The No Pass Zone Pitfall

In every hospital I’ve ever worked, we’ve observed something called the No Pass Zone. The No Pass Zone means that when a call light is on outside a patient’s room, whoever is nearby, no matter what their job title, stops and answers the light. We go in, we tell the patient we saw the call light was on, and we ask what we can do to help.

No exceptions. You do not walk past a patient room when a light is on. Ever.

We drill this like crazy at new employee orientation. We tell clinical and non-clinical staff alike, “Do not walk past a room if there’s a light on. It doesn’t matter if that’s not your patient or you’re not an RN, or you’re in a hurry. If a light is on, you go in.” It’s crystal clear.

So what could possibly go wrong?

I was on my way up to the 3rd floor one Thursday morning to do my daily patient rounds. Each of us on the leadership team has an assignment of four patient rooms to round on. We ask questions about their stay, like which staff member can we recognize for doing a great job, what can we be doing differently to make your stay with us a little better, and some focus questions about a specific topic we’re trying to measure, like quiet and restfulness or RN Communication.

I got off the elevator with my rounding questions all ready to go when the very first room down the corridor had its call light on.

My eyes locked in on that soft white glow hanging from the ceiling. I could see nothing else. This was it. This was my moment. I was going to answer a call light. My mother, an RN of nearly 50 years, would be so proud.

I went into the room and saw a face that was familiar to me. He was a patient from a few weeks ago who had been in one of my assigned rooms for several days; I’d gotten to know him a bit. He looked different today.

“Hi!” I said. “I remember you! I saw your light on, how can I help you?”

“I need my nurse,” he cried. “My stomach is in so much pain and I just pooped myself and I called the nurse and I need help!”

“Oh my… okay… I’ll find your nurse… hang on… I’ll get some help.”

I ran out into the hallway and saw the manager of the unit. “Hey,” I said, “I answered the call light in room 301. The patient said he pooped himself and needs his nurse.”

She looked at me and said very calmly, “Okay, Kate, I’ll get his nurse. You know you were just in a room with a patient who has C-diff, right?”

I stopped dead in my tracks. “What?” C.-diff is clostridium difficile, a nasty little bug that wreaks havoc on your colon.

“Kate, go wash your hands with soap and water. Didn’t you see the signs on the door about contact precautions or notice the cart with all the PPE on it?”

Actually, no. I hadn’t.

Right outside the room there was a cart with PPE – personal protective equipment –  gowns, gloves, and masks and a big sign warning that we needed to take precautions before entering. I was so fixated on the call light, I never saw them.   

Thankfully, I hadn’t actually touched anything in the room, but I still felt like I had cooties all over me. I washed my hands for what seemed like an hour.

Here’s the thing: depending on our lens, we tend to fixate on certain things. As the patient experience director and a non-nurse, when I saw a call light, all I could think to do was answer it. Immediately. Someone needs help. Go help.

What we can’t forget to do is pause and take a look around. Notice the big red signs on the door. As you walk around the giant cart of PPE to get to the door, stop for a second and ask yourself why it’s there. Don’t get so caught up in your own forest that you can’t see the other trees.

Author: Kate Kalthoff

It's simple: leave people, places, and things better than I found them. For more than 20 years, Katherine Kalthoff has been working to improve the way healthcare organizations connect with the people they serve. She began her career at Gift of Hope, the organ procurement organization for Illinois, approaching families and securing their consent to donate a loved one’s organs for transplant. Through compassionate, empathetic listening, Kate led the Family Services team to one of the highest consent rates in the country. From there, Kate went to Advocate Health Care, Illinois’s largest healthcare system, as a Physician Relations and Business Development Manager, improving physician satisfaction and strengthening the relationships of both the employed and independent physicians with the system as a whole. Just prior to joining Northwest Community Healthcare as the Patient Experience Officer, Kate was the first Manager of Patient Experience at DuPage Medical Group where she built a platform of organization-wide service excellence through her inspiring brand of education, training, and one-on-one coaching. A much sought-after speaker and trainer, Kate has a very simple approach to her work: leave people, places and things better than you found them.

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