SAN FRANCISCO — Consider, for a probably unpleasant moment, your previous hospital visits. And then imagine a health-care institution where:
--Patients stay in an area that looks more like a condo than a hospital ward.
--Nurses are trained to give patients therapeutic massages.
--Patients are not only taught how to read their own charts, they (or their family members) are invited to make entries on the charts so physicians and nurses can know exactly what the patients think of their progress, how they feel about the way they're being treated or any other observations or suggestions the patients might want to communicate in writing.
Free Nutritional Counseling
--Patients are given free nutritional counseling if they desire; and if they find the standard hospital menu is not healthy enough for them (or not ethnic enough or junky enough), they're permitted to have whatever food they want brought in for them. Healthful snacks are provided round-the-clock and there's even a small but well-equipped kitchenette where patients or their family members can prepare food. It's not uncommon there to see a patient, such as Neil Murphy, who suffers from bone cancer, making his lunch while attached to an i.v.
--Sony Walkman stereos are available to patients, as is a library of audiocassette tapes and books. In addition, a movie of the week is shown on a videocassette recorder in the nearby patients' lounge, where there is also a library of video tapes for 24-hour viewing, should a patient not feel like sleeping or disturbing a fellow patient with TV sound.
--Even bedridden patients have access to outdoor air as patients' rooms have windows that can be opened.
--Twenty-four-hour visiting hours prevail, and family members are permitted to spend the night in patients' rooms or in the nearby patients' lounge.
--On admission, patients fill out forms regarding such things as preferred sleep patterns. When at all possible, these individual sleeping schedules are not interrupted with meals, tests or administration of medications.
--Patients receive packets of information on such subjects as their medical conditions, what to expect from certain tests they will undergo, what their medication accomplishes and what its side effects may be. If they want to know more, patients have borrowing privileges at a nearby medical library that delivers.
--There is "primary care" nursing in which each patient has one primary nurse responsible for his or her care, a "patient advocate" nurse to whom both doctors and other nurses report. In conjunction with the primary-care nurse, a patient discusses and makes decisions about every aspect of a hospital stay.
--The noise is at such a low level the place sounds like a library.
--"Little" things mean a lot. Where possible, anything institutional-looking (chrome or Formica, for instance) has been removed and in its place are warm, home-style furnishings made of oak.
A counter/barrier between the nursing station and patients has been removed. Harsh lighting has been replaced with soft, indirect lighting, complete with dimmers.
Brash, cheery, "upbeat" color schemes and supergraphics have been cast out in favor of low-key neutral colors believed to be more soothing.
In patient rooms, plain sheets and bedspreads have been banished and replaced with gently-shaded florals. The art on the walls has been carefully chosen not to be offensive (nature themes predominate).
Patient rooms are outfitted with bulletin boards and plants to avoid the stark, antiseptic look of traditional hospital rooms. And patients are encouraged to bring a few of their own things from home--pillows or quilts perhaps--to further counteract feelings of displacement and alienation experienced in strange environments.
All this is clearly no dream. It is a working reality on the sixth floor of Pacific Presbyterian Medical Center in the Pacific Heights section of San Francisco. The floor has been dubbed the "Sheraton Bypass" but its guests pay no more than other patients elsewhere in the hospital.
Open since June 3, the Planetree Model Hospital Project is being billed by its creators as "the nation's first consumer-oriented hospital unit." And even though some of the 13-bed unit's features are not yet in place and minor kinks are still being worked out, the project is already being hailed as a success by both outsiders and insiders at Pacific Presbyterian Medical Center.
And perhaps the unit's greatest indication of success--beyond the comments and letters from an almost entirely satisfied cadre of patients, nurses and doctors--is the fact that other health-care institutions are already calling Planetree and asking for help in setting up similar units.