Lessons from a medical center
By Bob Levoy

Is there anything about your practice that possibly irritates patients and which you and your staff are unaware?

You don’t think so? Consider the problem that was recently discovered at Montefiore Medical Center in New York City.

A survey covering a range of topics — from doctors to food to housekeeping — given to patients when discharged from the hospital revealed, of all things, the patients’ No. 1 complaint was the high level of noise in the hospital.

What had been completely overlooked (or underestimated) by management was the cacophony of seemingly unavoidable noises in a medical-center setting — beeping monitors, ringing telephones, squeaking meal carts, blaring intercoms, loud TVs, and late-night conversations among staff in the halls.

“Noise is not only an irritant, but an obstacle to healing,” says Margaret Amato-Hayes, RN, clinical director of nursing. “Studies have shown there is a relationship between excessive noise and a slowing of the healing process. Noise also contributes to increasing stress and anxiety levels.”

As a result, the Silent Hospitals Help Healing (SHHH) program was initiated on the fifth floor of Montefiore Medical Center by Elodia Mercier, RN, the administrative nurse manager of the floor.

Mercier launched SHHH in her unit to provide patients a quieter environment in which to receive care. “The goal was not so much to eliminate noise,” says Mercier. “That’s impossible. The goal was to reduce noise where we can.”

The walls of her unit are filled with “SHHH” signs and workers wear buttons that show a nurse with her finger to her lips. All equipment — from IV poles to medication carts ­— was sent for lubrication and/or repair.

Administrative nursing managers monitor hallway conversations to keep them to a minimum, intercoms are turned down, staff switch their beepers to vibrate mode, and patients have the option to wear headphones while watching television.

As a result, overall decibel levels have fallen significantly. On Mercier’s unit, noise levels had been as high as 90 decibels, which is comparable to that of a busy street. Today, the floor maintains decibel levels of about 65, on par with a typical library.

The effects of SHHH have been remarkable, says Mercier. “Within two weeks, patients said they were sleeping better, and the staff told us they were less stressed.”

“When people are ill, they are sensitive to stressors like noise. We owe our patients quality and compassion, including a quiet, calm environment in which they can heal,” says Mercier. “It’s just a matter of work habits.”

The experiences at the medical center offer several lessons for busy chiropractors:

• Get patient feedback. In the day-to-day rush of seeing patients, staying on schedule, dealing with assorted emergencies, and returning phone calls, it’s easy to lose track of patients’ emotional needs.

Periodic feedback is essential. Brief patient surveys, follow-up phone calls of selected patients, and focus groups are among the ways you can assess patient satisfaction. In the case of Montefiore Medical Center, “noise” as a major complaint, let alone the top complaint, was the furthest thing from anyone’s mind.

• Act on what you learn. The solution to this No. 1 complaint from patients cost the hospital absolutely nothing to implement. Might there be comparable complaints in your practice that could be solved with a simple change of work habits?

• Little things count. In today’s hypercompetitive times, healthcare providers, as well as hospitals, must look for ways to differentiate themselves. Obviously, many other aspects of a hospital have to be highly regarded to give it a competitive edge, but the little things add up.

Action step: Learn what, if anything, is irritating your patients and fix the problem.

Bob Levoy’s newest book, 222 Secrets of Hiring, Managing, and Retaining Great Employees in Healthcare Practices, is published by Jones and Bartlett Publishers. He can be reached at b.levoy@att.net.