BY: LAURIE EBERST, RN, M.B.A.
When our bodies fight disease or recover from injury, one of the main components in healing is rest. To sleep, we need quiet, calm and peace. Yet so often when people enter hospitals, they are unable to rest amidst the paging, the beeping and whirring of machines, the clicking of heels.
The needs of the hospital's staff sometimes take precedence over the needs of the patient. Some believe they must have intercom systems so they can quickly find another staff member, Or that they must have polished, laminate floors that are easy to clean. In the midst of all of these "musts," quiet is denigrated, dignity denied and healing becomes a secondary consideration.
When we designed Catholic Healthcare West's Mercy Gilbert Medical Center in Gilbert, Ariz., a suburb of Phoenix, we were determined to create a healing environment, a commitment that began before the first concrete was poured, before the first pulse was taken. We focused Mercy Gilbert on being a place of peace that harnesses the latest technology and extends radical loving care — a philosophy taken from the book of that name by Baptist Healing Trust founding president Erie Chapman — through employees who have been chosen to serve. Opened in June 2006, Mercy Gilbert may be a new hospital, but it is rooted in the history and mission of the Sisters of Mercy.
PEACE AND QUIET
When we were in the early phases of building Mercy Gilbert, I had a personal experience that changed my perspective on hospital environments. Though I have worked in health care for many years, most of them as a registered nurse, I most clearly saw the hospital experience through the eyes of the patient when my mother was hospitalized for open heart surgery.
I spent many hours bedside, supporting her physical and emotional well-being. It seemed whenever she was comfortable and ready to sleep, the intercom would page a nurse or call a doctor to the telephone. Or a thundering, floor-buffing machine would swoop past her door, startling her awake. These frustrating experiences culminated with my mother announcing she just wanted to go home so she could sleep. That's really all she needed — sleep in an environment where her body could recover.
This experience led me to emphasize noise reduction in patient care areas throughout Mercy Gilbert. I wanted Mercy Gilbert to be free from overhead paging, in-room intercoms, loud machines rolling down hard, long hallways and voices calling to each other at the nurses' station. To this end, we carpeted all patient hallways and purchased vacuum cleaners with silencers. We eliminated overhead paging by using a system of wireless telephones carried by all physicians and nurses. We poured the floors extra thick to reduce noise between levels. We even opted not to use elevator or lobby music. Anywhere we could foster a quieter environment, we did. As I write these words, our hospital's census is at capacity. Yet, if you were to walk our hallways, you would never know it. The quiet and calm are pervasive.
But please don't think that our quiet environment is a silent one. Along with the positive effects of colors and natural light, my research on healing environments revealed the beneficial properties of music therapy. Mercy Gilbert patients can listen to music or enjoy a good laugh from a comedy channel via an interactive media system in their rooms. The Harp Foundation, a local not-for-profit, sends harpists to perform throughout the week in the hospital's main entrance and in various patient departments, providing a calm and relaxing environment for everyone.
Our design also was intended to promote privacy and dignity. Mercy Gilbert has a separate, "back of house" bank of elevators for staff to navigate through the hospital and for patient transfers. A patient on his way to radiology, for example, needn't worry he will run into a neighbor in the elevator. Patients deserve the dignity of preserving their privacy during what is often a stressful time.
All of our work to create this environment has been rewarded in myriad ways — some unexpected. One of the most important has been in a reduction of errors in administering medications. As health care providers, we know that caregivers who have fewer distractions are less likely to make errors. Our quiet environment allows our caregivers to be fully engaged in the moment, in service to our patients, without interruptions.
Thus, the staff and physicians say they love working here. We conduct bi-annual employee and annual physician satisfaction surveys. Results are very positive. We also have been named among the Phoenix metropolitan area's Top Ten Best Places to Work, an annual award list based on reports from employees. The people who work at Mercy Gilbert have embraced our healing hospital concepts and use them as a way of everyday life. In fact, the employees are now the catalysts for further improvements, thanks to a program we developed called Brain Waves. Our teams seek new, innovative ideas, focusing on ways to save money, create higher patient satisfaction and improve the overall quality of our facility. We use a phrase that has really taken hold: We take care of patients the Mercy way.
A PLACE OF BEAUTY
Along with being a place of healing, Mercy Gilbert is a place of beauty. At every turn, we have woven together aesthetics and care. We have taken advantage of the beautiful desert flowers and skies in much of our artwork that flows throughout our hallways, patient rooms and public spaces. Community members actually speak of our grounds as having the atmosphere of a resort; indeed, the Gilbert Chamber of Commerce gave its first beautification award to Mercy Gilbert.
