Nurse holding hand of woman in bed
The new call bell system in use in nine inpatient units at Toronto Western Hospital has dramatically cut down on noise, improving the patient experience. (Photo: iStock)

To recover from injury or illness, taking time to rest is a key consideration. At Toronto Western Hospital (TW), actively ensuring patients can get a good night's rest has become a priority.

While replacing a nearly 25-year-old nurse call bell system, several teams across UHN Digital, Infrastructure, TW clinicians and leadership noticed an opportunity to reduce noise on inpatient units.

The teams noticed noise on the units reached upwards of 70 to 80 decibels regularly. This meant the noise levels on inpatient units ranged between the comparable sounds of a vacuum cleaner to as loud as a lawn mower on a daily basis.

"We could've just focused on replacing the call bell system, but we wanted to think beyond that," says, Sandra Li-James, Director of Professional Practice at TW.

"We wanted to see how we could improve patient experience with telecom as a whole."

Today, nine inpatient units at TW use new wireless handheld devices as part of the internal nurse call bell system.  The new system allows patients to call for assistance from their bedside and communicate directly with responding nurses through their wireless device. Requests can then be handled quickly and discretely as needed.

The old call bell system, installed in the 1980s, required patients to call the nursing station where their request would play out on an intercom. If the patient wanted something personal, anyone nearby could overhear.

Two staff members holding call bell devices
The new system allows nurses to respond directly to patients through a wireless device, which allows for the handling of requests quickly and discreetly while cutting down on overhead noise. (Photo: UHN)​

The request would then be crafted into a brief message and announced through overhead speakers for a member of the nursing team to take action. With staff also using overhead paging to contact one another, patients were hearing these broadcasts almost every 10 minutes throughout their day.

"[The old system] didn't help with creating a healing space or with building relationships between the nursing team and patients," says Janet Newton, TW Vice-President and Site Lead.  "We wanted new call bells and phones but more importantly, we wanted our patients to feel like they could have real two-way conversations with staff."  

Improving patient and staff experience

The focus on noise reduction was driven by patient experience interviews, data collected from UHN Digital and staff observations. Ultimately, the project reinforced UHN's commitment to its primary value – the needs of patients come first.  

As the new system went live, the patient satisfaction scores rose.

"Someone actually talks to me when I press the call bell," shared a patient in a survey.

"It's great! Each time [I called], nurses have acted quickly and attended to my need."

The implementation of the new call bell and wireless devices also created a significant shift for staff – where triaging of patient alerts was no longer conducted at the nursing stations, but now occurs directly in the hands of frontline staff.

Ensuring seamless transition between call bell systems required training of nearly 600 staff to support TW's nine inpatient units, which cover more than 200 beds. Digital staff were also available to provide 24-hour support after training.

The TW Nurse Call Bell Project touched almost every department at the hospital. Collaboration from technical, clinical and infrastructure teams helped to ensure the success of the project.

"At the end of the day, this was a joint effort by so many of our teams to make UHN a better place for patients," says Janet.

"We wanted to benefit patients, families and staff alike with a calmer and quieter environment."​

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