In Someone Else's Shoes

Southside Tower 6. See gallery below for IDs.

Sometimes an innovation isn’t necessarily a new concept, but a time-tested idea that gets dusted off and reimagined. Consider the updated tradition of Southside Hospital’s“no-pass zone,” known internally as “Answer the Call.”

The genesis of “no-pass” comes from a hand-written patient letter about slow call bell response by staff during the patient’s hospital stay.

“The manager on our unit took that letter seriously and decided to do something about it,” said Maria Alvarado, RN, an oncology nurse who has worked at Southside for five years. “She said that until you’re on the patient side and push the call bell to see who comes and when they come, you can’t relate to what they are experiencing.”

Shoe-Leather Reporting 

Considering someone else’s experience in order to gain empathy isn’t exactly a new thought. We’ve all heard about not judging people until walking a mile in their shoes, but making that idea a habit doesn’t often come naturally.

It requires determination to think differently, to see the world through someone else’s eyes. So the nurse manager enlisted Ms. Alvarado to conduct a test. Ms. Alvarado became a “secret shopper” of sorts, placed in a vacant hospital bed with the nurse manager by her side. She then pushed the call bell button and waited. Ms. Alvarado pushed it once, twice, several times. How long would it take for someone to answer?

Nearly five minutes.

“I wasn’t sick or in any kind of distress, but the waiting made me anxious and frustrated,” Ms. Alvarado said. “What bothered me most was I could hear people right outside the room having conversations and I actually saw some people pass by. I felt like I was being ignored and that their conversations were more important than my well-being. If I felt like that when I was fine, you can only imagine how much worse it is for patients in distress or discomfort.”

Five minutes of waiting seemed like an eternity to Ms. Alvarado. “When you’re working and going about your life, five minutes goes fast,” she said. “But when you’re sitting there waiting, it feels like forever. The waiting builds resentment,anger and raises the question of trust: How can I really be sure you’ll be there if I really need you?”

Answering the Call

Once a staff member answered Ms. Alvarado’s call bell, the nurse manager who waited with Ms. Alvarado called all the staff members into the room. She explained what happened, and Ms. Alvarado shared her feelings of isolation, trust and frustration.

Staff members had a variety of reasons for not responding. For example, the nurse who covered that room knew it was vacant. Others said it wasn’t in their district. Other staff members, including dietary and unit clerks, explained that they wouldn’t be able to help with medical issues. But after Ms. Alvarado shared her perspective, the consensus from everyone on the unit was that they could do something — even if it was just checking in and then getting someone who could assist.

That’s when the “no-pass zone” went into effect. “It didn’t matter if you were from environmental or dietary services, a nurse, doctor or the hospital’s executive director,” said Patricia Farrell, RN, Southside’s associate executive director of patient care services. “If you were within five feet of a patient room where the call light was on, you could not pass it without checking in to see what the issue was. It has become our policy and the response has been tremendous.”

Since “no-pass” became policy last fall, patient satisfaction discharge data has gone up, Ms. Farrell said. She added, “Our goal is to increase the patient satisfaction of patient response time for their needs from the current 56.4 percent to being consistently between 90 and 100 percent. The numbers continue to go up. We’re on our way.”

Patient letters still come, but Ms. Farrell said they now sound like this: “The night shift nurse was very kind and she came within a minute after I rang the bell. She was active and ready to help.”

Ms. Alvarado concurred. “It should be the standard for every hospital across the nation,” she said. “It has been working out great. We haven’t had any issues. Walking in someone else’s shoes has been a real eye-opener.”



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