Still, in the design phase, we wanted to achieve more than a pretty hospital — we wanted to use beauty as an element to enhance the spiritual well-being of our patients. Our mindful selection of art pieces to place in public entrances helps create some of the atmosphere we were after. When people walk into our hospital, we hope they feel the warmth. We hope they sense that this is a place connected with a spiritual foundation. When we began building the hospital, we put stained glass between the lobby and the chapel instead of a wall. This subtly shows our visitors the seamless passage from our doors into an inspirational place and underscores our belief that healing and spiritual well-being go hand in hand.
Our interior designer, Deborah Brandt of San Diego's Brandt Design Group, and I aimed for a different kind of message in our pediatric unit. Instead of traditional primary colors, we chose oranges, lemony yellows and lime greens, hues that reflect a healthy, vibrant lifestyle and gave us a fun, "fruity" concept to carry throughout the unit with artwork and puzzles for our children to enjoy.
CHOSEN TO SERVE
I always say that if you think the outside is beautiful at Mercy Gilbert, you should see the inside. Because inside our walls is the heart of the hospital: our employees.
When people come to work here, we emphasize that they are not being hired, but rather they have been chosen to be part of our mission. I talk to every new employee during orientation, and I congratulate them on being asked to be part of our team. You see, we don't just hire people because they have a specific set of skills. We invite them to join us because they have extraordinary skills and a sacred heart, a calling to conduct the work of healing — not just collect a paycheck.
The results have been amazing.
Every month during our leadership meeting, we invite a patient to come back to our facility to talk about their experience. Along with the patient, we invite every person — from physicians to housekeepers — who was in contact with the patient during their stay. Often, the patient talks about how their lives were bettered and even changed by the care they received. They thank the employees in front of the entire leadership team. Usually, there is not a dry eye by the end of this experience. It's just one more way that we fuel our purpose — this is why we come to work every day.
I also have a quarterly tea with employees who have been recognized by a patient's letter. This tea is historically symbolic because Sr. Catherine McAuley, one of the founders of the Sisters of Mercy, encouraged others to enjoy fellowship with a "comfortable cup of tea." During these teas, I read aloud each letter that a patient has sent in praise of an employee. I believe this is a powerful way to thank our employees and remain connected to our traditions.
RADICAL LOVING CARE
All of these elements in our restful place of healing build toward perhaps the most important facet of Mercy Gilbert: radical loving care, the philosophy championed by health care industry leader Erie Chapman. Following his concept of a healing hospital fosters our strong culture of compassion. It takes all health care workers back to our roots and reminds us why we first went into health care.
To remind every caregiver who walks into a patient room of the sacred nature of his or her work, we have installed "touch pads" outside each patient room, plaques engraved with the words "Pause, Reflect, Heal." Employees stop to say those words before crossing the threshold of the room. They encourage each person who will interact with a patient to take a moment to reflect on his or her role in helping that patient heal.
I was recently asked what this radical loving care really looks like. One of my favorite stories is of a young man who came into our intensive care unit suffering from the West Nile Virus. The manifestation of this disease wracked the man's body with such pain that at one point he told his nurse, "I don't think I can go on like this." This man, a sales executive in his 20s with a beautiful wife and adorable 1-year-old, was ready to give up hope. But his nurse rallied the troops. She made sure that every person who came into his room gave him love and encouragement. Slowly, the man improved until three weeks later, he was able to go home. Yet, reflecting on his experience, he decided he couldn't go on — not with the life he had led. He wanted to help others the way he had been helped. He quit his job, went back to school and is now an EMT for a local fire department. Every day he touches others with the same radical loving care he received. He gives Mercy Gilbert the credit.
All of these elements — radical loving care, a quiet atmosphere, a chosen staff — are integral to Mercy Gilbert's healing environment, notable for its high employee engagement, low incidence of prescription-drug errors and an incredible quality of care. Since we opened our doors in June 2006, we have been recognized:
- No. 1 Medium Size Acute Care Hospital – Arizona Business Magazine
- No. 1 Healing Hospital™ in the Nation – Baptist Healing Trust
- One of the "Best Places to Work in the Valley" as compiled by the Phoenix Business Journal.
- Among the top 50 in Modern Healthcare Magazine's ranking of "Best Places to Work in the Nation"
I like to say that in creating this healing environment, I was the farmer that planted the seeds. The employees and physicians provide the water and sunshine. The entire team has taken ownership of our culture, and everyone contributes to nurturing our philosophy of healing. The results are evident in many ways.
Our facility has grown dramatically in three years. Beginning as an 88-bed hospital, we are now at 212 and looking to eventually expand to 400. We have 40 acres on which we can still build, and we fully anticipate that some day we will add a third and fourth wing.
As we grow, we've learned that we can never take for granted the culture that we have developed in our healing environment. It requires continuous thought and effort. In every employee forum, we address it. We celebrate the many honors our hospital is receiving because of it, and we give all credit to our employees, who make it happen every day.
LAURIE EBERST is president and chief executive of Mercy Gilbert Medical Center in Gilbert, Ariz.