Silence, Soothe, & Sleep: Session Recap: Key Takeaways from Christina Musser and Marissa Schwartz at NGPX 2025

2025, NGPX. KEYNOTE: Creating The Environment of Rest: Silence, Sooth, & Sleep

Announcer: And with that, I would like to invite our very first speakers this morning, and they're from St. Luke's University Hospital. We have Christina Musser and Marissa Schwartz. So if you would make your way to the stage, please, we're delighted to have you. Please join me in welcoming them.

Christina Musser, Senior Director Virtual Care & Patient Experience, St. Luke’s University Hospital Network: Oh, I'm meant to wear my glasses. You want mine? No, they won't work. Good morning everybody. Good morning. How did you all sleep last night? Did any of you happen to turn on your TV and see Gwyneth Paltrow? With Weston, I'd like to say that we had something to do with, arranging that. But she was talking about the benefits of sleep and I think we had nothing to do with it.

However I think it really underscored for us that sleep is a basic human fundamental need and it's so important for us as humans and patients are humans. So we were really excited to see that. And a couple things that happened to me this last week, or one thing that happened, my dad had to go into the hospital.

Urgently because his appendix decided he didn't wanna live in his body anymore. And he said three things to me during conversations I had, he was in a different state. One was when I asked him how he rested, he's you can't get any sleep in a hospital at night. The second thing was I did sleep really well during the day.

Okay, that's a problem. And the third thing is he said, was. Why are the nurses partying at the nurses station? I'm like, all right, dad. I said next week I'm going to a conference and I'm gonna be speaking about this specifically in the hospital and I hope I can solve it for you.

But with that, my name's Christie Musser. I am with St. Luke's University Health Network. I am the senior director of Virtual Care Digital Health. And then get to co-lead patient experience with this wonderful person, Marissa Schwartz. I've been with the network for 16 years but I've been in healthcare my entire career, which is.

30 years and I dated myself. That's okay. You talked about yesterday, someone said about having a seat at the table and that digital health getting a seat at the table with digital health. We've got this great relationship because we co-lead patient experience and I over also oversee digital health.

So digital patient experiences at the table for digital health and everything. But digital health has an equally challenging time with getting a seat at the table. In organizations. So check on your digital health friends because they may not be okay. Invite them to the table when you are able to get to the table.

With that, I'm gonna hand it over to Marissa.

Marisa Schwartz, Senior Medical Director, St. Luke’s University Hospital Network: Good morning everybody. All look fantastic today. I'm Marissa Schwartz. I'm the Senior Medical Director for patient experience for St. Luke's University Health Network. I also oversee the hospitalists. And some other clinical operational areas. I've been with the organization for 23 years.

I'm a nurse practitioner. I still practice clinically. It's very important to me to continue to be at the bedside. And what we have for you today is the work that is we're very passionate about. But before we get into that, I'll tell you a little bit about St. Luke's University Health Network. We are in, located in Pennsylvania and New Jersey.

We have, yeah. I think 15. I don't know. Every time I turn around, I feel like we're adding on another campus. Think 15 hospitals at this point. 24,000 employees. A medical school, the longest running nursing diploma program in the country. We just started A-C-R-N-A school. All the things. We have level one trauma center down to a rural community critical access hospital.

But what is very exciting for St. Luke's is the A HRQ, the Agency for Healthcare Research and Quality, recently wrote a playbook about top organizations in the country in regards to patient safety and quality. And St. Luke's was one of the top three. We are a very safe place for patients to get care, and we're super excited about that.

So I think that's gonna be at your you'll be able to read that in the near future. And like I said, I'm a hospitalist. So I've heard for the last 25 years from my patients, you can't get any damn sleep around here, just like Christie's dad. So what you have in front of you is a framework that I created with Christie's help.

And this is something, this is a presentation that we use throughout our organization. Our intended audience is usually nurses, nursing aides, nurse leaders, physicians, advanced practitioners. We adapted it for you all as patient experience leaders. But we wanted to run through it as we structure it for our teams so that you can understand how we approached this topic with them.

So we start with this. We're hearing from our patients, they're frustrated, they're irritable, they're s slang. I thought I was being really cute coming up with that word, but to my disappointment, it does exist in the urban dictionary, but it describes. The phenomenon that patients are experiencing when they're sleep deprived.

And if you think about it, they're sleep deprived. They're in an environment that they don't, they're not comfortable in, and they're sick, or they're recovering from some sort of catastrophe. They need sleep because if they're sleep deprived and they're s lary, they're not, this is, these are true things that happen.

