Sometimes the best medicine can be family and friends.
That's what a new pilot
project for MUSC's Medical Intensive Care Unit (MICU) and other
critical care units found.
The Pascales would agree.
New Yorker Peter Pascale
didn't know what to expect after learning that his father, James, had
fallen and was taken to MUSC. After a month and several visits to
MUSC's critical care units, the Pascales found themselves at the MICU,
where James continues to receive comprehensive, specialized care
recovering from a broken neck and other complications. Peter has had to
juggle spending quality time with his father while accommodating other
family as visitors.
concierge Renoitta Fludd, right, reviews family information with
hospital visitors David and Joan Rogers.
The Pascales and other
families can now enjoy the flexibility of visiting their loved ones
whenever they want thanks to the new open visitation policy. The effort
is part of the medical center's shift to accommodate patients, families
and visitors and has potential to improve a patient's outcome and
experience and the family's satisfaction.
Janet Byrne, R.N., MICU
nurse manager, said that hospital leadership tested this in a pilot
program for MICU patients. The policy was then adopted based on
research results that found that hospitals with liberalized visiting
hours contributed to improvements to patient care and communications
between patients, families and clinicians.
"Bottom line, it's just
the right thing to do for patients and families," she said.
The unit's previous
visitation policy allowed families to visit during specific hours and
was dependent on the patient's medical status and guided by their
assigned shift nurse. The new policy allows families to visit patients
(two visitors at a time) almost anytime, except for periods when staff
undergoes shift changes. During two-hour period quiet times, activity
is reduced to a minimum—no procedures or tests are conducted, lights
are dimmed and voices are encouraged at whisper level. Families are
encouraged to visit the cafeteria, walk outside or sit at the patient's
"Both patients and staff
love it," Byrne said.
MICU is a 17-bed adult
critical care unit where employees focus on the care and comfort of
some of the sickest and most severely compromised patients. The MICU
team cares for patients with cancer, diseases of the blood, lung, liver
and kidney or diagnosed with gastrointestinal problems. Patients can
stay for as little as a few days to up to several months. The team
works closely with the unit's house concierges, Volunteer & Guest
Services employees, to accommodate families and visitors. The
concierges are located in the MICU waiting area and help families
locate discounted lodging and dining around the area. Byrne takes time
to check in and round on all MICU patients and their families.
The study, which evaluated
critically ill patients and the effectiveness of an unrestricted ICU
visitation policy, was conducted by Donald M. Berwick, M.D., and Meera
Kotagal of the Institute for Healthcare Improvement. Their findings
were published in the Journal of the American Medical Association in
Additionally, the new
policy also establishes visitation rights for Medicare and Medicaid
patients. Last fall, the Centers for Medicare & Medicaid Services
unveiled new hospital visitation rules for Medicare and
Medicaid-participating hospitals. The rules focus on a patient's rights
and recommended equal visitation privileges based on race, color,
national origin, religion, sex, sexual orientation, gender identity and
disability. It also required hospitals to have written policies about a
patient's visitation rights. The policy has been adopted for use in
other adult critical care areas including CCU/CTICU, MSICU, STICU and
Surgery and Medicine Acute
Critical Care service lines director Tom Hubbard also feels that
anxiety and stress on families can reflect on a patient's status and
"When a family member is
restricted to when they can visit their loved one, they are more likely
to be anxious, angry and lined up at the door when visiting hours
begin," said Hubbard. Once the new open visitation policy was
introduced in January to MICU and subsequently to other ICUs, hospital
staff noticed marked improvements to family satisfaction. "Knowing that
they are not restricted to certain visiting hours, family and guests
seem more relaxed and at ease when visiting their loved one," said