Impossible seemed more like it. No one could think of a way to design a double room that met all those criteria. But one manager spotted a peculiar double room in a trade journal, went to check it out while vacationing in Florida, and upon his return excitedly described the room he'd seen: L-shaped, with the two beds arranged at right angles to each other, each along one of the two limbs of the L. Because the room entrance and bathroom were located at the bend of the L--the entrance on the outer bend and the bathroom on the inner--caregivers could enter and walk directly to either bed, and neither patient would have to walk by the other to get to the bathroom. The patients' views of one another were partially blocked by the outside walls of the bathroom, which jut into the room somewhat. Fiddling around with the layout, the team hit on the idea of placing cabinetry at the bend that further blocked the patients' views of each other, as long as one or both beds were in the flat position, offering privacy. But if both patients felt like a little companionship, they could raise the heads of their beds, angling themselves forward enough to visually clear the obstructions and see each other. Unfortunately, putting a window at both ends of the room was out of the question; there would have to be a single window in only one patient's half of the room. But the team figured out a compromise of sorts. If they placed the window directly alongside one of the beds, then the patient in that bed would be close to the window but would have to turn to the side to see it, while the patient in the other bed would be farther from the window but would have a straight-ahead view of it. When the full-scale mock-up was tested, it got a thumbs-up.
What to do about giving patients better access to nurses? In almost all hospitals, every wing has a central nurses' station, which typically means that some patients are located the hospital equivalent of a block away, which raises their anxiety. The solution: abolishing the central station and instead creating individual nurse workstations around which four rooms are arranged, fanlike. That way, each patient can look out along his or her bed and see the primary-care nurse sitting some 15 feet away. Some of the nurses objected, insisting they needed to be near other nurses to constantly share information and just to socialize to ease the pressure of the job. But Lynn Werdal wasn't having any of it. "Hospitals had always been arranged around the caregivers' needs," she says. "But this was all about the patients' needs."
Still, Charmel and the team wondered, could the very nature of nursing and doctoring--that is, the culture of medicine--be changed to suit patients?
When people say hospital environments can be highly infectious, they usually mean it in a bad way. Not in the case of Griffin. Dropping by one of the kitchens is a good way to see why.
Baking muffins in the oncology-unit kitchen today is Maureen Bolde, a senior citizen who regularly volunteers to come by and do what she can for the patients. "When my husband was alive, he was sick here, and the nurses were so wonderful to us, I could never pay them back," she says. She tells the story of the time one of the nurses asked her if she knew how to change her husband's dressing. She told the nurse she had done it several times. Show me, the nurse said. At first, Bolde thought the nurse hadn't believed her and wanted her to prove that she could do it correctly. But then she realized the nurse was watching so she could learn and imitate Bolde's technique--the nurse felt that having different styles of dressing might make the man uncomfortable.
Bolde is one of 400 regular volunteers, all of whom feel pretty much the same way she does about Griffin. Some lead patients to rooms. Some hold their hands before and after surgery, and in some cases during surgery. Some staff a "room service" program and run around meeting requests for snacks, books, videos, slippers, and anything else a patient cares to ask for. A volunteer once fielded a call from a patient who had been rushed to the hospital on April 14: Would the volunteer mind getting the patient's tax forms from her car and bringing them to her accountant across town? The forms were filed on time.
Patients, predictably, are high on Griffin. John DelPrete, a 28-year-old small-engine mechanic and Derby resident who bears an extraordinary resemblance to the late comedian Chris Farley, is sitting in a lounge, about to be discharged after battling back from a blood-platelet disorder. "The last time I was in a hospital," he says, "I was five years old, and my parents couldn't see me until they got off work, and then the nurses made them leave at 8. This time my best friend got off work after midnight, and he was here until 3 a.m. It was great."
DelPrete says he used to be uncomfortable thinking about illness, his or anyone else's. "I was the biggest guy on the football team, but I passed out at the sight of a needle," he says. But, like all Griffin patients, he was encouraged to look over his charts, was offered literature about his illness, and took part in a detailed "case conference" the day after his admission, in which nurses and doctors discussed where he stood now, what tests needed to be performed, what was likely to happen based on the test results, when he could expect to leave, and what might happen in the coming months and years. Now DelPrete matter-of-factly quotes the rise and fall of his platelet count over each of the last few days as if he were an intern. "My nurse, Jane, gave me a real positive attitude," he says. "Now I see the light about taking care of myself." He nods with his chin at the corner of the lounge where his three-year-old-daughter, Alexandra, is playing.
