ED touched by angels slashes complaints

Volunteers bring a human touch to patients

Three or four years ago, St. John’s Health Center in Santa Monica, CA, would typically receive one letter every week or two complaining about some aspect of care in the ED; perhaps once a month, it might get a letter complimenting that service. Today, "We get one letter a week complimenting the staff, and I mean a great letter," says Russ Kino, MD, FACEP, FACEM, medical director of emergency services.

And complaint letters? "We get one every three months or so," he adds.

At the root of this impressive reversal in patient and family satisfaction is a volunteer program called Angels of the ER. Co-sponsored by Kino and Carla Hummer, RN, then a recently retired employee health nurse, it is composed of about 35 "angels" who take four-hour shifts seven days a week to provide assistance and companionship, while at the same time, keeping an eye out for medical situations that should be brought to the attention of staff.

For example, the volunteers meet and greet individuals in triage and registration. "They are the first people the patient and family come in contact with," Hummer explains. "They escort them to the waiting area; and every 15 minutes, they will come around to let them know they’re not forgotten."

The angels are trained by the head volunteer to identify any change of symptoms from admission and to deal with potentially hostile patients by offering "verbal first aid." For example, the angels repeat concerns back to patients, say they are here to help, and say that if the patients put themselves in the ED staff members’ hands, they will receive the best care available.

There are generally two angels on each shift. If needed, they can provide ice for a sprain or strain, provide a blanket, or help a nurse turn a patient. They not only work in the exam area, but in clinical areas as well. "They hold hands, help with children, and so on," Hummer explains.

Because ED staff are so busy, Kino explains, they often do not have sufficient time to devote to the human side of medical care. That’s where the angels come in.

"In any ED, you are incredibly busy and very focused on the technical aspects of the job, and there is relatively little attention given to [patients’ personal needs]," he adds. "The angels sit down and talk to people about trivial things, reassure them, bring them a cup of water, interact with the family — all things that are not related to attending to their medical problems."

The Angels of the ER program is not just another volunteer program, Kino continues. Many hospitals have volunteers who run tasks for the staff, and St. John’s already had such a group, he says.

"We really wanted something to utterly isolate the human issues. It was never intended that they be go-fers for staff in any way," Kino notes.

At the outset of the program, Kino expressed this perceived need to a meeting of the Irene Dunne Guild, then the only volunteer group at the hospital, which Hummer attended.

"It was clear we needed a new patient advocate program," she points out.

"Carla asked if she could do this, and she was just fantastic," Kino recalls. "Then a couple of other ladies who knew her joined; people heard about the program, we put ads in the local paper, and people joined up." The ER, he notes, "is a glamorous place to work." In fact, they had to be selective about who they chose.

"A lot of young people wanted to join, but typically they are not well-suited because they haven’t been through life’s ups and downs," Kino explains. Today, he says, "We pretty well have the whole week covered."

In fact, the hospital no longer has to rely on advertisements to recruit volunteers. Last month, a Los Angeles Times article about the program resulted in 100 calls from potential volunteers.

The focus on hiring volunteers with real-life experience has paid off. Hummer tells the story of one angel who, on her first day, worked with parents of a child who was a victim of sudden infant death syndrome.

"She herself had experienced the death of teenage son," Hummer recalls. "She was so comforting. The staff were undone." The volunteer subsequently did some debriefing for staff members, she says.

In another instance, a psychiatric patient appeared very distracted. "The angel asked the patient what he liked to do, and he told her he liked to dance," Hummer relates. "She danced with the patient, and he became quiet."

She considers the angels a vital link in the communication chain between patients, family members, and staff. "When you are waiting and anxious, sometimes all you really need is a human touch," Hummer adds.

Sources

For more on the Angels of the ER program, contact:

  • Carla Hummer, RN, Angels of the ER, St. John’s Health Center, Santa Monica, CA. Phone: (310) 454-7233. E-mail: Carlahummer16@msn.com.
  • Russ Kino, MD, FACEP, FACEM, Medical Director, Emergency Services, St. John’s Health Center, Santa Monica, CA. Phone: (310) 582-7089. E-mail: russ.kino@stjohns.org.