Why Hospitals Should Treat You Like a Kid

New policies and amenities making hospitals more homelike.

ByDr. Larry Borges and Kim Carollo
April 05, 2012, 5:23 PM

April 6, 2012— -- Imagine lying in a hospital bed, afraid, stuck repeatedly with needles to draw blood for tests you don't understand. Next to you lies another patient -- in a bed so close that each of you hears everything the other has to go through.

This is the reality for many hospitalized adults in the U.S.

In a New York Times editorial, Dr. Perri Klass, professor of journalism and pediatrics at New York University, laments this state of affairs and offers wisdom from the pediatric community to illustrate how small changes could make a big difference.

Among these changes, she suggests, are drawing blood with smaller needles and letting family members stay with patients in the hospital to allay the fear of being alone.

While Dr. Klass acknowledges that change takes time, she raises an important question: When will adult medicine catch up?

ABC News reached out to hospitals across the country to find out how they are working to improve patients' experiences. Some of what we heard was just what the doctor -- Dr. Klass, that is -- had ordered. Many institutions are now using smaller needles and tubes when they draw blood, both to improve comfort and conserve valuable blood for the patient.

The Baptist Hospital East in Louisville, Kentucky, for example, often uses smaller "butterfly" needles in the emergency room and intensive care unit. This is especially important when it comes to elderly patients with smaller veins, they said.

Dr. Matthew Weissman of the Ryan-NENA Community Health Center in New York takes his approach to drawing blood a step further. Not only does he tailor needle size to the patient, he tries to cut down on blood draws altogether by bundling laboratory tests together, and he makes sure to carefully explain every test that he runs.

In the ICU at Stanford Hospital in Palo Alto, Calif., they are using smaller needles to prevent unnecessary pain. And if a patient needs a loving hand to hold to get through the pinch, their relatives will be there morning, noon and night. The ICU has made limited visiting hours a thing of the past.

The hospital's administrators said in an email that they meet regularly with their partner facility, Lucile Packard Children's Hospital, to discuss policies, procedures and what works best for patients.

And improving patients' experience is moving beyond simply instituting new hospital policies. Many hospitals are literally paving the way to let loved ones stay by a patient's side. New hospital construction is increasingly focused on patient privacy and accommodations for patients and their families.

At City of Hope, a cancer treatment facility in Duarte, Calif., patients helped guide construction of its new Helford Clinical Research Hospital. The intention was to ensure that the patient perspective was considered and to create a more "home-like" environment.

That's exactly the experience Hannah Komai, now 21, received when she underwent 11 months of chemotherapy for bone cancer at Helford in 2010 and 2011.

She had already lived through the fear and stress of watching her father undergo treatment for prostate cancer, and was petrified of what awaited her. Both her cancer and her father's are now in remission.

But she said her illness and the intensive chemotherapy regimen were much easier to endure because of the "second home" environment Helford offered.

"It's much homier," she said. "They offer a lot of opportunities to get out of the hospital room, so I was able to spend time outside the room so I wasn't cooped up.

"They also had sleeper beds in every room, so my parents were able to stay with me, which made it comforting so I could get through the night."

The hospital also has special "teen rooms" where there are computers and video games, as well as family rooms that feature full kitchens, a TV room and other amenities.

Komai was also grateful for the sharper needles the hospitals used, avoiding repeated pricking with blood draws because of inadequate blood return.

"It was a lot less painful," she said.

Other hospitals now offer other patient--friendly options, such as Massachusetts General Hospital's new wing of single-occupancy rooms that provides privacy.

"The staff commented on the first day here, how the use of pain and sleeping meds had dropped because of the use of single rooms," said Jean Fahey, a senior clinical nurse specialist in the neuroscience unit.

But perhaps the biggest sign that the times are changing is what has transpired at The Christ Hospital in Cincinnati. There, efforts to improve the patient experience have managed to change the age-old practice of physician "rounds," or the daily gathering when doctors discuss a patient's care.

Dr. Jeffrey Schlaudecker learned several years ago from his wife -- then a chief resident in pediatrics at Cincinnati Children's Hospital -- that when doctors discussed the care of children, the families were invited to listen in.

This was not the case in adult medicine, where the doctors would talk amongst themselves and relay requests to the nursing staff, who in turn would tell the clinical assistants what was needed. At some point, the patient would hear what was happening to them, however garbled the message had become.

"I spent a couple of days with experts at the kids' hospital," said Dr. Schlaudecker, a geriatrician. "We were chit-chatting about the similar situations that families are in. In pediatrics and geriatrics, families are faced with a new situation and new diagnosis. There's a lack of information but still a desire to know what's going on."

So they started inviting the families to join them. Instead of rushed updates on a patient's disease, half-answered questions about changing medications, and confusion over test results, the team staged a daily group conversation involving the doctors, nurses, the patient and their family.

There were initial worries about time constraints and efficiency in the busy world of the hospital, but in the end, it was the right call.

"The model allows for stronger bond between doctors, nurses and families," said Schlaudecker, who also emphasizes the advantage of the new model in educating young doctors, "Putting the intern doctors at the bedside, presenting the information and the plan, I think it's better teaching. It's safer care, and just better care."

Preliminary data show that the new strategy is working as well. More than 90 percent of doctors and nurses Schlaudecker surveyed felt that rounding with the patients and families was an improvement over the old system.

For Komai, the experience of receiving treatment in an environment that felt much more like a home and a lot less like a hospital helped her endure nearly a year of chemotherapy and beat her cancer.

"I think that it's good for other people who are going through very tough situations to not have to deal with being in an uncomfortable place," she said. "That should be the least of their worries at times like these in their lives."

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