Jessica Gallo rolled her half-size harp into a patient’s room, finding her hunched in a tight ball, her face contorted in pain. It was intolerable, the patient told her, but Jessica learned from the patient’s nurse she had just received her medication. Gently Jessica asked her if she could play a little on her harp, that it sometimes is a good distraction. The music was simple: a few notes at a time with space in between. Not knowing when the next note will sound, says Jessica, can shift a patient’s focus away from pain. After a few minutes she asked the patient if she’d like to hear more and heard “yes, please.” Soon, the patient fell asleep.
“It was the best gift of the day, seeing her able to rest,” says Jessica, who is piloting a therapeutic music program at Virginia Mason. “For people to feel like someone is there, alongside them as they push through something difficult, are moments I’m privileged to be in.”
When Foundation funds to improve patient care in the Critical/Progressive Care Unit became available last year, Director Shirley Sherman, RN, remembered Jessica volunteering to play for patients in 2014. Jessica was working to complete a two-year Certified Music Practitioner program, splitting her time between Virginia Mason and a rehabilitation center. The response from patients, families and team members had been so positive, Shirley set up a small working group, including two physicians, team members from palliative care and Patient Relations to map out a new therapeutic music program pilot with Jessica.
Last fall Jessica began playing two days a week for critical and progressive care patients, but this time her impact on patients would be documented. A key element of the pilot is conducting surveys of both patients and team members, allowing the data to inform Experience-Based Design (EBD), a methodology used to improve patient care based on what’s most meaningful to patients receiving care.
Of the 64 patient surveys documenting how patients felt before, during and after hearing the music, 98 percent registered a positive reaction. Even more striking, of the 83 percent of patients who indicated neutral or negative feelings before hearing the music, only 2 percent of respondents reported those feelings after hearing it. Even patients’ reports of positive feelings rose sharply after hearing the music, by 82 percent in the surveys.
Virginia Mason surgeon Scott Helton, MD, joined the pilot working group knowing therapeutic music would directly support a patient care practice he introduced in 2013, known as Enhanced Recovery After Surgery (ERAS). ERAS is a multidisciplinary approach designed to reduce patients’ psychological stress response after surgery and shorten recovery time. In his practice Dr. Helton observes firsthand the transformative power of music in the hospital setting.
“When Jessica plays it’s like magic flows from her harp,” says Dr. Helton. “You can see tension and anxiety released from a patient’s face. You can watch their pulse rate drop on the monitor. There is a peacefulness that falls over the room. Tears sometimes flow from patients, family members, even nurses as they witness the calming effect on someone who was anguished or hurting. In 35 years of practicing medicine, I have seen few things that compare with therapeutic music for having such an immediate, dramatic effect on patients.”
With the success of the pilot, the working group hopes to expand therapeutic music to other hospital and clinic settings, such as ambulatory medicine, procedural recovery rooms, palliative and end-of-life care. Recently Jessica added sessions in the Oncology Infusion Center, where her harp provided therapeutic music to both patients waiting for infusions and those already roomed.
“We saw the individual room doors slide open so they could hear Jessica’s harp,” Shirley remembers. “Over and over we hear from patients that they’ve never experienced this in a hospital. We want this to be available for patients who are struggling, to see if it can make a difference clinically. Could this be an intervention for pain? Using less pain medication can mean a patient recovers sooner and goes home sooner.”
An important aspect of therapeutic music is how attuned it is to the patient and situation, and unlike recorded music, can be adjusted in real time. As a Certified Music Practitioner, Jessica understands the type, volume, cadence, and pitch of music needed, depending on what the patient or family is experiencing. Her ability to quickly gauge the mood and emotions of others is what separates the art of therapeutic music from simply playing music.
“Having witnessed the power of Jessica’s music, I am hopeful that we can start a therapeutic music program at VM,” says Dr. Helton. “I see it as an incredibly important element of patient-centered care and the ERAS program. This will distinguish us from other hospitals and be a powerful tool in our ability to deliver what our patients, families and team members feel is high-value care.”
A version of this story previously appeared on Virginia Mason’s internal news site.