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Improving Patient Satisfaction through Bricks and Mortar

SSOEBy Craig Pickerel

With more healthcare systems adopting a pay-for-performance model as a way to improve the quality and cost-effectiveness of healthcare services, the impact of patient satisfaction scores continues to play an ever-increasing role in the way hospitals are evaluated.

Starting in 2012, Medicare will begin using patient satisfaction scores to determine part of its reimbursements to hospitals. Because reimbursements will be linked to patient satisfaction and not just outcomes, the design and construction of facilities need to be geared toward creating the most positive patient experience possible. Well-designed healthcare facilities will not only contribute to producing measurable results and positive outcomes, but can also change the perception of the care provided.

Research shows these perceptions can make waiting times appear shorter, make patients feel they are receiving better treatment and make staff appear more welcoming and responsive.

Because few patients have the specialized knowledge to evaluate staff on diagnostic abilities and technical expertise, patients tend to base experience on what they visually see and understand, such as the design of the physical environment.

Even before entering the facility, patients will begin to associate the quality of care with the exterior of the building and the maintenance of the grounds and landscaping. If the landscaping provides a welcoming environment and is well-maintained, people perceive they will receive better treatment. But if the site and landscaping look disheveled and untidy, patients will not anticipate receiving quality care.

A major factor that impacts the way patients rate a visit is through interactions with staff members. The first encounter with staff, typically with the hospital receptionist or greeter, can set the mood for the entire visit and can influence a patient’s impression negatively or positively. Providing a designed space that facilitates positive interaction and communication with staff is essential. An open space with good visibility and accessibility to the receptionist, along with good acoustics to allow for clear communication and privacy, can greatly contribute to a positive first impression of the staff.

Often the most significant predictor of patient satisfaction is waiting times. In the emergency department, reducing actual wait time is important, but the patients’ perception of time spent waiting can be equally important. The term “waiting room” is just that, a room to wait. Patients and visitors expect it. With patients typically under a certain level of anxiety and vulnerability while waiting for test results or an exam, hospitals face the challenge of not exceeding expected wait times. Providing positive distractions becomes critical in the design of healthcare waiting areas, and can be achieved through visual artwork, different seating and waiting arrangements, and providing views to nature and daylight.

The waiting area is a space that can set the tone for the entire visit. Offering different types of seating arrangements and waiting configurations allow patients to choose seating based on individual needs and preference. Waiting rooms should provide comfortable seating areas with access to privacy zones for patients and families, while having views to the outdoors and plenty of natural daylight. Numerous research studies have shown the physical and psychological benefits of offering views to the outdoors and daylighting. Having access to views and daylight can reduce stress and anxiety, lower blood pressure, reduce the need for pain medication, improve recovery times and reduce the length of hospital stays. If patients cannot get comfortable in the waiting area, they will carry heightened anxiety and stress levels to the exam room. A well-designed waiting experience has the potential to improve the perception of the quality of care and patient satisfaction.

The American Medical Association has shown in research that certain types of artwork can act as a positive distraction by reducing stress and anxiety during a patient visit. Art is often the most visible component of a space. Different forms of visual artwork can create positive diversions and help take a patient’s mind off of pain or stress, thereby helping to reduce perceived waiting times.

Patients typically spend the majority of time recovering in their room, so the design of the room should allow for an easy transition from home life. Rooms should be designed to support patient healing and family involvement. Family zones should offer accommodations for visitors to stay overnight and to assist in the care and recovery of the patient. Rooms should include cable television, wireless Internet, music and movies. Having a desk with workspace to plug in a laptop can allow family members and visitors to keep up with emails and work while being away from the office. Providing the option for direct ordering of meals and concierge services can make the patient feel like a valued guest. Offering a wide range of amenities for all genres, such as a secure patient garden or operable windows, increases the likelihood that each patient will have activities and different forms of entertainment to make recovery a positive experience.

Providing world-class care to the patient with a focus on positive outcomes always needs to be the driving factor in the way healthcare systems operate. In such a competitive market, not only are outcomes measured, but also how a patient rates an experience. Creating designed environments that can improve patient satisfaction may help to acquire new patients while sustaining existing patients. There are numerous ways hospitals can change the perception of care that is provided within a healthcare facility. These perceptions may give healthcare systems an edge against the competition, while providing the opportunity to receive more in reimbursements as the healthcare industry moves more toward a pay-for-performance model.

Craig Pickerel, AIA, NCARB, LEED AP BD+C, EDAC, is a lead project architect at SSOE Group. He is focused on delivering efficient healing environments for a variety of healthcare facility types. Pickerel is a leader in the implementation of Evidence-Based Design concepts — with an emphasis on patient-focused care, lean principals and sustainable design. He can be reached at 419-255-3830 or


Posted December 14, 2011

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