They don't participate in physical therapy the next day. They don't wanna go for their testing. They're not even ordering their meals. They don't care what they're served. This is really the motivation behind the work. And when I'm talking to the nurses or the physicians or the, my usual audience, I run through the clinical benefits of sleep.

There are tons of benefits. Your body is equipped to rest and recover. Let's start with your brain. I have not been able to convert to the West Coast time change since I literally got here. I have been up since AM every single freaking day. Guys, I'm telling you, I am so sleep deprived. If I start slurring my words, I am not drunk.

I am not having a stroke. Please don't call 9 1 1. I'm literally sleep deprived because my brain has not been able to detox. That's what your body needs to do when you're sleeping. We can move to your heart. When your heart, when your body is resting and sleeping, your blood pressure decreases, your heart gets a break, doesn't stop eating.

That's death. That's a different intervention. It's equipped to rest and recover. Okay? So when I'm talking to my clinical teams, I spend quite a bit of time talking about the health benefits because what that does then is it connects the people that my teams to the work. They get it. They understand, oh, they're reminded of why we actually need to sleep.

So I'm gonna hand it back over to Christie to talk to you about the framework, silence Soothe sleep and how we're accomplishing tackling sleepless night.

Christina Musser, Senior Director Virtual Care & Patient Experience, St. Luke’s University Hospital Network: Thanks. So I'm gonna quickly go through this just to set the stage so we can have a great conversation. But really our goal for redesign is to help patients achieve five or more hours of sleep a night, which is less than the average human needs, but that's what we're gonna try to do.

And it silent sues sleep and there are three pillars. What this framework is not, it is not a checklist. We are not giving people checklists. What we're doing is creating something that, with an understanding of the why and then how they can approach it, the things they need to consider. But then each individual unit can take that and run with it and own it.

'cause if they own it, they're going to be all in. So we're not telling them how to do it. But we're giving them the tools to do it and the understanding about it. So the first part is silence, and that's really the strategy is to reduce noise in the environment. Okay. The environment has to be considered.

You're gonna get a lot of people saying we can't do this, we can't do that. First thing I'm gonna say is you can, we can always question do, maybe we can actually let's have the conversation. But number two, let's focus on the things that we can do. I think the best story from this pillar that we've had is EV.

S. As she was presenting raised their hand and they said, you know what we can do. We cannot go into a patient room before seven A or yeah, before AM in the morning. And they've implemented that right away. So EVS at the table said, this is what we can do. So a lot of things that can be done. And then you move on to soothe, and this is the personal preference, the individualization of healthcare.

Right? And so I'm gonna just, the fan here,

Marisa Schwartz, Senior Medical Director, St. Luke’s University Hospital Network: he's my prop.

Christina Musser, Senior Director Virtual Care & Patient Experience, St. Luke’s University Hospital Network: Personalization. Every patient has things that they need to sleep at home. And so asking them, what is your bedtime routine? What do you need from home? Marissa, she's gonna need this fan. Okay.

Marisa Schwartz, Senior Medical Director, St. Luke’s University Hospital Network: I travel with it. It goes in my carry on.

Christina Musser, Senior Director Virtual Care & Patient Experience, St. Luke’s University Hospital Network: Yes. So this is what she needs to sleep.

I need a weighted blanket. I could not bring my weighted blanket because I would've been way over in the, but that's what I need. Alright. What are those preferences? What can you what can we do to help patients get those things that they need, whether it be medication or physical things or just a routine.

And then the final thing is sleep. And that's actually putting all of this into action. And we call it tucking In waking up and setting expectations. You tuck people in, you tuck your kids in. I don't know, you tuck yourself in at night, right? Let's put our patients to bed intentionally and then set the expectations that, Hey, Mr.

Jones, you know what? We're gonna shut your door. We're gonna make it this quiet for you. It's really important that you sleep tonight. And why? And then in the morning we're gonna check up with you and check in with you, however it may be with the morning team to find out how you did sleep and if there was any issues you did have, what can we do to maybe alleviate that the next night?

So it's really that, that putting it into action and narrating the care, being intentional about making the, I heard this yesterday, making the invisible, visible. So that's the framework. And now I'm gonna pass it back to Marissa to talk about what we've been able to do with this.

Marisa Schwartz, Senior Medical Director, St. Luke’s University Hospital Network: So when we first, we start, we've been working on this for probably two years.

This has not been an overnight thing. We have started with, talking with nurse leaders and they came up with some great ideas. So we've really taken the mindset of partnering with our teams and learning from 'em. They came up with some sleep accessories. We, early on, we collaborated with our marketing team.

