Design and Operational Considerations
We describe architectural techniques for improving the quality of patient sleep and engaging family care partners that are backed by evidence as improving health outcomes. Download PDF of the full article: Patient Experience
As providers face increased competition and regulations that tie reimbursement to patient satisfaction, improving the patient experience represents a significant opportunity. For hospitals that elect not to prioritize this aspect of care, the patient experience can become a serious risk. At FreemanWhite, we help providers implement process improvements, overcome obstacles that limit patient satisfaction, and develop staff accountability systems. Above all, we seek to help staff recognize the enormous impact of patient satisfaction, particularly in emergency care.
A successful patient satisfaction initiative does more than improve the quality of care and boost patients’ perception of care. It also builds respect between healthcare professionals and patients, promotes staff accountability, and improves public opinion of the professionals at a facility. In working with providers throughout the country, FreemanWhite staff has helped clients alleviate a wide range of weaknesses affecting the patient experience. While each provider faces unique challenges, we find that certain areas consistently provide opportunities for improvement.
Helping Patients Get a Better Quantity and Quality of Rest
Patients frequently suffer from poor sleep when hospitalized, leading to increased stress, impaired immune function, ventilatory compromise, and disrupted thermoregulation. Studies show that these effects may hinder the healing process and contribute to increased morbidity and mortality.
The following environmental approaches have shown promising results in improving patient sleep:
- Specifying wall treatments, ceiling and flooring materials that absorb noise
- Sound absorbing panels at nurse stations
- Noiseless paging systems
- Subtle lighting for the nurse entering a room at night to maintain circadian rhythms
- Examining everything that makes a sound – even hinges on closet doors
At FreemanWhite, we are committed to integrating data and research in our architectural solutions.
Research has shown that better staff-family communication in the hospital increases the level of family members’ involvement in providing care for the patient at home, which can contribute to reduced readmissions. Our family-centered designs encompass a number of concepts that provide a comfortable environment and social support, enabling families and friends to continuously care for their loved ones. Some of our family-centered design concepts include:
- Designing family sub-waiting/lounge spaces in clinical areas that allow family members to take a break from the oftentimes stressful environment at the bedside. These are also an opportunity to stay close by and offer convenient and efficient consultation when it is advantageous to step away from the patient.
- Changing the shape of public/waiting spaces to create modular family areas, allowing for greater privacy.
- Providing positive distractions such as listening to music (with headphones!) or computer access for family members who need to work while attending to their loved one.
- Dedicated staff and family zones within the patient room. Although not new, we continue to see the benefits of providing separate family and staff zones for room participants to occupy without impinging upon one another’s responsibilities. In many of our inpatient room designs, we provide a family zone with a desk, sleeper sofa, technology access, and controllable lighting. Staff can complete charting or documentation at the patient’s bedside and simultaneously maintain a conversation with the patient and family. Patients frequently report their appreciation for these amenities in our clients’ FSICU 24 satisfaction surveys.
We frequently help clients implement strategies to increase understanding of patients’ perspective, eliminate errors, address medical issues efficiently, honor privacy and confidentiality concerns, and reduce apathy. Our team of experts deploys process mapping, computer simulation, and interactive data dashboards to help clients maximize their people, procedures, technology, and infrastructure. When we streamline door-to-room, door-to-provider, and door-to-treatment times, we reduce unnecessary waiting and ensure patients and families feel cared for throughout their visit. And although this innovative and proprietary technology goes a long way to enhance positive change, it is the experience of our people and our ability to facilitate effective and lasting change that is our most powerful tool.
We design our improvement initiatives to be implemented systematically, with the goal of achieving specific outcomes. Raising patient satisfaction scores above the baseline measurement is our most obvious measure of success. However, we also recognize the importance of sustaining these efforts. Our expertise in creating lasting change is based on our ability to help staff improve communication, understand patient expectations, increase the ability to identify and resolve problems in patient satisfaction, and build credibility and trust.
The Biggest Impact: Helping to Impact Cultural Change
To achieve these goals, our consultants use numerous tools, which we have tested and refined in the field. We work closely with management to achieve appropriate nurse-to-patient ratios, implement team staffing models, and review physician zoning and staff rounding procedures. We also evaluate the feasibility of support services, such as concierge programs. In addition to patient satisfaction surveys, we use benchmark data to help hospitals understand how they compare with in-market competition and out-of-market best practices leaders.
Although senior management may genuinely seek to create a culture that promotes patient satisfaction, we often find that clinical staff resists ownership of their potential influence. Accordingly, our engagements also focus on helping staff support the value that patient satisfaction is an important component of care. We help management implement tools to effectively measure patient satisfaction and to hold staff accountable for related initiatives. (From the blog: Four Ways Staff Can Improve Patient Satisfaction With Scripting)
An important part of improving the patient experience is to clearly define a successful outcome. We work with providers to create and achieve a unique vision of exceptional care. Often, this requires building a culture dedicated to a very low occurrence of customer complaints, ongoing communication, and other hallmarks of a positive patient experience. We help providers attain this vision and, in the process, solidify market share by increasing return visits and enhancing public reputation.
ABOUT THE AUTHOR Mark Furgeson AIA ACHA
Mark is an adjunct professor at Cornell University co-teaching a course on the intersection of policy and design in the School of Design and Environmental Analysis. The course investigates Evidence Based Design (EBD) with the intention of clarifying the uncertainty regarding scientific evidence and the investment in facilities. This experience provides FreemanWhite access to world class research and a unique perspective regarding the components of EBD that are most beneficial to Healthcare.