SHM Converge Scientific Abstract ePoster Gallery-Quest for Quiet: A Patient-Centered Quality Improvement Initiative to Enhance Nighttime Rest and Patient-Reported Sleep Quality on a General Medicine Unit

Quest for Quiet: A Patient-Centered Quality Improvement Initiative to Enhance Nighttime Rest and Patient-Reported Sleep Quality on a General Medicine Unit

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This quality improvement project at NYU Langone Health aimed to improve nighttime rest and patient-reported sleep quality on a general medicine unit by reducing avoidable overnight disruptions. Poor sleep in hospitalized adults is linked to worse outcomes, including longer length of stay, higher pain, and lower patient satisfaction. Using a patient-centered approach, the team identified major sleep disruptors with a Sleep Disruption Questionnaire and implemented three interventions between August 2024 and March 2025.<br /><br />First, default vital sign frequency for clinically stable patients was changed from every 4 hours to every 8 hours. Second, early-morning routine lab draws were shifted from 4 AM to 9 PM for patients expected to discharge the next day, and later expanded more broadly when clinically appropriate. Third, the team monitored safety using Behavioral Emergency Response Team (BERT) and Rapid Response Team (RRT) activations.<br /><br />Results showed improved sleep across several Richards-Campbell Sleep Questionnaire domains. After the vital sign change, sleep latency, number of awakenings, and overall sleep quality improved. After changing lab timing, sleep depth improved substantially, with additional gains in other sleep domains. Patient experience also improved: HCAHPS “Quietness of Hospital Environment” scores increased from 0% before interventions to 46% after the vital sign change and 75% after the lab-timing change. Safety was maintained, with stable or decreased BERT and stable RRT activations.<br /><br />The project concluded that reducing nonessential nighttime interruptions—especially less frequent vital signs and rescheduled lab draws—can meaningfully improve inpatient sleep and perceived quietness without compromising safety.

Asset Subtitle

Kriti Thapa

Meta Tag

Author List Anessa Uretsky, Brittany Studwood, Dhara Shukla, Kriti Thapa

Category Innovations

Concept Hospitalized Patient Sleep

Concept Sleep Disruption

Concept Patient-Reported Sleep Disruption Tool

Concept Patient-Reported Sleep Quality

Concept Sleep-Promoting Practice

Distinguished Non-Finalist

Presenter Organization NYU Langone Health

Presenting Author Kriti Thapa

Track Quality Improvement

Keywords

hospital sleep quality

quality improvement

nighttime disruptions

vital sign frequency

lab draw timing

patient-centered care

inpatient rest

Richards-Campbell Sleep Questionnaire

HCAHPS quietness

patient safety

Hospitalized Patient Sleep

Sleep Disruption

Patient-Reported Sleep Disruption Tool

Patient-Reported Sleep Quality

Sleep-Promoting Practice