They helped us brand it. St. Luke's has a star. We have, we're from the Lehigh Valley and the Moravian Church and Moravian Stars. Prevalent. So that's in our logo and that's incorporated into our silent tooth sleep logo. But other things that the teams came up with were sleep kits. We have them, we're not using them.

So the teams made carts and sleep totes so that they owned it there. It's their, remember we created a framework, so this is them putting their flare on it. But there's plenty of, accessories. They came up with door hangers and magnets to some of the door frames. Have the ability to put the magnets on the outside, and when the patient's tucked in, that's their sign that we're not to disrupt this patient for a few hours.

Again, I, we started this early on, and I leave this in here because it begs the opportunity to tell you what we learned from creating this. A sleep survey. So when we first came up with the idea, I called my friend Christie and said, listen, I wanna t tackle sleep. She was like, okay. And I said, no, I'm serious.

Oops. Here's my idea. He I basically brain dumped on her and she was like, oh my gosh, you're creating a framework. So then I called the chair of medicine and I, he's the hospitalist. I said, listen, I wanna tackle the sleepless nights at the hospital. Here's my idea. He's from New York and he said, you're of effing genius.

And I was like let's not go that far, but okay, I have him in my corner. So then I called one of our presidents who is a, an excellent operational leader. She oversees the largest of our campuses. She's I love sleep. Yes, let's do this. And then I called our CNO. I was very strategic with the people who I was calling to.

Get them to understand what we needed to do, and then went in front of leaders and then went, and I had a couple of leaders say let's start on my floor. So we thought about, let's, how are we gonna measure our success? Let's create a three question survey. We did this with it and with marketing.

You can see the questions up there. How did you sleep last night? What contributed if you didn't sleep well and do you have any special requests? The intention of this was to be transactional. We would learn from the patients the following day. I didn't sleep well last night. Here's why. Help me for tonight not to replace rounds or conversations with the pat, the physician, and the nurse.

But it was a way for us to collate the data and, learn from it and be able to drive change. Then we found out CMS was adding some questions onto the HCAP survey. And for once I was like, oh my God, are we ahead of, are we ahead of this? Are we ahead of this? Do we act? We're ahead of this. So we paused our three question survey for now.

But we were learning, to my surprise, actually, patients were saying they were sleeping. They were scoring themselves excellent at this time at the Bethlehem campus on this one unit. You wouldn't be surprised as the disruptions, the IV pumps pain. I was woken up for testing, et cetera. But we did pause this right now because of the CMS questions.

So here's where we're gonna spend the last few minutes on our results here. And this is what we're actually really proud of. The St. Luke's Allentown campus is our center city campus. Two East. It's not a pretty, it's not a, a new hospital. Two East is a medical floor, but look what they're doing.

I wouldn't care if they went from the first percentile to the third percentile because that would be improvement. But look what they're doing with the quietness and the restfulness domains. Then the Easton campus is a small little community hospital. One, one medical floor, 36 patients. They have telemetry and mossimo, the safety net.

Again, they're being deliberate with how they're caring for patients at night. And the hospitalist team there, because it is so small, is rounding at night, taking vital signs away for the Q4, every four hour vital signs. If the patient's stable, let's get rid of 'em. Why are we waking patients up at AM to do labs?

We should stop those types of things. And we're doing that at that campus because again, it is so small. The key thing with these two. Two hospitals is we have nurse leaders who are into this and owning it and really encouraging their teams to be creative and to be consistent. And then here's the Bethlehem campus.

Remember the operational leader who said, yes, I love sleep. Let's do it. P six is the trauma floor, and P seven is a neuro geriatric cognitive floor, stroke floor. Look what they're able to, they're, look what they're doing with. They're, these are the hcaps restfulness domain questions. We're so proud of the teams.

They're owning this, they're having fun. Rick Evans talked about fun yesterday. The teams are actually having fun with this because we didn't beat them over the head and said, your quiet scores suck. You guys need to fix it. No we took a different approach. We started with the why. What's our problem and why do we even care about this?

We talked about their clinical, the clinical benefits of sleep. And we're seeing the results now. We just have to maintain it and we have to get these types of results throughout the entire network.

Christina Musser, Senior Director Virtual Care & Patient Experience, St. Luke’s University Hospital Network: We have to make it a way, and we talk about this, we're not just doing an intervention or an initiative.

What we're doing is saying, this is how we are going to care for patients at St. Luke's. This will be the St. Luke's Way, and it's just the way we do things. And so we're embedding it in our culture.

