The bustling main floor of Canada’s big hospitals, with their unfettered entryways, coffee shops and fundraising tables, are now places of the past. In the pandemic, they feel more like fortresses, guarded by screeners in masks and an array of rules sure to intimidate patients and visitors.
To counter this new normal, some hospitals are taking steps to reassure and welcome patients daunted by the virus and restrictions.
“There are certain realities of operating through a pandemic that made us choose to do things that felt very uncomfortable,” said Sean Molloy, director of patient experience at North York General Hospital in Toronto. “We are trying to be very conscious of the fact that this is not normal and (that) we have created barriers.”
Patients’ concerns about the pandemic policies were the catalyst, said Molloy. Since North York General has had patient experience as a strategic focus for nearly a decade, the concerns were easier to hear since patient members sit on almost all hospital committees.
A major barrier was the hospital entryway. It became a bottleneck as screeners were confronted with nuanced questions such as whether family members would be able to attend an appointment or information on scheduled appointments.
Based on input from patient advisors, North York looked to sectors like the hotel industry to improve the patient and visitor experience.
The result was a “welcome mat” that included a new concierge desk staffed by clinical personnel able to address longer discussions about hospital entry, assistance with appointments and masking policies.
An impasse no more, the entryway now moves efficiently, screening more than 3,000 visitors, patients and staff per day and is also decorated with cards of compassion and other posters made by school children for patients and staff.
But it is the hospital’s website that does the heavy lifting to prepare patients and families for a hospital visit. New online videos describe visitor access, proper use of masks and donning and doffing personal protective equipment.
“It is not the screeners that are the first thing patients see. It is the website,” said Molloy. “It is for patients to make sense of things before they get here.”
However, for patients who do not comprehend the pandemic, such as young children or people with severe mental health problems, hospitals still seem formidable.
Dr. Samina Ali, an emergency physician at Stollery Children’s Hospital in Edmonton, says national conversations on social media spurred pediatric hospitals to make themselves less scary. One such early initiative was the creation of posters showing the unmasked, smiling faces of healthcare staff to humanize them to patients.
“Children are incredible at reading faces and deciding how they feel about you. Now we don’t have those faces visible to them,” says Ali. “One of our pediatric pain nurses saw these posters and recommended we use them.”
The hospital was also caught off guard by one side effect of restricting movements in the hospital – patients couldn’t get food. Now, says Ali, the emergency department refrigerator is kept stocked and nurses and doctors are more likely to offer patients and their families food and drinks.
“When I offer food to families, the gratitude is palpable,” she says. “It humanizes the experience a little bit, particularly if they were coming into the emergency for the first time during the pandemic. It looks like another planet.”
The Centre for Addiction and Mental Health in Toronto is also balancing the needs of patients with mental health problems with pandemic restrictions to continue to provide essential mental health services.
Normally, group treatments, communal activities and visitors are a major source of comfort and support for hospitalized patients, said Physician-in-Chief Dr. Vicky Stergiopoulos, Now, “the physical layout and the nature of mental health problems and illnesses make social distancing difficult.”
In light of these limitations, Stergiopoulos says CAMH has gone virtual for all of its usual inpatient group activities, including visits with loved ones. In addition, outpatient programs have conducted more than 16,000 virtual appointments since March while continuing to hold in-person appointments for those not comfortable using digital platforms.
Back in Edmonton, Ali says she and her colleagues understand they are a big source of fear in patients and family members in the emergency department.
“We are seeing families who are coming in stressed out, sometimes behaving scared and sometimes manifesting anger, but much of their fear is spurred by yellow gowns, masks and worry of getting COVID-19.”
She said she hopes the changes to address those fears are here to stay.
“I feel like the words and actions I hear and see are just a little bit kinder. They have made our ED feel like a kinder and gentler place through the pandemic.”
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Thank you Catherine, for sharing these improvement experiences by North York, CAMH, Stollery Children’s Hospital. As a patient advisor, am so pleased to hear of the positive contributions by advisors informed by their “patient experiences”. We need to hear more about the changes that are having positive effects in the health care system. Not about just the process or, procedural improvements/changes are important. Articulating the “human dimension benefits” make these experiences come alive for the patient, caregiver and health providers. Appreciate and hope to hear of more such experiences.