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Call Light Analysis

Audra Brooks, Shannon Grabe, Melissa Bisel, Tessa Grewe
Ferris State University

The purpose of this strategic analysis paper is to identify a clinical need and focus on how to
improve the quality of the process. For this paper we recognized the need of improving call light
response times at Spectrum Health Butterworth, specifically the 2 South Unit. The goal of this
analysis is to determine if changing the call light response policy will decrease response times
and improve patient satisfaction. Spectrum Health Butterworth collected data through an
electronic database that measures the amount of time that occurs between the patients initiating
the call light until the time the staff member turns it off. Another source of data is a survey that
the hospital uses to measure patient satisfaction of their overall hospital stay. The results showed
that the implementation of the new call light policy showed decreased call light response times
and a significant increase in patient satisfaction.

Call Light Analysis
Having been in the hospital setting for five semesters, hearing different alarms and bells
is normal. When a bed or chair alarm rings, everyone makes a mad dash to answer it. However,
when a patients call light rings, many will just wait for the patients nurse or nursing assistant to
answer the call. The purpose of this call light analysis is to look at ways to improve patients
safety and quality of care by decreasing the time it takes for their needs to be met. Developing a
plan where everyone works together as a team to answer call lights is one way to improve patient
quality of care and safety. This could also improve patient perception of satisfaction in the care
that they received during their stay at the hospital and the increase the likelihood to recommend
their family and friends.
The strategic planning process will be used to alter the call light policy at Spectrum
Health. Strategic planning is a process by which the guiding members of an organization
envision their future and develop necessary and appropriate procedures and operations to
actualize that future (Yoder-Wise, 2014, p. 312). The first step in this process is to identify the
clinical need for this change, and develop an interdisciplinary team to help develop goals and
strategies. Reviewing data collection and developing outcomes makes it possible to implement
the strategies developed in order to improve the issues with the call light. Lastly, this analysis
will include evidenced based theory and research to evaluate and analyze improvement of this
Identify Clinical Need
According to Tzeng (2010), little research has been done on patient call light use and
staff response time, which were found to be associated with inpatient falls and satisfaction
(p.52). Hospitalized patients spend most of their time in their room, therefore, use of call lights is
necessary to have their needs met. There are various reasons for patients to use their call lights
which include toileting assistance, intravenous problems, pain medication, repositioning and
transfer assistance, personal assistance like food and water, obtaining information, getting the
nurses' attention, and accidentally pushing the call light. The need for this intervention was due
to the fact that patients were reporting on their hospital stay surveys that it was taking too long
for staff to attend to their needs. According to Tzeng (2010) the most frequent comments of
patients include: delays in getting call lights answered, variation in the call light response time
from a low of less than a minute to a high of 20 minutes, the amount of time it took to handle the
patient's request once the light was answered, and the patient's request not being fulfilled once
the call light was answered (p. 53). Delayed call light responses put patients at risk for injury
and also decrease quality of care and patient dignity.
Designs an Interdisciplinary Team
The purpose of developing an interdisciplinary care team is to improve quality of care for
patients by answering call lights in a timely fashion. Team members include any staff member
that collaborates in the care for patients. This would include physicians, residents, physicians
assistants, staff nurses, nurse aids or technicians, the nurse manager, environmental service
personnel, members of the dietary team, and physical therapy. This tailored interdisciplinary
team will collaborate about the issues that affect the timely answering of call light. Each team
member has a different view point and background that can be used to develop the specific
outcomes that are necessary to achieve the goal of quality of care. However, the focus of this
team must be on the patient so that ideas are developed and problem solving can occur (Yoder-
Wise, 2014, p. 362).


