When a terminally ill patient at Elmhurst Hospital wasn’t able to get comfortable in his bed, he asked for his recliner from home, and the nursing staff worked to get it for him. He later passed away at the hospital, comfortably tucked into his chair.
Other Elmhurst nurses have planned a wedding for a patient who was hospital-bound, arranged an anniversary party for another, and provided personal items for patients who couldn’t afford them.
Meeting these sorts of needs is well beyond the scope of what hospital nurses typically do. But Elmhurst is far from ordinary, both in terms of its facility and its nursing staff. The hospital has been ranked one of the best in the world for patient-centered care, and one of the best in the country for nursing.
“We form relationships with our patients. That’s key,” says Jean Lydon, RN, MS, MBA, AOCN, vice president and chief nursing officer at Elmhurst. “We strongly believe here that patients heal better and faster in a caring environment. So it’s a caring environment by design, and by the way our caregivers provide the care.”
At Edward Hospital, a shared leadership structure allows administrators and nurses to make joint decisions about how nursing is practiced. “It’s really [about] having the decisions happen at the right level. Why should I be saying how a nurse does her job every day?” explained Patti Ludwig-Beymer, PhD, RN, vice president and chief nursing officer at Edward.
Like Elmhurst, Edward has been recognized for its exceptional performance in nursing. Both have such strong reputations, in fact, they’ve become destinations for nurses from around the world who are pursuing similar excellence.
In the last five years, Edward has hosted visitors from England, Sweden, Korea, France, Australia, Kenya, Japan and the Netherlands. Elmhurst also has had visitors from Australia and the Netherlands, as well as from Brazil, Hong Kong and Saudi Arabia.
The Netherlands visitors were the most recent for both hospitals. Advanced practice nurses (APNs) from Tergooi Hospital spent time at each facility in October 2016 and April 2017. In April, they also visited Linden Oaks Behavioral Health.
In October, each member of the delegation was assigned for a day to a specific unit at Edward, shadowing a nurse or nursing leader. Elmhurst provided the nurses with education on different topics, including the hospital’s prestigious Planetree Distinction, as well as shadowing experiences in specialties like the outpatient Heart Failure Wellness Clinic, wound care, immediate care and the emergency room.
Tergooi Hospital doesn’t yet have Magnet status, but its nurses have sought out Edward and Elmhurst as models of how to achieve it. “They learn a little bit more about healthcare in America. And we have open dialogue with them about how it is in the Netherlands compared to the United States,” Lydon says. Both Edward and Elmhurst plan to host more nurses from the Netherlands in June 2017.
Elmhurst: Seeing through a patient’s eyes
Lydon believes the three key elements that draw visitors to Elmhurst Hospital are its Planetree and Magnet awards, and the facility’s unique design. Planetree, a nonprofit organization that works to improve how patient care is delivered around the world, has recognized Elmhurst several times for its achievement and innovation in the delivery of patient-centered care.
“We are one of nine hospitals in the world to have Planetree Distinction,” Lydon says.
Elmhurst’s goal is to provide patient-centered care in a healing environment. That means patients’ needs, and those of their families, come first, as do relationships.
“When I talk about patient-centered care, it’s really [seeing] through the eyes of the patient. How can we make it a better experience for the patient? How can we educate them and prepare them for when they go home from the hospital?” Lydon explained.
Elmhurst nurses and caregivers understand that each patient has different needs and concerns, and they tailor their care accordingly. Nurses get to know patients and their families, and what’s important to them. For instance, they gauge what patients want in terms of visitors and personal care. If they want certain family members to stay 24/7, that’s allowed. If patients prefer to shower in the morning, nurses work to make that happen.
“It’s really about what the patients and families need and want, because we are trying to humanize the healthcare experience. Being in the hospital can be a very scary experience, and you’re treating patients and families at their most vulnerable period of time,” Lydon says.
As part of the Planetree philosophy, Elmhurst runs a care partner program, in which patients choose people to care for them once they return home. For instance, a nurse might teach a care partner how to change a dressing. The hospital offers complementary therapies, pet visits, guided imagery and Reiki, and there’s a non-denominational chapel. Lounges and balconies are set aside just for patients’ families. If families want to bring patients certain foods, they’re allowed to, as long as no health or dietary regulations are broken. Everything is done to preserve health and safety, Lydon says, and in an effort to give control back to the patient.
