No Pass Zone Fuels a Patient Centered Culture

Written By: Kristin Baird, MHA, BSN, RN

Picture this. You’re a patient in a hospital and you’ve dropped your reading glasses on the floor. You can’t get out of bed. You’re not in dire straits, but you’re bored—you can’t read without your glasses. You’ve turned on your call light and you’ve seen a number of people walk past your door. Nobody has stopped in to check on you.

What kind of patient experience are you having?

While call lights have traditionally been viewed as signals for nursing staff to assist patients, many hospitals are broadening the target audience for these lights to include not only nurses, but literally any employee of the hospital. After all, as in this example, anybody could easily stop in to help a patient retrieve their dropped reading glasses.

The concept of the No Pass Zone originated a number of years ago from the Hospital Quality Institute (HQI) as a patient experience initiative to provide quick responses to patients’ needs. The idea is that anybody within the organization—from registration staff to the CFO—can be responsible for answering call lights and attending to patient needs. Having a No Pass Zone in place contributes to quality, safety and service. At the same time, it sends a strong message to every employee in the organization that these are OUR patients. When they signal for attention—it’s all hands on deck.

When doing our culture assessments, having a successful No Pass Zone is a litmus test for discerning just how “patient centered” an organization is. Many hospitals throw around the term “patient centered” yet often the reality of the situation tells a much different story. We often ask the question, “Is everyone in this hospital patient-centered, or is it just the nursing staff?” We’ll often hear: “Oh, everybody is!” Then we’ll ask them if they’ve instituted the No Pass Zone concept. I love the concept because it is a great example of organizations really putting some teeth into the term “patient-centered”—it’s one very straightforward thing that hospitals can do to send a clear message that being patient-centered is everyone’s job.

Now, I don’t suggest that hospitals simply make an announcement that suddenly everyone is responding to patient call lights. In fact, in my own experience of having implemented a No Pass Zone in a hospital where I worked, I know that it takes preparation. That experience taught me that some staff members are eager to step in and are actually excited to feel a part of the care team. At the same time, others may be literally terrified of stepping into a patient room. What might they find? What should they do? After all, not every job in a hospital involves direct interaction with patients.

Most requests—like the request to have help in retrieving reading glasses, are very straightforward. Things including: opening or closing blinds, adjusting the heat, filling ice water, or moving the side table closer are simple, non-clinical tasks that serve the patient. These examples are common reasons for patients to put on their call lights and don’t require clinical expertise. Of course other requests may not be so readily addressed and may require the employee to seek additional assistance. That’s why it’s so important to establish ground rules and give staff the tools to ensure that a no pass zone program will work smoothly.

Prior to implementing a no pass zone, everyone in the organization should be informed about the idea behind it and why it’s important. They should understand how such a program can help with patient-centeredness goals. And they should be provided with information, education and training about what tasks they can readily do and when they need to seek assistance from nursing staff.

It's also important to have conversations with staff members about concerns or anxiety they may have and to help them work through those concerns. And, you need to make sure to give staff an outlet for follow-up—who to ask about situations they’re not sure how to address, who to contact in certain types of situations, and how to close the loop so this information can be shared with the individual who originally asked the question.

Successful No Pass Zone initiatives go well beyond issuing a directive that: “From now on everybody is responsible for answering call lights.” It takes thought, preparation and follow through. The ultimate goal is to help every person to feel prepared and empowered to be a part of the care team.

One example of successful implementation is West Chester Hospital in Ohio under the direction of CNO, Patrick Baker. After learning about his success, we invited Patrick to share his story as a case example in a webinar on April 26th. He’ll talk about how he identified the need for a No Pass Zone, how he implemented it and the impact it is having on both patient satisfaction and improving the culture.

Join us for a No Pass Zone webinar on April 26 at 11:00 CDT to learn how to implement a no pass zone in your organization here. Our guest speakers include Patrick Baker from West Chester Hospital as well as Dr. Gregg Alexander from Health Nuts Media, the creators of an innovative video training module. They’ll discuss why the no pass zone is an essential part of a patient centered culture and how to engage your entire staff in making the process effective.

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