Have you ever heard the tale of The Guardian Angels of UPMC? Well, this tale isn’t just a story made up to help children fall asleep at night -- it’s a reality for transplant patients at UPMC hospitals.

It all began when the Transplant Experience Working Group decided to participate in a patient shadowing experience. Stemming from the Six-Step Patient and Family Centered Care Methodology, The Guardian Angels are making strides to improve patient experience throughout the entire care cycle.

Here’s what you’ll get a glimpse of in this article:  

• How the UPMC Guardian Angels came about
• The process to become a Guardian Angel
• How the Guardian Angels are improving patient experiences
• How patients are reacting to learning they have a Guardian Angel onhand
• How the Guardian Angels are benefitting from working with transplant patients
  

Experiencing the Process Through a Patient’s Eyes

To dig into the process and  understand the patient care cycle from the ground up, UPMC identified a special team to focus on identifying opportunities for  improvement. This team was tasked with shadowing patients and their families to truly understand their transplant story.

This group used the idea of patient- and family centered care as a starting point and based their shadowing process after it. Basically, this means that they would not only focus on the patient's medical needs, but their physical and emotional comfort while at the hospital as well.  The patient’s experience was not only limited to their physical health, offering a holistic view of the process.

Once shadowing began, it was easy to identify many patient and family challenges almost immediately. Here are the main challenges they found:  

• Navigating the hospital was a difficult task for nearly everyone
• Communication between hospital personnel and patients was easily misunderstood
• Status updates to families on the patient’s progress and condition were far too infrequent
• Patients and their families were not familiar with staff or processes to know where to go or who to ask if they needed assistance
  

Once shadowing was complete, the patient and family thanked the shadower and called them  their “Guardian Angel,” and that was the moment the idea of the angels were born. In collaboration with the University of Pittsburgh, the UPMC Guardian Angels officially took flight in February 2011. Year after year the program continues to grow and has received grant money to fund the program from the Picker Institute.

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Becoming a Guardian Angel

When implementing the program, it only made sense that these Guardian Angels would be someone who had a personal interest in the patients. So, UPMC decided that they would look to hire nursing and social work students who could show a special interest in the patients and program.

Imagine looking for an internship or part-time position and coming across the job title “Guardian Angel.” If that title doesn’t catch your eye -- we’re not sure what would. Once the position was posted, UPMC selected six angels to begin their program. Each angel brought their own background and experience to the program and motivation for becoming a Guardian Angel.

What does it take to become a guardian angel? Basically, a crash course in transplants 101. Angel-training was compiled through co-design with transplant doctors, nurse coordinators and other hospital employees from parking to the emergency room and everything in between. Now, you can see why a nursing or social work student would benefit from the program just as much as the patient.

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From there, the angels were trained in many different ways. Here are a few of the different experiences they had during  training:

• Spent time shadowing and learning from transplant teams, such as observing patient evaluation.
• Learned to understand various checklists for each transplant type they may experience
• Participated in a scavenger hunt to learn the different areas of the hospital (such as where ATM machines are, cafeterias, waiting areas, elevators and more) so they could help others navigate the facility
• Became knowledgeable of how patients are summoned for a possible transplant.  Toured the transplant operating room.
  

The six chosen angels completed their training with excitement and upbeat attitudes. After completing their training, they were ready to start helping transplant patients through their experience.  

A Personalized Hospital Liaison

Once the program was up and running, Guardian Angels would greet possible transplant recipients upon arrival. The patient  now has a personal hospital liaison,addressing many of the concerns identified during the primary shadowing process map.

The angels are there to help with guiding patients through the hospital, answering their questions, and as a general resource that allows the angels to be a personal liaison for transplant patients during their visit.

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One  of UPMC’s Guardian Angels explains how difficult it can be for people to navigate the hospital. "UPMC is very overwhelming. It's huge, people don't know where to go," said Rachel Roscoe,

In many cases, they know what patients and family members need even before they do. Sometimes in the craziness of transplant summonings, people forget to think about their own needs, such as getting dinner or a place to stay.

The angels are there to remind family members to stop into the cafeteria and get dinner or help them find a hotel close by.. They comfort the patient when family members need to step out, ensuring that patients who may be experiencing stress and anxiety are not left alone.

A Lasting Impression

Holly Rute was called into UPMC on two different occasions for a possible double-lung transplant. Each time she came to the hospital, she had two  different experiences -- one pre-angels and one once the program was established.

Arriving at the hospital to receive a possible double-lung transplant is a stressful and uncertain time.  During her first experience, Mrs. Rute found herself worrying about small things that someone else could have easily had a solution for -- like wondering when her family would need to step out for dinner. This small uncertainty is enough to tarnish something that had the potential to be a good experience. In the end, she was sent to without her transplant to wait for the next call.

Mrs. Rute’s second experience with her potential double-lung transplant was very different..The Transplant Guardian Angels were established and she had someone there to answer her questions, comfort her, and sit with her when her family went to grab dinner. It made the process a little less frightening and gave her someone to keep her company when her family couldn’t be there.

“It was very comforting,” said Mrs. Rute “Just the title of her position is comforting, having someone come in and say, ‘I’m your guardian angel.’”

Many patients have said that having a Guardian Angel by their side makes the transplant process a little less scary.

The Experience Through The Guardians’ Eyes

After completing their training, all six guardians were ready and eager to get started. Some angels were called in with patients who were awaiting news on their transplants, while others took the time to visit with patients and donors at the liver and kidney clinic and expand their knowledge.

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Many of the Guardian Angels have received positive and encouraging feedback from their patients, reassuring them of the importance of this position. It is also offering them a great opportunity to expand their knowledge and experience by learning about the transplant process first hand. Younger nursing students participating feel they have a competitive advantage by being an angel.

One angel, Ms. Squeglia stated, "I love it, absolutely love it. It's the best thing I ever signed up for, it's a really great experience to see what it's like to go through the process." She truly believes she is getting just as much out of the program as the patients she works with are.

The Future of the Angels

The Guardian Angels of UPMC have made a lasting impact and with a positive feedback, they have a bright future at the hospital.

Patients look forward to meeting and spending time with their angel, and surgeons are asking where the angels are and want to know when they are on call. The program has grown so much since the original shadowing process, and will continue to grow and touch the lives of many more transplant patients in years to come.