BRIEF REPORTS RECYCLING AS A PROJECT FOR A HOSPITAL’S SHELTERED WORKSHOP Charles
G.
Watson,
Ph.D.
uSheltered workshops have grown dramatically in popularity over the last decade, not only because they provide an important alternative to work details and recreational programs but also because they can provide therapeutic benefits to certain patients. These benefits include the development of work-related skills, reinforcement of patients for productive activity, reduction of the anxiety associated with jobseeking, and occasionally the development of specific skills for use in postdischarge jobs. At the St. Cloud (Minn.) Veterans Administration Hospital the sheltered workshop begun in 1965 has been faced with increased competition for contracts with sheltered workshops being developed elsewhere in the state. As a result of our need for additional work programs and the environmental interests of several members of the workshop’s supervisory committee, a small, experimental recycling program was instituted with four to six patients in the spring of I 972. It has grown rapidly and now provides work for 16 to 18 patients, with additional expansion under way. At the beginning of the program the hospital’s kitchen and canteen contributed all their cans and bottles, and the housekeeping staff collected newspapers from the wards. As soon as that operation was working smoothly, the program was expanded to include contributions from hospital employees. They are made through a system of ten pick-up stations5 5-gallon oil drums-scattered around the hospital grounds. In addition, a drop station for the general public was established on the hospital grounds for the collection of cans, bottles, scrap iron, aluminum, and paper. Next, area bars, restaurants, churches, and schools were asked to save cases of bottles and cans, to be Dr. Watson Veterans
14
is
acting
associate
Administration
HOSPITAL
chief
Hospital
of
staff
in St. Cloud,
& COMMUNITY
for
research
brought to the hospital weekly by hospital trucks. Some 35 establishments now participate in this phase of the program. Finally, a monthly paper drive was instituted in the community as a joint program of the hospital, a local National Guard unit, the Junior Chamber of Commerce, and a college student group. Paper is collected one Saturday each month at local shopping centers and school parking lots by Jaycees and sheltered-work patients and is transported to the hospital by National Guard trucks. The program’s sheltered workers help collect the materials, then sort and process them. Newspapers and cardboard are bundled. Cans and bottles are washed when necessary, sorted, crushed or broken, and stored in drums. The materials are then loaded on hospital trucks to be transported to the plants that buy them. Cans are sold to a Minneapolis scrap broker who bales and resells them for conversion to low-grade industrial steel. Newsprint is sold to an insulation manufacturer, who shreds and fireproofs it to produce cellulose home insulation. Aluminum, scrap metal, and corrugated cardboard are sold to local salvage dealers. All proceeds go to the patients as payment for their work. After then
newspapers for shipment
are to
collected, workshop patients an insulation manufacturer.
at the
Minnesota.
PSYCHIATRY
*\;
bale
The program now processes one-third of a million pounds of material each year, nearly 60 per cent of it newspaper. Roughly half of the material comes
from
the
hospital’s
kitchen
and
canteen
and
from
employees. However, the percentage received from the community has been increasing rapidly. Although prices obtained for the materials vary substantially, in general they have increased dramatically with the advent of energy and paper shortages. At current rates the program is grossing roughly $3900 per year. Even so, the financial return to the
workers
is modest.
tients
in our
other
sheltered-work
The
program
hourly
wage
is roughly
projects,
half
but
earned
by pa-
that
earned
it can
be
in
aug-
mented by diverting funds from other work-for-pay programs. A potential difficulty is that the hospital is located some 70 miles from its steel, glass, and paper outlets. Transportation costs could negate the program’s profits, but happily, the hospital’s engineering service provides free transportation as its contribulion to the program’s therapeutic mission. The environmental impact of the program has been substantial. Enough paper is now recycled here
each year to insulate 130 Enough glass and aluminum duce 170,000 nonreturnable
average-sized are collected
homes. to pro-
bottles and 31,000 beverage cans, and recycled cans yield enough steel for 40 Volkswagen beetles annually. In addition, the recycling program significantly cuts the amount of
landfill space used by the city of St. Cloud. As a result of the recycling program, we have been able to expand the services offered by the hospital’s sheltered-work program as well as benefit the environment. The program has been well accepted in the hospital and has added to the institution’s favorable image in the community. With the increasing need for sheltered-work programs in many hospitals, choice
we believe for those
a recycling developing
program projects
presents elsewhere.
another
The scale was adopted by the Michigan Department of Mental Health in June 1971 for use in all state hospitals for the mentally ill. The Indiana Department of Mental Health began using the scale in all state ,
institutions
various
Eder, M.S.Ed. Kukuiski, M.S.
institutions
humaneness tient, and
staff
of care by the
twice
as determined by the patients themselves.
The Rev. Donald Eder is Catholic chaplain at Logansport (md.) State Hospital and a chaplain consultant to the Indiana Department of Mental Health. The Rev. Stanley Kukulski is the Catholic chaplain at Northville (Mich.) State Hospital. Copies of the Client Satisfaction Scale and information about its use may be obtained from the authors.
in
a year.
the differences,
their own of care.