Gaining Planetree recognition is no easy feat. It was five years from the time Lydon and her colleagues began gathering information about it until they received their first award. To be considered, a hospital must take part in a rigorous evaluation. The staff perform a self-assessment, submit written documents, and host an in-depth site visit with Planetree representatives.
In the midst of its Planetree preparations, Elmhurst designed, built and moved into a new replacement hospital in 2011. They enlisted a Planetree architect to help in the design, so patient care would form the core of the construction. The emergency room has four-bed pods and the inpatient facility has 12-bed pods, and each room has a private bathroom. The pods are equipped with everything the nurses and caregivers need, which eliminates the need for a central nursing station. Family members are given key cards to their loved one’s room, so they can come and go as needed.
A centralized call-light system means all of the lights are located on the lower level, and the calls are answered within seconds and routed directly to the nurse, which creates a quiet environment. The hospital was designed with special areas for patient transport, so they’re never in public view when shuttling to or from a procedure.
“[I]t was a very thoughtful design,” Lydon says, and “we can be more efficient in how we provide the care, because of the way we built the hospital. We have had [visitors] who are building a replacement hospital, and they come here to look at what we’ve done.”
Also in 2015, Elmhurst earned recognition as a Magnet hospital for nursing excellence from the American Nurses Credentialing Center (ANCC). More than just an honor, Magnet recognition holds tangible benefits for hospitals and their communities. It means higher patient satisfaction with nurse communication, among other benefits.
Elmhurst employs 794 nurses and 28 advanced practice nurses. The number of APNs has increased, and they’re stationed in a variety of areas, including the inpatient units, outpatient specialty clinics and palliative care. The nursing staff is involved in shared governance councils, and they collaborate with administrators to determine what’s working and what’s not.
Edward: Three times a Magnet
Edward Hospital has been named a Magnet hospital three times—first in 2005, and again in 2010 and 2014. Edward is one of just six hospitals in Illinois to gain Magnet status three times or more. There are more than 1,200 nurses at Edward, including advanced practice nurses.
Ludwig-Beymer pointed to four reasons Edward is a destination for visiting nurses: the hospital’s excellent, autonomous nursing staff; inter-professional collaboration; high-end, innovative procedures; and care in a healing environment.
As part of Edward’s shared leadership structure, nurses comprise a majority of several different councils. They provide input, help develop policies and weigh in on whether the hospital will modify the products and equipment it uses.
“It’s always a shared decision between administration and direct caregivers,” Ludwig-Beymer says. By involving nursing staff, the hospital makes better, more-informed decisions.
Ludwig-Beymer, who’s been a nurse for 43 years and practiced in a number of hospitals, says she’s not seen anywhere else the positive regard and relationships that exist at Edward between nurses, physicians and other members of the healthcare team. She also believes Edward stands apart from many community hospitals because of the procedures it offers. The hospital is one of just a few places in Illinois performing complex structural heart interventions, as well as complex surgical procedures with advanced cancer. “To be able to offer those services in a community setting is also a big draw,” she says.
Edward goes to great lengths to provide high-quality care in a healing environment. In 1992, it was the first Illinois hospital with all private rooms for patients. In 2002, it was the first in the state to offer animal-assisted therapy (AAT). Specially trained dogs and their handlers visit patients for five to 10 minutes at a time, in just about any part of the hospital, any day of the week. Edward’s research has suggested that patients who receive AAT need less pain medication after surgical procedures than those who don’t take part in the visits.
Families and visitors are encouraged to spend as much time with patients as they’d like. Health coaches are part of a patient’s journey, too. They participate in pre-surgical procedure classes, and help educate patients and their families before discharge.
As a Pebble Project hospital, the Edward facility was designed with features that have been shown to increase the satisfaction of patients, family members and staff. The features include separate patient, family and clinician space; a focus on safety; and a therapeutic environment with appropriate lighting, décor and noise reduction.
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