H.U.S.H Initative Starting October 1, 2014


HUSH initiative

Why are we implementing a new procedure? Past interventions and initiatives have been unsuccessful due to inconsistency and no accountability.


  • FY14 HCAHPS “Quietness of Hospital Environment” scores were at their lowest.
  • Too many visitors on the unit or at patient’s bedside are frequent contributors to a noisy environment.
  • Increased noise level at the nurse stations when other departments are present. Shift change is a large contributor to the increased noise level.

Improvement Outcomes:

  • Studies show that a quiet environment contributes to faster healing, decreased length of stay and improved patient satisfaction.
  • Increase our HCAHPS score when it comes to “Quietness of Hospital Environment” question, which will also improve our overall patient satisfaction score.
  • Educated staff empowered to support a healing environment for our patients.

How are we planning to improve our scores? We will provide education, set appropriate expectations and implement new processes.

Implement on the Nursing Unit:
It is important to understand what the inpatient units will be doing during quiet time.

The hospital operator will announce quiet time at 1:45pm daily.

Each floor designate a responsible Associate to perform the following:

  • Techs and Nurses: Inform patient’s we are preparing for quiet time; ask them to minimize noise. They can help by using headphones for TV, turning cell phones on vibrate, etc.
  • Nurses: Dim lights on the unit
  • Techs and Nurses: Closing patient’s doors
  • HUCS: Close unit doors to each unit at 1:45p.m.

Patient care will be continued, however, we will try to minimize as much as possible during this time.

Nurses will educate patients and any visitors present regarding visiting hours and quiet time upon admission. A Skylight short education video is in production; once available nursing will be required to show patients upon admission and units will be monitored for compliance.

Implement in ER, PACU, SDS, CATH Lab, and Radiology Departments:
Before patients are taken to the nursing units please discuss with patient’s family members the recommended 2 visitor per room option; additional visitors will need to wait in the visiting lounge and take turns; this will help us maintain a quiet healing environment.
We understand this will require a huge change. Nursing leaders will follow up regularly to ensure these processes are followed.

Please inform your staff to call security for assistance and support if you have any issues with visitors.

H.U.S.H Initiative FAQ’S

  1. Will signs be posted to help enforce/inform staff and visitors of this initiative?

    Yes! Signs will be delivered to each unit. They should be posted on the outside of the unit doors and in break rooms so that staff and visitors will have a visual reminder to lower voices and be respectful of quiet hours.

  2. What happens when it’s quiet time and several Associates are talking loudly on the unit and no one is listening when they are asked to keep voices low?

    Please notify your Charge Nurse or Supervisor of the situation and ask for assistance. If issues continue, department leaders should be notified via email (if leader is unavailable) of specific situations; provide details for appropriate follow up.

  3. What if a patient’s family member asks to spend the night because their care expectations are not being met?

    First inquire why they feel that their loved one is not receiving appropriate care; reassure them we provide exceptional care. Let them know they will be notified of changes in their loved ones condition and for added comfort, they are welcome to call for updates. It is important to ensure this is communicated with the nurse taking care of the patient as well as passed on to the patient’s future nurses. Exceptions will be made for patient with declining condition, patient is confused – family member needs to “sit” overnight; or peds patient. NOTE: appropriate bed assignment is required (private room preferred).

  4. What if 3 visitors are in a patient’s room at one time?

    First assess the situation. If the noise level is loud or excessive, please ask visitor(s) to support our healing environment by lowering their voices. If the situation does not improve, kindly ask one of the visitors to wait in the visitor lounge area. Explain our recommended 2 visitors at a time policy. If all attempts fail, ask your Charge Nurse or Security for assistance.

  5. What do I do if I notice someone in the hallway with no visible identification?

    Kindly ask for identification such as a visitor ID badge, employee badge or contractor ID badge; inform guest it must be displayed at all times. If they are unable to produce an ID badge please escort them to the front desk to obtain one. If you are met with resistance please notify Security immediately. This is for the safety of all our patients and staff.