An Improvement Project to Increase HCAHPS Quiet Scores and Improve the Patient Sleep Experience by Implementing Bundled Care and Other Clinical Strategies

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provides measurable data about the patient perspective of their hospital care experience and is publicly reported so consumers can compare hospitals when deciding where to receive care. This study looks at the survey question, “During this hospital stay, how often was that area around your room kept quiet at night?” which measures the patient perception of quietness of the hospital environment at night. Currently, Mercy Hospitals of Bakersfield is ranking low in this area. In an effort to increase HCAHPS quietness scores and provide their patient’s with a better sleep experience, the hospital began a patient experience rest improvement project in November 2017. The project implemented bundled care and other clinical strategies such as no vitals signs on stable patients, respiratory treatments ordered while awake, and radiology procedures after 5 a.m. to allow uninterrupted sleep from 10 p.m. to 5 a.m. on three units of the hospital in January 2018. HCAHPS survey ‘always’ quiet data were analyzed for the three units. This study found an increase in patient ‘always’ responses for two units (2W and 4W) and a decrease for one unit (MST) of the hospital. However, the improvement project is in the beginning phases of implementation so results cannot be generalized. Based on the preliminary results and analysis recommendations were made. Recommendations include continuing the project to change nursing culture, implementing quiet champions and teams, and ongoing program evaluation.