Hospital focuses on patients, families

Massages, fold-down beds complete with blankets and pillows for visitors and microwaveable meals in waiting rooms are just part of the new offerings from Ashland Community Hospital as it moves to a more patient and family-centered approach.

ACH Organizational Transformation Manager Kathi Wilcox said the hospital — which is celebrating its 100th anniversary this year — has long been known for its caring approach to patients. But since the hospital affiliated with the international nonprofit organization Planetree in 2006, staff members have been looking at every aspect of operations to make sure patients and their families come first. Planetree helps hospitals provide care and programs that focus on the body, mind and spirit.

"The question we always get from the public is, 'Aren't we already patient-centered?' But over the years, processes and systems have developed in hospitals that are about what works and is convenient for physicians, nurses, the dietary staff and everyone else who works at the hospital," Wilcox said. "The patient and family is not necessarily at the center."

One of the hospital's most recent innovations is to launch a massage program for patients, staff members and families that began this month. Three massage therapists are at the hospital Monday through Friday.

The hospital tested a pilot massage program in June to gauge its success.

"We did an evaluation with patients, staff and physicians," Wilcox said. "The feedback was overwhelmingly positive. It overcame the idea that it was 'fluff.' People said they used less pain medication. Patients who had pre-surgery massage were less anxious and more relaxed."

Judy Hilyard, a registered nurse in the Intensive Care Unit, said a staff member created a guided imagery CD with words and music. Patients can begin listening to the CD two weeks before surgery. It guides them through a head-to-foot relaxation exercise and asks them to imagine themselves feeling relaxed on the day of their surgery. It also has patients visualize blood flowing away from the operation site to other parts of the body. They are encouraged to imagine their bodies as healthy and strong after the surgery.

"Anecdotally, doctors said that patients lost less blood," said Hilyard, although she cautioned that the hospital has not yet studied the effect systematically.

Focus on families

The hospital is redesigning its waiting rooms with the comfort of families in mind. In one unchanged waiting room, chairs and couches line the walls in what Wilcox called "bus station set-up." Changes to that room will include arranging the furniture in more intimate groupings.

A redesigned waiting room in the medical/surgical section of the hospital has been renamed the family and visitors comfort zone. A sign on the refrigerator reads, "Visitors and families are welcome to the snacks in this refrigerator. Please help yourself."

Hospital staff members rather than designers picked out waiting room sofas equipped with built-in recliners.

"We recognize that families are good medicine for the patient. We want to include them and create a welcoming environment and not have them sit in a hard, cold chair day after day," Wilcox said.

Ottomans double as foot rests and storage space for pillows. Visitors can use the Internet on a computer station or watch television. Throughout the hospital, visitors and patients have the option of watching Channel 100, which has music and nature scenes that research shows slows the heart rate and relaxes people.

Visitors who want to stay overnight at patients' bedsides can sleep in chairs that fold out into beds. The beds fit into small spaces and have sheets, blankets and pillows — providing comfort to weary visitors who would otherwise have to spend the night sitting up in chairs.

The hospital added a small waiting room where visitors can consult privately with surgeons about patients.

To help address spiritual needs, the hospital now has a chaplain serving patients and visitors at the hospital. Before, a chaplain was only available for people involved in the hospital's hospice and home care programs.

Hospital staff members are even looking at the art on the walls from the perspective of patients and visitors. Abstract paintings with vigorous brushstrokes and scenes with dark, cloudy skies are being replaced with serene landscapes and still lifes.

A harpist plays on Wednesday and Thursday mornings and the hospital has devoted wall space to the paintings of local artists in an effort to bring more art and music into the hospital.

Looking at the future

The hospital is putting the finishing touches on a health information library that will be open to community members, regardless of whether they are patients or family members.

"It will have credible and reliable information for the community — unlike googling it on the Internet," Wilcox said.

Staff members are researching everything from how to allow patients to use aromatherapy and acupuncture, to how to keep noise levels down, to how to get patients to talk openly with their doctors about what alternative medicines they are using.

"Eighty percent of the community is using alternative medicine, but they don't reveal it to us. People need to be comfortable talking about the medicine they're using. We need, ultimately, to be able to offer people options," Wilcox said.

Determining exactly how much these changes are costing the hospital is difficult. Wilcox said in many cases, there is no extra cost. For example, waiting rooms are periodically refurnished, so the issue becomes how to pick out new furniture that best fits the needs of visitors.

The changes could end up bringing more people to the hospital, she said.

Hospital Chief Executive Officer Mark Marchetti said examining all aspects of hospital operations to see how they fit the Planetree organization's philosophy fits in with the hospital's effort to scrutinize all its activities from a financial perspective.

The financial overview was prompted in part because federal payments to pay the bills of Medicare patients don't cover the hospital's costs. The shortfall accounted for the majority of $8.4 million in uncompensated care the nonprofit hospital provided in the fiscal year that ended on June 30.

"Our embracing of the Planetree philosophy is based on our hope that it reflects what we have been, what we can be and what the community wants," Marchetti said. "It creates differentiation between Ashland Community Hospital and other hospitals in our area so that Ashland Community Hospital will be their hospital of choice."

Staff writer Vickie Aldous can be reached at 479-8199 or

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