Winchester Hospital, a 229-bed facility just north of Boston, has announced that it has eliminated defined visiting hours, effective immediately. With some exceptions -- operating rooms and for clinical reasons including infection concerns for the patient or visitor, safety, clinical care and interventions, or if the patient needs rest -- people visiting patients can do so whenever they wish. "We recognize the value of emotional support during the healing process," said Kathy Schuler, vice president of patient care services and chief nursing officer at Winchester Hospital. "We hope this new policy will benefit all patients."
This is good stuff and a nice contrast to the story below. It would be interesting to know whether the initiative was driven by the staff or whether it came out of consultation with a formal patient advisory council. At BIDMC, it was the latter, as described here, after our ICU Patient and Family Advisory Council suggested to the MDs and RNs that it would help accommodate family members who work late and allow loved ones to visit at their convenience, rather than at ours.
Yes, a great idea and great question re: initiative. I also wonder, if and hope that, staff were and are part of the process of decision-making process. Communicating with family and responding to needs/questions is extremely important. It also requires time and hopefully, there will be staffing support as part of making this work.
ReplyDeleteA collaborative effort could be awesome whereas an imposed change w/o input from staff or administrative support for making it work could lead to problems.
This is good news. In 2005 the most miserably run, callous ICU dept. ever, where my patient-family experienced my mother's 3 wk terminal hospitalization, first opened each day on at 10am or 11am -- and of course MDs round at 6-7a, so there went any chance of crucial provider face time. And more often than not, PF members would queue up at those damn double doors, which were late in opening.
ReplyDeleteYes, another sore point in my not-written CEO letter mentioned in your previous post - I drove 2 hours to my mom's hospital only to discover the ICU hours closed in 5 minutes. I hate to admit that I found it particularly galling as a physician, accustomed to unchallenged access anywhere at any time.
ReplyDeleteMaybe I will write that letter after all....
nonlocal MD
I used to live in NE TN. They abandoned visiting hours years ago. One hospital was unlocked 24 hours a day with people coming and going. The lack of security made me nervous. I often wondered if the decision was made due to nursing staff shortage. Family members often did many things nurses used to do.
ReplyDeleteWhen my husband was hospitalized due to a missed diagnosis by his internist, I stayed with him 24/7. The staff most graciuosly supplied me with a cot and all the bedding. On a later admission, I caught a medication error that saved him from complete kidney shutdown.
There are still far too many medical errors happening in hospitals. Every nurse I speak o says you have to have someone with you 24 hours a day as an advocate. Open visiting hours are needed to for that happen to happen.
The hidden curricula of both education and healthcare have many similiarities. The initiative in this hospital reckons to that in education 2 decades ago. After repeated allegations of questionable care/instruction/relationships with students, the presence of unannounced observations, videotaping and other interaction with parents & community members and administrators became a somewhat expected norm. Sure there is more to improve. But you will be hard pressed to find a teacher or school administrator at any level of education that does not expect these elements as a regular part of their profession.
ReplyDeleteHealth care professionals would do well by their profession and those it serves to be accoustomed to an "open campus" policy. (Yes, that means a new level of security and tools as well. That's a whole other "show")
This reminds me of one (of several times) that my mother was in the hospital and they came in to weigh her about 4am. I knew this because I was staying at night with her (notice I did not say "sleeping"). My mom was wobbly even when awake, much less when awoken in the middle of the night. I asked one of the nurses one time why they weighed patients at that time of the day/night and she said, "Well, it fits our schedule better."
ReplyDeleteI'm happy to share Winchester Hospital's perspective. The decision to eliminate official visiting hours was made by our Nursing Leadership Council, based on our staff's philosophy that patients should decide who they wish to have by their side during hospitalization. Additionally, we noticed that staff made so many exceptions to the visiting hours that we felt ready to simply eliminate defined hours. That being said, we do believe that rest is an important part of healing and do try to limit unreasonable numbers or times of visitors. These limits are defined not by policy, but through conversations with our patients and their families.
ReplyDelete