Issue 2 : Positive Distraction for Patients

From Onsite Health Center of the Future
Jump to: navigation, search

Problem:

- Patients and family are often left waiting for hours for treatment, test results and/or while under observation. This can lead to agitation, helplessness and boredom as well as frequent staff interruptions.


Research:

Positive distraction can mean several things:

1) Distracting patients from pain and anxiety during procedures:

  • Researchers have confirmed that music that promotes relaxation can decrease patients' anxiety and improve their emotional state. One study showed that music can also assist in pain management during procedures. (Brunges, 2003)
  • Several articles referred to devices already employed in hospitals and their efficacy. These include a Virtual Reality device to help distract patients from intense pain (Sass, 2007)--proven to be more effective than music, books and yoga breathing. Bedside touchscreen LCD display allowing for flexible use between patients and staff (from cable-ready TV to reading x-rays), etc.

2) Distracting patients/family from long wait times in waiting room:

  • In a recent study by the CDC, the average time a patient waits to see an ER doctor has increased from 38 minutes to 1 hour. (Associated Press, 8/6/2008) This further underscores the need to provide distractions/entertainment in waiting areas.

3)Distracting patients confined to their room (beyond just having a TV to switch on):

  • "Evidence-based research has shown that certain kinds of art, restful views, and access to nature and natural light help distract patients from the hospital sounds and sights around them as well as improve mood and relieve stress."


Measure:

What do patients/family need distraction from most (i.e. "institutional" design of space; noise from equipment and adjacent patient rooms; procedures; stretches of downtime with nothing to do or look at?) What would be the most useful, effective and cost effective area to improve?

- Create survey or organize committee consisting of former patient/family members to report personal experiences, frustrations and potential ideas and solutions.

- Measure frequency in which patients/family interrupt staff for status updates and/or vocalize frustration. To be conducted in waiting area and patient room. (Does the number increase if family members are present?)

- Review previous research on the effectiveness of “distracting” devices already being used in other facilities, such as aquariums, artwork, tv, ceiling décor, etc.


References:

Evidence-Based Design in a Healing Environment [[1]]

"MEDIVista: bedside entertainment for patients" [[2]]

Hoffman, Hunter et al. "Virtual Reality Pain Distraction" APS Bulletin 15.2 (2005) [[3]]

"Average ER waiting time nears 1 hour." Associated Press, Aug. 6, 2008 [[4]]

Brunges, Michele. "Music therapy for reducing surgical anxiety." AORN Journal (2003): 816-818 [[5]]

Comments: Ackerman Other issues - distraction for patient might result in distraction to staff. At Emory we have TVs in nearly every enclosed room. They often are left on and some of the techs and cleaning staff will sometimes become absorbed in a show... that ties up a bed and that staff member. I walk into the room and ask if I can turn the TV off as I am pressing the button. I don't want the patient distracted from answering my questions. The noise and action is distracting to me as well. For some procedures I will turn the TV on to give the patient an distraction. Don't forget about telephones - are they good or bad? What unexpected ways are distractions going to be used (e.g. patients call the clerk by their phone rather than the intercom and spoof being someone else to get the physician or nurse on the phone, let's not forget the entire extended family calling frequently for updates...)

There are many more papers (actual data, not just press releases) that look at use of VR devices for "distraction" of patients during painful procedures. Family members more frequently seem to need distraction as they are not getting poked and prodded and medicated etc. So what are the measures? VR device studies have looked at pain scores and requirements for sedation and analgesia. Percieved wait vs. actual might be appropriate for other "distractions". You need to pick something more focused that you would like to distract patients or families from so you will have a more meaningful way to approach measuring it.