Hospitals Urged to Review Visitation Policies

Visitation rules based on "outdated beliefs that frequent contact with loved ones interferes with care" neglect the negative consequences of restrictive policies, says a group that advocates for family-centered care.

Hospitals are considering allowing families 24 hour access to their loved ones—but some hospital employees worry that relaxing security policies will come to mean the end of boundaries in care settings.

The Institute for Patient- and Family-Centered Care (IPFCC) is challenging hospitals to reevaluate their visitation policies. Through its Better Together Campaign, IPFCC hopes to raise awareness of the benefits of unrestrictive visitation policies and make hospital leaders aware of negative consequences associated with restrictive visitation policies.

"It's really tragic that the majority of hospitals in the US have restricted visiting policies, and there's no evidence that it's the right thing to do," says Beverly Johnson, president and CEO at IPFCC said in a phone call. Nevertheless, restrictions are the norm.

"All too often, families and loved ones are prevented from being with patients, leaving them alone and isolated, often when they need support the most," says IPFCC's Johnson. "These policies are based on outdated beliefs that frequent contact with loved ones interferes with care, exhausts the patient, or spreads infection; research and hospitals' experience show that these just aren't true."

The benefits of allowing relaxing visitation rules include less anxiety for patients and their families, who may be able to speak for the patient and answer questions about medical history that might help clinicians.

After a child who had been raised by his grandparents was not allowed to visit his grandfather in the ICU and was separated from him when he died, leaders at Contra Costa Regional Medical Center in Martinez, CA, realized that changes had to be made, recalls Anna Roth, Contra Costa's CEO.

The boy had been raised by his grandparents, but was not allowed to visit his grandfather in the ICU where he died.

So Contra Costa began looking at how to integrate patients' families into their care. First Roth had to make sure everyone in the hospital understood what that meant. "The most common concern from nursing and security were that we would be taking away boundaries—but that's not correct," she says.

"Our policy welcomes families 24/7, but that doesn't mean there aren't boundaries," says Roth, adding that there are many misconceptions about what open visitation means.

"We always consider safety and our patients' preferences in every situation. But now, having a family member or loved one by the bedside is the norm, in every unit of our hospital."

The new approach is to treat families as a part of the patients' care team. That includes the patient's family, front line staff, the security team, nurses, physicians, other clinicians, and any volunteers who work with the patient.

"We're offering better care, safer care, and empowering our staff to do the right thing," says Roth. The biggest change, though, has been with interactions with families and the community. "Previously, we only had relationships with angry families."