Data Collection
Spectrum Health Butterworth implemented a method to collect data on call light response
times and patient satisfaction. To determine the time it takes for call lights to be answered they
use a system that electronically measures the length of time it took from the moment the patient
pressed the call button to the time it was answered. When going into a patient room with a call
light on, there is a button that needs to be pressed to turn it off. This data was collected on 2
South, the orthopedics/progressive floor.
In order to measure patient satisfaction and likelihood to recommend, Spectrum Health
sends out surveys to patients regarding their stay. The survey is implemented through Press
Ganey Associates, a widely known company that assists hospitals in improving their
performance and patient satisfaction. These surveys include information on the patients stay, the
faculty, and the overall experience. When patients mail the surveys back they are placed in a
database and each floor receives a monthly report that gives them a grade and informs the staff
on patient experiences. These two tools are used in combination to develop the call response
This method of collecting data supports the role and responsibilities of a leader when
implementing a quality improvement plan. According to Yoder-Wise (2014) a leader
implements and monitors systems for internal and external reporting of information (p. 393). By
using leadership strategies to collect data by monitoring information, patient safety and quality of
care can be improved.
Established Outcomes
The goal for improvement is to develop and maintain patient safety and satisfaction. The
most important outcome is for call lights to be answered in less than two minutes in person. The
most reported reasons for call light use by patients and their families are pain medication,
personal assistance and bathroom assistance (Tzeng, & Larson, 2011, p.75). If patients are forced
to wait too long for their call light to be answered they are more likely to get up to use the
bathroom on their own and increase their risk for injury. Call lights being answered in a timely
fashion will help with patient satisfaction because most patients feel as though their call lights
are a matter of their safety and this is one way a patient can exercise control over their care.
Making sure call lights are a priority will help with nurse-patient communication.
Implementation Strategies
In order to implement this policy change, the transformational theory will need to be
used. According to Yoder-Wise (2014), transformational theory refers to the process where the
leader attends to the needs of the organization and motivates followers. This theory promotes
staff to be responsive to patient needs.
Kouzes and Posner (2007) identify five key practices in transformational leadership. The
first one is challenging the process. By questioning the way call lights were being answered the
Spectrum Health 2 South Unit was able to implement a new way of answering the lights. Instead
of the lights going to the phones they now call out so that each staff member is aware that there
is a patient need.
The second step requires everyone to come together to achieve a goal. This unit was
required to work together in order to anticipate patients needs. For the call light response
initiative to be effective, each staff member must perform hourly rounding focusing on the 5
Ts which are toileting, tidy, tolerance to pain, technology, and turning (Spectrum Health,
2014). If these are done each hour, patients will not need to call out as much. Other interventions
used to improve call light response time include: no pass zone, all patients are everyones
patients, light on light out and a walking/ watching (Spectrum Health, 2014). This means that no
matter what if staff walks by a room and a call light is on that staff member is responsible for
answering it.
The third step is enabling others to act. By gathering data on call light responses, staff
was able recognize the importance of hourly rounding which empowered them to make a
difference and improve patient safety and satisfaction. The fourth step is to model the way. This
call light process will not work if the manager is not involved. The leader must take an active
role in changing the process. Linda, the manager on 2 South explained that she is a firm believer
in this process and the data backs it up. Each day of the week, the manager is on the floor
answering call lights when she is able to. She connects with staff to ensure their days are going
well and helps when needed. The fifth step in this process is offering praise. When the manager
notices employees doing their hourly rounds, answering call lights, or running to bed exits she
rewards them for making a difference.
There two main goals of the call light response initiative is to decrease response times
and increase patient satisfaction. This analysis shows that at it took the unit on average about five
minutes to answer a call light in November 2013, before the call light response initiative was
implemented. By reviewing the data collected for March 2014, the call light response times were
under two minutes. Spectrum Healths call light initiative decreased call light response times by
over three minutes. After analyzing the data on call light response times, this quality
improvement has shown to be more effective in answering patients needs quicker.
As discussed above in the data collection section, each unit at Spectrum Health receives
monthly grades regarding patient satisfaction, their overall experience, and likelihood to
recommend. Before the call light response initiative was implemented, the 2 South Unit received
a 70% when looking at patient satisfaction. In March 2014, this unit received a 90% patient
satisfaction rating. When evaluating the effectiveness of the call light response initiative, the data
proves that patient safety increases along with satisfaction.
Patient satisfaction and safety is an essential part of nursing care. When patients have
increased satisfaction they have a more therapeutic relationship with their nurse; this relationship
is critical to their care. The research has shown that by simply being more proactive and
answering patients call lights in a timely manner and in person, we can improve their
satisfaction with the care they receive. With the implementation of the strategies that have shown
to be effective on 2 South throughout the entire hospital, both patient satisfaction and safety
would greatly improve.

Press Ganey Associates Inpatient satisfaction, Likelihood to Recommend
Tzeng, H., & Larson, J. L. (2011). Exploring the relationship between patient call-light use rate
and nursecall-light response time in acute settings. CIN: Computers, Informatics,
Nursing, 29, TC75-TC80. Retrieved from
Tzeng, Huey-Ming. "Perspectives Of Staff Nurses Of The Reasons For And The Nature Of
Patient-initiated Call Lights: An Exploratory Survey Study In Four USA Hospitals."
BMC Health Services Research 10.1 (2010): 52.

Yoder-Wise, P. S. (2014). Leading and management in nursing (5th ed.). St. Louis, MO:
Elsevier Mosby.