February
Chaplains
and
1974,
are
wherever
patients’
con-
possible,
perceptions
Several considerations were taken into the development of the scale. It had to applicable to a wide range of hospitals, and wards. It had to cover four areas staff and patient attitudes toward each quacy of support services; adequacy of cilities;
and
feelings
about
control
beof
the
account in be broadly programs, of concern: other; adephysical fa-
procedures,
such
as punishments and restrictions. It had to be simply worded to ensure patient comprehension. It had to be short enough to fit on a single sheet of paper. And finally, it had to be simple to score. The first questionnaire was developed by one of the authors (SK). Since then there have been several revisions, and refinements are still being made. Six people-three chaplains, two research sociologists, and a systems analyst-have played a central role in its development. In its present form, the questionnaire contains 24 questions or statements to be answered by circling yes or no. Among them are, Is there a quiet place to be alone? Do you think the food in the hospital is satisfactory? The staff treats me respectfully. Do you have a safe place to keep your Does
friend
#{149} In 1971 the chaplaincy department of Northville (Mich.) State Hospital developed a scale to measure patient satisfaction with the hospital’s treatment program. Called the Client Satisfaction Scale, it focuses
ill
of treatment as perceived by the paprovides the information needed to enable
to reduce
tween quality
who
respects
the quality perceived
mentally
sidered in the best position to administer the scale because they are not identified with the treatment team. Thus patients may be less hesitant to express their true opinions about the hospital’s services. The scale affords management a measure of the
things?
on measuring staff and as
the
the
staff
really
your bed and bedroom what is happening to helping me. I would Have you ever been hospital? Would you
A SCALE FOR MEASURING PATIENT SATISFACTION WITH HOSPITAL SERVICES Donald Stanley
for
after it had been tested in a pilot project at Logansport State Hospital. The scale is administered by chaplains at the
my
be asked
care
what
needs
help?
and
rights
as an
individual.
to complete
I think?
Are
satisfactory? Are you told you? I believe the hospital is go home tomorrow if I could. punished unfairly while in the recommend this hospital to a
the
I
same
think
the
Staff
hospital
may
questionnaire,
also
putting
themselves in the patients’ position. Scores are obtained by determining the percentage of positive responses (those favorable to the hospital) for each of the 24 items. Data from the questionnaires are keypunched onto cards and scored by computer. The first survey of patients in Michigan mental hospitals in the summer of 1972 showed that patients
they
were
satisfied
received.
VOLUME
26
But
NUMBER
with
68
that
finding
per
1 JANUARY
cent
of
raised
1975
the
the
services
question
15
G.
Watson,
Ph.D.
uSheltered workshops have grown dramatically in popularity over the last decade, not only because they provide an important alternative to work details and recreational programs but also because they can provide therapeutic benefits to certain patients. These benefits include the development of work-related skills, reinforcement of patients for productive activity, reduction of the anxiety associated with jobseeking, and occasionally the development of specific skills for use in postdischarge jobs. At the St. Cloud (Minn.) Veterans Administration Hospital the sheltered workshop begun in 1965 has been faced with increased competition for contracts with sheltered workshops being developed elsewhere in the state. As a result of our need for additional work programs and the environmental interests of several members of the workshop’s supervisory committee, a small, experimental recycling program was instituted with four to six patients in the spring of I 972. It has grown rapidly and now provides work for 16 to 18 patients, with additional expansion under way. At the beginning of the program the hospital’s kitchen and canteen contributed all their cans and bottles, and the housekeeping staff collected newspapers from the wards. As soon as that operation was working smoothly, the program was expanded to include contributions from hospital employees. They are made through a system of ten pick-up stations5 5-gallon oil drums-scattered around the hospital grounds. In addition, a drop station for the general public was established on the hospital grounds for the collection of cans, bottles, scrap iron, aluminum, and paper. Next, area bars, restaurants, churches, and schools were asked to save cases of bottles and cans, to be Dr. Watson Veterans
14
is
acting
associate
Administration
HOSPITAL
chief
Hospital
of
staff
in St. Cloud,
& COMMUNITY
for
research
brought to the hospital weekly by hospital trucks. Some 35 establishments now participate in this phase of the program. Finally, a monthly paper drive was instituted in the community as a joint program of the hospital, a local National Guard unit, the Junior Chamber of Commerce, and a college student group. Paper is collected one Saturday each month at local shopping centers and school parking lots by Jaycees and sheltered-work patients and is transported to the hospital by National Guard trucks. The program’s sheltered workers help collect the materials, then sort and process them. Newspapers and cardboard are bundled. Cans and bottles are washed when necessary, sorted, crushed or broken, and stored in drums. The materials are then loaded on hospital trucks to be transported to the plants that buy them. Cans are sold to a Minneapolis scrap broker who bales and resells them for conversion to low-grade industrial steel. Newsprint is sold to an insulation manufacturer, who shreds and fireproofs it to produce cellulose home insulation. Aluminum, scrap metal, and corrugated cardboard are sold to local salvage dealers. All proceeds go to the patients as payment for their work. After then
newspapers for shipment
are to
collected, workshop patients an insulation manufacturer.
at the
Minnesota.
