Response to Call Lights
I have found that regardless of the patient satisfaction measurement tool, three key points are most important to a patient's perception of care:
- attention to the patient's personal needs;
- the staff's response to call lights.
- how the patient's pain was managed; and
When I was at a hospital on the west coast, speaking with nurse leaders, one of the Studer Group coaches gave a very beneficial presentation on response to call lights, all based on her own research and personal experience as a nurse. The nurses responded well to the presentation, which covered response to call lights in relation to patients' perception of care. Yet, the most favorable response from the nurses was the discussion of how call lights relate to the core of nursing-providing great clinical care.
Below are some insights and tips from our coach on how to improve a patient's perception of response to call lights.
Response to call lights
When patients are placed in a hospital bed there is one piece of equipment they feel is their lifeline: the call light. As care providers, we even say things such as, ''If you need anything, just press this button and we will be there,'' or ''If you start feeling worse, I want you to call me right away!'' While it is generally reported as a patient-satisfaction issue because it is one of the questions most patient satisfaction surveys ask, all nurses realize it is most definitely a quality-of-care issue as well.
There are four distinct opportunities to assess as you improve your organization's response time to calls, thus patient care. They are: when, why, who, and how.
When do call lights occur?
Checklist: Do you know your unit's call light frequency? Do you need to change who or how to accommodate the pattern? Do you have methods to track?
Suggestions: We found that call lights tend to be clustered during meal times, shift changes, and bedtimes. Looking at staffing patterns; utilizing CNAs better during shift changes; having RNs doing rounds one hour before shift change; and creating nighttime turndown services are all suggestions to help adjust resources to match when call lights go off.
Why do call lights occur?
Checklist: What are the reasons patients call? Are they preventable? Can you track them?
Suggestions: We have found that toileting and positioning call lights can be eliminated by frequent rounding of the Nursing Assistants. Pain medication call lights can be eliminated by RNs putting PRN pain doses on their list of scheduled medication doses. These two items alone can account for up to 50 percent of call lights.
Who answers the call lights?
Checklist: Who is currently responsible for this task? Is this the best or only option? Can you assign primary responsibility but have backup? Can everyone play a role?
Suggestions: We have seen several ways to increase the resources you have to answer call lights beyond just nursing. Ancillary departments, both clinical and non-clinical can be trained to respond to call lights. Increasing the number of people available to perform the task can increase your ability to respond in a timely manner.
How are call lights answered?
Checklist: Via intercom? In person? Via pagers? How quickly? What tone of voice and words are used? What's the staff's attitude? Interruption of our work or the purpose of our work?
Suggestions: When answering via the intercom, use your name and use the patient's name. "Hi, Mr. Smith. This is Sherry, the unit secretary. How may I help you? I will let your nurse know. Someone will be with you _____."
The next step for your organization is determining the time expectation for someone to be with the patient. Personalize every interaction as much as possible and use good basic customer service behavior: smile, make eye contact, use direct, focused attention and active listening. Every call light represents a patient need (and sometimes a critical one).
Call lights are a quality-of-care issue that patients can effectively measure. It influences their perception of the overall quality of the care they are receiving. Some final recommendations:
- Call lights are preferably answered in person.
- The best timeframe is within one minute.
- Call lights should be answered by someone who is cheerful, caring, and responsive.
- Response to the request should occur within five minutes.
By focusing on call light response, an organization can see multiple results from one action, including improved quality of care. One is the perception of improved quality of care, and another is improved communication and responsiveness. All are heavily weighted in how patient perceive their care.
References:
Karen Van Handel, Barbara Krug, St. Luke's Medical Center, Milwaukee, WI, in Orthopedic Nursing, Jan/Feb 1994. Vol 13/No 1.
Albany Area Hospital and Medical Center, Albany, MN, published by Patricia Gersh, MA, RN, in Nursing Management 1996:27(10):46, 48-50.
