24 * LITERATURE AS AN INTERVENTION TO IMPROVE THE PATIENT EXPERIENCE AND FACILITATE THE BUILDING OF RAPPORT

Abstract

Background: The patient journey through the acute hospital setting can be, amongst other things, an isolating and boring one. One issue is the lack of mental stimulation afforded on wards where there are no televisions or radios available, another is the amount of time available outside the clinical setting for ‘normal’ conversation (especially with patients who have few visitors).Innovation: A patient library service was started across the open bays of two geriatric wards (n = 24), providing a selection of fiction and non-fiction books for the duration of the patient's admission. The books are taken around the wards on a library trolley which is restocked daily. Importantly, the books are offered to patients by one of the junior doctors, allowing an opportunity for conversation and rapport to be built outside of the confines of clinical management. It also affords increased opportunities to uncover and treat reversible sensory issues (myopia, hyperopia and hearing impairment) which may confer benefit regarding reducing rates of delirium (Inouye SK et al, NEJM 1999 340(9):669)Evaluation: The service was evaluated using a survey administered before (n = 12) and two weeks after (n = 24) commencement. It demonstrated a reduction in subjective levels of boredom and an improvement in satisfaction with the patient experience. In addition, patients were glad of the opportunity to have a conversation unrelated to their medical care even if they did not borrow a book. Several patients were noted to have significant visual impairment, leading to interventions. Junior doctors appreciated the service as a forum for building rapport.Conclusions: The provision of an inpatient library service on a small scale has been shown to improve the patient experience whether or not a book is borrowed. By increasing opportunities for communication we have subjectively improved rapport and enabled sensory impairments to be noted and appropriate action taken