PSYCHIATRY
*\;
bale
The program now processes one-third of a million pounds of material each year, nearly 60 per cent of it newspaper. Roughly half of the material comes
from
the
hospital’s
kitchen
and
canteen
and
from
employees. However, the percentage received from the community has been increasing rapidly. Although prices obtained for the materials vary substantially, in general they have increased dramatically with the advent of energy and paper shortages. At current rates the program is grossing roughly $3900 per year. Even so, the financial return to the
workers
is modest.
tients
in our
other
sheltered-work
The
program
hourly
wage
is roughly
projects,
half
but
earned
by pa-
that
earned
it can
be
in
aug-
mented by diverting funds from other work-for-pay programs. A potential difficulty is that the hospital is located some 70 miles from its steel, glass, and paper outlets. Transportation costs could negate the program’s profits, but happily, the hospital’s engineering service provides free transportation as its contribulion to the program’s therapeutic mission. The environmental impact of the program has been substantial. Enough paper is now recycled here
each year to insulate 130 Enough glass and aluminum duce 170,000 nonreturnable
average-sized are collected
homes. to pro-
bottles and 31,000 beverage cans, and recycled cans yield enough steel for 40 Volkswagen beetles annually. In addition, the recycling program significantly cuts the amount of
landfill space used by the city of St. Cloud. As a result of the recycling program, we have been able to expand the services offered by the hospital’s sheltered-work program as well as benefit the environment. The program has been well accepted in the hospital and has added to the institution’s favorable image in the community. With the increasing need for sheltered-work programs in many hospitals, choice
we believe for those
a recycling developing
program projects
presents elsewhere.
another
The scale was adopted by the Michigan Department of Mental Health in June 1971 for use in all state hospitals for the mentally ill. The Indiana Department of Mental Health began using the scale in all state ,
institutions
various
Eder, M.S.Ed. Kukuiski, M.S.
institutions
humaneness tient, and
staff
of care by the
twice
as determined by the patients themselves.
The Rev. Donald Eder is Catholic chaplain at Logansport (md.) State Hospital and a chaplain consultant to the Indiana Department of Mental Health. The Rev. Stanley Kukulski is the Catholic chaplain at Northville (Mich.) State Hospital. Copies of the Client Satisfaction Scale and information about its use may be obtained from the authors.
in
a year.
the differences,
their own of care.
February
Chaplains
and
1974,
are
wherever
patients’
con-
possible,
perceptions
Several considerations were taken into the development of the scale. It had to applicable to a wide range of hospitals, and wards. It had to cover four areas staff and patient attitudes toward each quacy of support services; adequacy of cilities;
and
feelings
about
control
beof
the
account in be broadly programs, of concern: other; adephysical fa-
procedures,
such
as punishments and restrictions. It had to be simply worded to ensure patient comprehension. It had to be short enough to fit on a single sheet of paper. And finally, it had to be simple to score. The first questionnaire was developed by one of the authors (SK). Since then there have been several revisions, and refinements are still being made. Six people-three chaplains, two research sociologists, and a systems analyst-have played a central role in its development. In its present form, the questionnaire contains 24 questions or statements to be answered by circling yes or no. Among them are, Is there a quiet place to be alone? Do you think the food in the hospital is satisfactory? The staff treats me respectfully. Do you have a safe place to keep your Does
friend
#{149} In 1971 the chaplaincy department of Northville (Mich.) State Hospital developed a scale to measure patient satisfaction with the hospital’s treatment program. Called the Client Satisfaction Scale, it focuses
ill
of treatment as perceived by the paprovides the information needed to enable
to reduce
tween quality
who
respects
the quality perceived
mentally
sidered in the best position to administer the scale because they are not identified with the treatment team. Thus patients may be less hesitant to express their true opinions about the hospital’s services. The scale affords management a measure of the
things?
on measuring staff and as
the
the
staff
really
your bed and bedroom what is happening to helping me. I would Have you ever been hospital? Would you
A SCALE FOR MEASURING PATIENT SATISFACTION WITH HOSPITAL SERVICES Donald Stanley
for
after it had been tested in a pilot project at Logansport State Hospital. The scale is administered by chaplains at the
my
be asked
care
what
needs
help?
and
rights
as an
individual.
to complete
I think?
Are
satisfactory? Are you told you? I believe the hospital is go home tomorrow if I could. punished unfairly while in the recommend this hospital to a
the
I
same
think
the
Staff
hospital
may
questionnaire,
also
putting
themselves in the patients’ position. Scores are obtained by determining the percentage of positive responses (those favorable to the hospital) for each of the 24 items. Data from the questionnaires are keypunched onto cards and scored by computer. The first survey of patients in Michigan mental hospitals in the summer of 1972 showed that patients
they
were
satisfied
received.
VOLUME
26
But
NUMBER
with
68
that
finding
per
1 JANUARY
cent
of
raised
1975
the
the
services
question
15
