Planetree: The Homey Hospital

I am spending the day in a 21st century hospital.
Classical music plays softly in the background. The numbers on the rooms are handpainted, with flowered borders. I am surrounded by subtle colors and indirect, full-spectrum lighting.

There are no long, echoing corridors. No hectic, fluorescent-lit nurse’s stations. No empty gurneys standing in the hall. Everything has the feel of a well-kept residence. The hospital of the future looks a lot like home.

Patients wear their own clothes, their own robes, and their own pajamas, just as they would at home. They lie on flowered sheets and are encouraged to sleep in.

Patients and family members can cook meals in a private kitchen or watch video movies in a cozy private lounge. There is no nurse’s station. Medical charts are prominently displayed, and patients are encouraged to read and write in them.

There is no restricted zone. Patients are welcome anywhere on the ward. There are no visiting hours. Friends and family are welcome at all times. Many choose to be here around the clock. In addition to providing companionship, interested family members are trained to give routine and advanced nursing care—changing dressings, caring for permanent intravenous lines, flushing out IVs and suctioning family members who are on respirators. Family members who learn these techniques can continue them at home after the patient is discharged.

All the comforts of home—yet this is all part of a top modern medical center. The CAT scanners, the MRI machines, the kidney transplant unit are just down the hall. Welcome to the Planetree Unit at Pacific Presbyterian Hospital in San Francisco. Welcome to a revolution in the way hospitals care for, and think about, the people they serve.

The story of the Planetree Hospital Unit begins in 1977. That was a nightmare year for 32 year-old Angelica Thieriot, wife of the publisher of the San Francisco Chronicle. She came down with a mysterious viral illness which nearly killed her, her son was hospitalized with osteomyelitis, and her father died after a long bout with cancer. At times it seemed as if she were spending more time at the hospital than she spent at her own home.
All of the comforts of home—yet it’s part of a top modern medical center. This is the start of a revolution in the way hospitals care for the people they serve.

Her doctors were unable or unwilling to give her information on her own diagnosis and on the procedures and treatments they proposed. Without adequate information, she didn’t understand what the specialists told her, and couldn’t participate in the most crucial decisions about her care. And she found the standards of comfort and support woefully inadequate. At one point she was left, forgotten, outside an x-ray room with a raging fever. She was appalled by the inhuman, impersonal treatment she received in what were supposedly the best hospitals in the San Francisco Bay Area. She decided that if she survived, she was damn well going to do something about it.

Luckily for the development of the patient-centered hospital, Thieriot survived, and did not forget her vow. The Planetree unit recently celebrated its fourth anniversary.

The nurses who work on the unit are among its biggest boosters. The thing they like best is the way it puts the patient in charge.

“Most people have a lot of control over their daily lives. But when they enter a hospital everything changes,” says L.V.N. Becky Guerra, a veteran of the Planetree unit. “Suddenly they find themselves taking orders. It can be pretty humiliating.

“At Planetree, it doesn’t work that way. When you check in here, it’s clear from the start that you arc going to be calling the shots. The staff members understand that it’s their job to inform and acommodate the patients, but that they have last word. We do things at their convenience, rather than forcing them to do what’s convenient for us. And we leave all final decisions about having certain tests or taking certain drugs up to them”

Does Ms. Equerry think the Planetree idea will grow and spread? “I think it’s almost inevitable. Once patients get a taste of the Planetree Unit, they never want to go anywhere else.”

Tom Ferguson MD Written by Tom Ferguson MD

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