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Time to Change

Donald M. Berwick, MD, MPP, FRCP; Meera Kotagal, BA

JAMA. 2004;292:736-737.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The sickest patients lie in intensive care units (ICUs) facing fearful illness; surrounded by overwhelming noise from pulsating ventilators and monitors; invaded by the necessary ministrations of nurses; and overhearing, if they are awake, strange and portentous conversations. Professionals buzz about them, but these patients are mostly alone, separated from those who love them by restrictive ICU visiting policies, except at rigidly specified times or with the doled-out permission of the ICU staff. Restricting visiting in ICUs is neither caring, compassionate, nor necessary.

Restricted hospital visiting hours began in the late 1800s for nonpaying patients in an attempt to establish order in the general wards.¹ For many decades afterward, paying patients remained free to have visitors at almost any time in their private or semi-private rooms. In the 1960s, however, in an effort to protect the patient and the family from . . . [Full Text of this Article]

Author Affiliations: Institute for Healthcare Improvement, Boston, Mass.

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