1. Identifying problems
   — The atmosphere in the department is extremely simple. But it takes too long to understand, how is the whole routine ticking.
   — The information provided on the information stands is official but useless for daily patients needs.
   — Some objects were missing or broken.
   — Cause of lack of information the personal had to tell same things every time, or did additional job. Like rewriting notes with the dates on every piece of food stored by patients in the fridge.
   — Some important health notes may stay unknown for the patients: the messure of temperature after operation could be missed.
   — Some patients did smoke and use sprays in public bathrooms.
   
   The department wanted the most cheap and quick improvements.
   The initial request of deparment management was to change age-worn signs for public bathrooms.
   
2. Adding informational messages.

— A general A3 message near the main dressing room added. This is the place where every patient comes to in the morning and spends some time waiting. So this was the perfect place to put the main instructions about:

• The need to discuss with your doctor the use of any additional medications
• Place to dispose bandages
• Availability, location and operating hours of the shower
• Timing in the department
• The Importance of measuring temperature after surgery
• Self-help for neck pain caused by long-term operations
  

— Message for public bahtroms with emotional note about feelings of the patients who are experiencing breathing difficulties after ENT surgeries

— Message for fridge users with an example of a food date note. This will save a half an hour for food service worker daily. The most cheap and fast way to create a standing message found. Message was placed directly on the fridge.

3. Some objects replaced, added, improved.

— Patients experienced the lack of paper napkins in the public dining room (the department serves food in the public dining room). Napkins added to each table.
— The broken watch at the nurses station replaced.
— Depressive looking stained backs of the bedside tables in the wards covered with plant pattern film to evoke positive feelings.
— Modern signs for public bathrooms created.

P.S. Some unusual additional improvement: this was not common to greet each other in the dining room. People came, got the food and set down to the tables with the food without saying anything. We talked to the group of patients who wanted to change the tradition and they started to wish “Bon appetit” in the public dining room and greet another patients near the public shower. This created a small new tradition which brought some joy into the hospital routine. The tradition lasted at least 2 weeks, according to that patient group information.