Press Ganey scores on the quietness of hospital environment typically lag behind national benchmarks, despite a series of interventions led by Unit Practice Councils (UPCs) and nurse leaders.
When, in September 2021, the combined quietness of hospital environment Top Box score for the Med-Surg Cluster (3M, ONS, and Oncology Units) dropped to 37.25, clinical nurse Anna Mercado, RN, BSN, ONC, Chair of the Med-Surg UPC, decided to escalate this problem to the Med-Surg UPC for its October meeting. Prior to the meeting, Director of Med-Surg Agnes Lalata, MSN, RN, CMSRN, CNML, approached Mercado to discuss a Quiet Champions strategy the Perinatal UPC had successfully implemented. Quiet Champions educate stakeholders and reinforce strategies for maintaining a quiet environment. After gathering more details, Mercado presented the idea to the Med-Surg UPC, which decided to adopt the idea.
Implementing the Quiet Champions Initiative
ONS clinical nurse Olga Breboneria, BSN, RN, CMSRN, volunteered to lead a task force charged with implementation. Modeling the program on the Perinatal UPC’s Quiet Champion strategy, the task force proposed that the charge nurse would assign a Quiet Champion at the beginning of each shift who was responsible for:
- Dimming lights on the unit
- Ensuring all doors to patient rooms were closed unless the patient refused or needed frequent observation
- Speaking up to colleagues when their conversations were too loud
- Being aware of unnecessary noises on the unit created by equipment, placing work orders or communicating with other stakeholders
- Communicating with patients about quietness and offering quiet packs that contain ear plugs and eye masks
- Coaching/reminding colleagues to have proactive conversations with patients to resolve noise
- Discussing quietness issues at huddles and getting feedback from staff
In addition, the task force developed scripts to improve communication with patients about noise issues and requested new signs made that would place a focus on maintaining a healing environment and quiet space.
“The result is that a quieter healing environment was achieved for Med-Surg patients, which improved patient care, as well as patient experience scores for quietness of hospital environment.”
Anna Mercado, RN, BSN, ONC, Chair of the Med-Surg UPC
Strong communication among Breboneria, the staff and Lalata was essential to advancing the initiative by securing necessary resources and educating all nurses in the Med-Surg cluster. Breboneria also created a PowerPoint presentation, and then she and Lalata worked with the Education Department to get the PPT offered in HealthStream, the organization’s e-learning system. Ninety-seven percent of nurses completed the module. In addition, Lalata had the Med-Surg managers add education about the initiative to huddle discussions in December leading up to go-live. Outcome data was regularly reviewed by Lalata and the UPC members.
“The Quiet Champion Initiative became a reality, thanks to communication between clinical nurses and a nurse director,” Mercado says. “The result is that a quieter healing environment was achieved for Med-Surg patients, which improved patient care, as well as patient experience scores for quietness of hospital environment.”
Acknowledgments:
Anna Mercado, BSN, RN, ONC, UPC Chair, ONS; Olga Breboneria, BSN, RN, CMSRN, Task Force Lead, ONS; Mary Serrano, Unit Assistant, ONS; Earl Fulgencio, BSN, RN, CMSRN, 3M; Frank Herrera, CNA, Oncology; Lisa Sandberg, BSN, RN, CPN, Pediatrics; Agnes Lalata, MSN, RN, CMSRN, CNML, Nursing Director, Med-Surg.
