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Hospitals Update the Hated Hospital Gown

‘Humiliating’ garment may soon be out of style

Hospital gowns are among the most vexing parts of being in a hospital. But if efforts by some health systems are an indicator, the design may be on its way out of style, according to Kaiser Health News.

The Cleveland Clinic was an early trendsetter. In 2010, it introduced new gowns after being prompted by the CEO, who often heard patient complaints when he was a practicing heart surgeon. That feedback led to a search for something new, said Adrienne Boissy, chief experience officer at the hospital system.

The prominent academic medical center ultimately sought the help of fashion icon Diane von Furstenberg, settling on a reversible gown with a front and back V-neck, complete derriere coverage, and features such as pockets, softer fabric, and a new, bolder print pattern.

Patients “loved the gowns,” Boissy said. “People felt much more comfortable in the new design, not just physically but emotionally.” In recent years, she added, “hospitals are looking at everything they do and trying to evaluate whether or not it contributes to enhancing the patient experience.”

It’s all part of a trend among hospitals to improve patient reviews and their own bottom lines –– fueled in part by the Patient Protection and Affordable Care Act’s focus on quality of care and other federal initiatives. The Centers for Medicare & Medicaid Services increasingly factors patients’ satisfaction into its quality measures, which are linked to the size of Medicare payments that hospitals receive.

Sometimes the efforts involve large capital improvement projects. But they can also mean making waiting rooms more comfortable, improving the quality of food served to patients, or, as in this case, updating hospital gowns.

Ultimately, this focus leads to “a better patient experience,” said John Combes, senior vice president of the American Hospital Association.

The Detroit-based Henry Ford Health System is in the process of updating its gowns, an initiative that began when the system’s innovation institute challenged students at the city’s College for Creative Studies to identify and offer a solution to one hospital problem.

The students responded with the suggestion to redo the garment that has often been described by patients as flimsy, humiliating, indecent, and itchy. The process took 3 years, but last fall the institute unveiled a new and improved version. It’s made of warmer fabric –– a cotton blend –– that wraps around a patient’s body like a robe and comes in navy and light blue, the hospital’s signature colors.

Patient expectations are part of the calculus. They “are demanding more privacy and more dignity,” said Michael Forbes, a product designer at the Henry Ford Innovation Institute.

When the institute tested his gown design, Forbes said, patient-satisfaction scores noticeably increased in a few days.

But replacing the traditional design is no easy task. What patients wear needs to be comfortable and yet allow health professionals proper access during exams, meaning it must open and close easily. The gowns also need to be easily mass-manufactured, as well as efficiently laundered and reused.

New designs can also be expensive. After Valley Hospital in Ridgewood, N.J., switched to pajamas and gowns that provide extra coverage, costs went up $70,000 per year, said Leonard Guglielmo, the facility’s chief supply-chain officer, because the new garments cost more to buy and maintain.

Beyond cost, more ingrained cultural expectations might also play a role in what hospitals think patients should wear, said Dr. Todd Lee, an assistant professor of medicine at McGill University, who co-authored a 2014 study in JAMA Internal Medicine, examining whether gowns were important and whether patients might be fine wearing their own or hospital-provided pants, instead of or along with gowns.

Often, doctors reported that pants or undergarments beneath gowns would have been okay, but patients said they were never given those options. Traditional gowns make it easier to examine patients quickly, and several doctors to whom Lee spoke seemed shocked at the idea that patients might wear garments other than the open-backed gown during their stay.

But the most common challenge isn’t necessarily doctors’ expectations or costs. It’s navigating hospital bureaucracies, said Dusty Eber, president of the California-based company PatientStyle, which designs and sells alternative gowns. In his company’s experience, hospital decisions are often made by committees, not individuals.

“There’s a lot of bureaucratic runaround,” Eber said.

Source: Kaiser Health News; March 31, 2015.

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