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Cultivating Collaboration

7. Make Patients Your Key Collaborators

Calm The Noise

Group innovation: Carlos Becerra, Floor Care Lead Worker, uses one of our new, quieter floor buffers to reduce noise on the Surgical Specialty Transplant Unit

Quieting a noisy hospital with a little help from everyone

IV pumps beep rhythmically. Overhead pages blare. Telephones ring. Employees interact. And a floor buffer buzzes in the hallway. It’s a typical evening at a hospital, but a totally atypical environment for peace, rest and healing. “Hospitals just don’t sleep at night,” says Colline Prasad, nurse manager on our Surgical Specialty Transplant Unit. “It’s like trying to sleep in downtown New York City.”

For many hospitals like ours, this environmental noise is on the rise. With every new piece of equipment that helps patients, there’s an alarm that disturbs them. And the more equipment we add, the louder things get. With no ability to turn off all the beeps and dings, solving the issue of hospital noise can seem hopeless, but we knew we had to take it on for the greater good of our patients. With our Shh! project, we found workable solutions to a seemingly unsolvable challenge, and it all started by what they had to say.

Acknowledge your limitations

1,000 sets of earplugs distributed in the past six months.

“We always want to bring the patient’s voice to our decision making,” says Chrissy Daniels, our exceptional patient experience director. When it came to the Shh! project, this meant acknowledging the issue with patients, talking with them about why hospitals are noisy, discussing the importance of quiet and sleep in the healing process, and asking for their ideas to help create a better environment.

“It’s not just about changing the environment. It’s also about having meaningful conversations with our patients; it’s about showing them that we care.” —Colline Prasad, Nurse Manager, Surgical Specialty Transplant Unit


From these conversations, one of our simplest yet most effective solutions began to take shape: earplugs. The idea came directly from a patient, who suggested that we hand out earplugs during the admit process, before patients become frustrated. Today, every patient gets a set in a specially designed package when they arrive, and they’re strongly encouraged to use them throughout their stay.

5% increase in patient satisfaction

Since implementation, the percent of our patients who select Always to the question “During your hospital stay, how often was the area around your room quiet at night?” has increased by 5%.

Like most of our strongest ideas, this one was the result of truly collaborative thinking—with the patient at the center of our creative thought process. “We meet regularly to review our patient satisfaction surveys and talk about what patients are saying,” says Kathryn Schumann, clinical nurse coordinator. “If we aren’t maintaining the gain in our scores, we discuss possible interventions, and the solutions are truly collaborative.”


Bring together diverse voices

To spark more innovation, we challenged staff from different departments—including custodians and telephone operators—to share their solutions to our environmental noise problem. “They thought of things I never would have thought of,” says former team member Mara Dykstra, then a supervisor in the Customer Service department. Our custodians purchased quieter floor buffers. And our telephone operators created new workflows to limit overhead paging.

Individually, their ideas might have seemed small, but together they had the power to change the experience for our patients. And so we kept going, working through months of ideas, suggestions and the initial pilot, until our quieter environment began to take shape. We created “daytime quiet hours” individualized for each patient, dimmed lights and shut doors in patient rooms more often, and developed Shh! posters to remind staff, family and patients of our protocol.

Align your values

To keep all of our diverse ideas from unraveling into chaos, our project stayed focused on the patient at all times. “We knew we wouldn’t agree on everything,” says Mara. “But we all viewed the patient as the most important element in our process, and that brought a sense of community and purpose to our group.”

Under the larger concept of creating an exceptional patient experience, we were also given the freedom to experiment with different ideas, rather than following predetermined directives or mandates, and that gave us the power to create truly meaningful solutions. “Change happens at the unit level,” says Chrissy. “Managers couldn’t just say we’re not going to clean floors after 9 p.m. We had to listen to our custodians’ ideas to come to the best solutions. We would never have thought of purchasing quieter floor buffers.”


This emphasis on collaborative design and execution has empowered us to turn down the volume in our busy hospital, making it a better place to heal. Colline acknowledges the power of getting the right people, asking the right questions and listening—even when you don’t want to hear it. “It’s not for sissies,” she says. Chrissy agrees, adding that their group collaboration went far beyond getting together and brainstorming. “We’ve developed a keen ability to edit and refine ideas together. And that’s truly innovative.”

How is your team quieting environmental noise? Share your best practices.