Abstract
Background: A quiet environment promotes rest and healing but is often challenging to provide in a busy acute care setting. Improving quiet in the hospital for designated hours improves patient satisfaction. Such efforts have typically been the primary responsibility of the nursing staff.
Local Problem: Two medical units with consistently low Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) "always quiet" scores were chosen for this study.
Methods: A multidisciplinary team used Lean methods and the Model for Improvement to test interventions for quiet time (QT) and used HCAHPS "always quiet" scores as the primary outcome measure.
Interventions: The team instituted nighttime and afternoon QT supported by rounding and scripting, dimming lights, lowering staff voices, offering a sleep menu at night, and replacing noisy wheels.
Results: Quiet scores improved on both units after 11 months.
Conclusions: Noise in hospitals is often beyond the scope of nurse-driven improvement; however, a QT protocol led by nurses, developed by multiple stakeholders, and focused on changing expectations for quiet can lead to measurable improvements in patient perception of quiet.