24-7 visiting hours

[A Former User]

Came across this in my Facebook feed today:

http://www.cbc.ca/news/canada/nova-scotia/family-sleepovers-make-hospital-life-a-little-more-normal-says-former-patient-1.3939071

A little serendipity! I just got interviewed on this very subject by CBC today because the CHUM (Université de Montréal teaching hospital network) plans to implement a 24-7 visiting policy in their new building that is slated for opening next year.

Funny thing is, I am with the McGill University Health Centre. The paediatric mission has always had a 24-7 policy for one parent to be able to stay at a child's bedside. The website for the adult sites state that things are flexible, with no mention of visiting hours, per say. In reality, many family members have probably been able to stay overnight at our new site, owing to single-patient rooms. But the older facilities still have 3- and 4- person shared wards where a 24-7 policy might be a little more tricky to implement.

What is the case at your institution?

[A Former User]

Amy, thanks for raising this topic of open visiting. Friends of mine had a bad experience recently in a surgical ward with too many visitors and too much activity & noise from the next bed in a two-person room. When they complained to nursing they were told that the [celebrity] patient “deserved” to have all those [important] visitors.

After suffering post-operative complications that lengthened his hospital stay, the last thing he wanted was a "bad neighbour" who would provoke him into becoming a problem patient himself and resented by his nurses.

Now, I am helping my friend pursue a non-confrontational discussion with the health provider. He has a Human Resources background and doesn’t want to complain, just wants to sensitize the care givers about the needs of patients trying to manage pain and recover.

The key, of course, is respect and consideration. That was true in the old days with strict visiting hours, too. Sensitizing patients and families requires staff to be sensitive as well.

But some other things are going on to make this more complicated. The background environment of hospital care may be more disruptive to rest and recovery, too. Now we have sicker people in hospital with more awareness about infection control, for example, so coming and going may be (should be) marked by the sounds of hand hygiene. Rooms are equipped with machines (and beds!) that tick and buzz, devices with alarms intended to interrupt relaxation. There's 24/7 activity everywhere: traffic and banter in the hallway, bright lights going on and off, more bedside activity with portable screening machines and frequent medication delivery and lab work.

When there is so much that's disruptive and unfamiliar, the poor patient has lots of challenges in finding sleep and lowering stress and sensory stimiuli, even in a single room.

The great thing about the 24/7 visiting hour issue is that it invites heightened awareness and discussion about how to make sure that care always focuses on what matters to patients --and that includes the best treatment, vital rest AND support from loved ones.

[A Former User]

My local hospital is also going to 24/7 visiting.

They are planning a new wing which is going to contain a much higher percentage of private rooms which will be great for the increased in visiting hours but I wonder what it will do to their revenue? They cited infection control as a good reason to have more private rooms, as well as patient preference, but I just paid an extra $310 for 2 nights semi-private last month and it is a lot of money.

Annette

[A Former User]

Looks like I was interviewed but they did not use any material with me.

@Annette you bring up a good point. Along with costs for the room, family members will also have to pay for parking! And that is another sore point whether you are an in-patient or not...

Mind you, if the institution has 100% single patient rooms, at least there isn't a premium to pay for your space and privacy, since all the rooms are the same...

[A Former User]

Yes, parking! It is an issue almost everywhere. High fees would seem to exploit the very people that healthcare workers and managers intend to help: it's about patient access and benefits of care support from family members.

This extra drain comes at the very moment of coping with many new stresses and burdens of illness, investigation, treatment and recovery. Along with health issues are challenges in rearranging responsibilities and schedules to accommodate new demands.

So the hardship is real and painful, and for what? An income stream that erodes care! As rates and revenue increase, it becomes increasingly difficult for administration to halt this inequitable practice. And yet, squaring parking policy with the high-minded "values and vision" for the care facility doesn't seem possible.

The acclaimed NHS patient leader David Gilbert has written a wonderful piece in The BMJ on this very topic. Read (free to download) here: "Car parking is a clinical quality issue" BMJ 2015;350:h1312.

I usually hear more about staff parking that patient parking. Maybe patients and family members don't feel it is wise to complain? How is this issue being pursued where you are?

[A Former User]

Hospitals in Ontario that charge over $10 per day now have to offer half price passes to patients and family. We bought one recently for Toronto Western Hospital for $62.50 for 5 days. A day is a 24 hour period and you can go in and out and not pay extra.

However what that hospital did was close off the easy access underground garage to patients. Now it is reserved for staff and the patient parking is in a area around the back, where you have to go outside to get to your car.

Sunnybrook did something similar so in a sense they are thumbing their noses at the Ministry of Health

[A Former User]

My local hospital has gone to 24/7 visiting hours with some trepidation. In the end, however, it was not at all a big deal. And it helps people who are shift workers etc.