieve and come up with an action plan and know that it's not going to happen overnight. There are small things you can do to make small impacts over time and you will see the overall experience will be better."
[You can contact Maria Hale at (914) 666-1951 or [email protected].]
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