Marisa Schwartz, Senior Medical Director, St. Luke’s University Hospital Network: So we have the quantitative results. We have, you can see the qualitative feedback that we're getting. I know you wanna, you have a couple of favorites.

Go ahead. There's a

Christina Musser, Senior Director Virtual Care & Patient Experience, St. Luke’s University Hospital Network: couple of favorites and I didn't bring my glasses up here. Gosh darn it. Okay.

Marisa Schwartz, Senior Medical Director, St. Luke’s University Hospital Network: Oh my god. Don't fall.

Christina Musser, Senior Director Virtual Care & Patient Experience, St. Luke’s University Hospital Network: Okay. I won't fall. I love this one that it says staff were awesome. Couldn't have been, better nurse. They went above and beyond after not sleeping for the first. And I think they meant a few days.

She had suggestions. They noticed that we were giving them suggestions on how they could get rest. And this one actually, I was able to get more rest than usual in a hospital. So they were noticing that something's changing. And there's just, I could go on and on, but because I don't have my glasses, it's very hard.

See, so I'm not gonna bore you with that. That's

Marisa Schwartz, Senior Medical Director, St. Luke’s University Hospital Network: okay. They can read them. You

Christina Musser, Senior Director Virtual Care & Patient Experience, St. Luke’s University Hospital Network: guys can read them. But it's great. It's, this is what drives us and keeps us going is to see that the patients are recognizing the intentional part of of what we're doing.

Marisa Schwartz, Senior Medical Director, St. Luke’s University Hospital Network: So to close this out we do have a video.

Oh, okay. Just kidding. It's a two minute video. We, this is used for internal purposes, for training, for teaching our team, so they can put a visual to what we're talking about here.

If it doesn't play, it doesn't ruin the whole presentation. It's okay.

Promotional Video: St. Luke's University Health Network continues to earn a stellar reputation as a national leader in quality and its unwavering commitment to exceptional patient care. Our focus on continuous improvement is what led us to launching Silence Soothe Sleep.

A program developed to promote uninterrupted rest, a critical part of recovery. Just kidding. Patients staying in our hospital deserve to enjoy quiet nights with quality sleep so they can get the necessary rest to recover through silent, soothe sleep. We're focused on a new benchmark ensuring patients get five or more hours of uninterrupted sleep each night during their stay.

When.Marisa Schwartz, Senior Medical Director, St. Luke’s University Hospital Network: Oh, back. That's okay. Back. We're gonna close it out. Don't worry about it. No. Just go ahead. Okay. Okay.

University Health Network continues to earn a stellar reputation as a national leader in quality and its unwavering commitment to exceptional patient care. Our focus on continuous improvement is what led us to launching Silence Soothe Sleep.

A program developed to promote uninterrupted rest, a critical part of recovery. Patients staying in our hospital deserve to enjoy quiet nights with quality sleep so they can get the necessary rest to recover through silent, soothe sleep. We're focused on a new benchmark ensuring patients get five or more hours of uninterrupted sleep each night during their stay, when clinically appropriate to achieve this network wide standard.

Teamwork is key. Silent, soothe sleep encourages staff to work together to coordinate care, understand patient's personal sleep routine and preference, minimize night, same routine disruptions and manage noise levels, especially in the overnight hours. Silent Soothe Sleep also focuses on intentional communications with patients so they understand we care about their quality of sleep.

We have also created an internal daily survey so patients can conveniently provide immediate feedback on their sleep quality each night. Measuring the success of silent soothed sleep is now a part of our patient Survey information, two questions specifically focused on gathering feedback about patient sleep.

These questions are during this hospital stay. How often were you able to get the rest you needed during this hospital stay? Did doctors, nurses, and other hospital staff help you to rest and recover? In addition to helping patients realize many health benefits from a good night's sleep? Caregivers will likely have the pleasure of caring for patients who are more alert and in more control of their emotions.

Silence, soothe Sleep. St. Luke's is committing to minimize disruption and maximize sleep for our patients.

Marisa Schwartz, Senior Medical Director, St. Luke’s University Hospital Network: Yay. Thank you.

There was one other picture up there, which is fine. We the units created sleep squads and there was a picture of them dressed in capes and the Avengers. We don't let them go in the patient's rooms like that, but they can do that, as they're like there, they're having fun.

There we go. So that's what matters. They're having fun with this. It's making an impact. And, thank you so much for allowing us to have some fun with this today. Thank you.

Sorry.

Announcer: It work. Thank you. No, that's so impressive. Thank you so much.