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Quiet Time Improves the Patient Experience
Christine Hedges1, Candice Hunt, Pamela Ball
1University of North Carolina Medical Center, Chapel Hill (Dr Hedges and Ms Ball); and UNC School of Medicine and UNC Health Care, University of North Carolina Institute for Healthcare Quality Improvement, Chapel Hill (Ms Hunt).
Background:
A quiet environment promotes rest and healing but is often challenging to provide in a busy acute care setting. Improving quiet in the hospital for designated hours improves patient satisfaction. Such efforts have typically been the primary responsibility of the nursing staff.
Local Problem:
Two medical units with consistently low Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) "always quiet" scores were chosen for this study.
Methods:
A multidisciplinary team used Lean methods and the Model for Improvement to test interventions for quiet time (QT) and used HCAHPS "always quiet" scores as the primary outcome measure.
Interventions:
The team instituted nighttime and afternoon QT supported by rounding and scripting, dimming lights, lowering staff voices, offering a sleep menu at night, and replacing noisy wheels.
Results:
Quiet scores improved on both units after 11 months.
Conclusions:
Noise in hospitals is often beyond the scope of nurse-driven improvement; however, a QT protocol led by nurses, developed by multiple stakeholders, and focused on changing expectations for quiet can lead to measurable improvements in patient perception of quiet.
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