The influence of hospitable design and service on patient responses

Hospital Environment and Medical Sociology: User-Centered Environmental Sociology Model Based on a Systematic Review

PURPOSE

This study investigates the relationship between environmental quality and medical sociology in hospitals and suggests a conceptual framework for understanding their interrelation.

BACKGROUND

Despite the importance of environmental properties in the sociological approach to users' health and the role of medical sociology research in the design of hospital environments, few studies have been conducted in the field of hospital environments and medical sociology interrelation. Therefore, this article attempts to fill this gap in our knowledge.

METHODS

A systematic review was carried out in five databases (Scopus, Web of Science, Google Scholar, MEDLINE, and ScienceDirect) based on PRISMA guidelines to survey how environmental quality and medical sociology factors are related in the medical/environmental sociology research and the hospital design.

RESULTS

The search yielded the final 17 potentially relevant articles after finding 3,840 records, screening 1,295 nonduplicate articles, and reviewing 158 full-text articles. The findings revealed that four main aspects of medical sociology (physical-biological, psychological, social, and economic) and hospital environmental quality (physical, social, and psychological dimensions) influence users' health and disease status. The hospital environment includes various social issues in medical sociology (like interactions, behavior patterns, lifestyle, work motivation, and culture). The physical and psychosocial factors of the hospital environment (such as spatial configuration, aesthetics, scale, privacy, and collective spaces) are associated with psychosocial aspects of medical sociology (like social class, behavior patterns, culture, and lifestyle).

CONCLUSION

Environmental features and psychosocial issues should be considered to improve users' health and experience in hospitals and to create a user-centered health-promoting environment.

Elderly users' perceptions of signage systems from tertiary hospitals in Guangzhou

Wayfinding in hospitals today is a significant challenge for urban residents, especially for the elderly. This study investigated the perceptions and attitudes of the elderly toward existing hospital signage systems to identify the wayfinding needs in the healthcare environment. This study collected 762 elderly participants' perceptions and personal preferences regarding 12 features of the existing signage systems in three hospitals in the Yuexiu, Haizhu, and Liwan districts of Guangzhou using a questionnaire methodology. The study further explored the differences in perceptions and preferences for signage based on the gender, age, and educational level of the elderly participants. The findings indicate that most of the elderly participants experienced becoming lost in the hospital; they typically chose to ask others for directions first, followed by using the signage system. Most of the elderly participants had positive attitudes toward the current hospital signage system. Furthermore, they emphasized the importance of the signage system's graphics, texts, colors, and updates, which directly affects the readability and comprehensibility of signs. We found gender differences in perceptions and attitudes toward signage; male participants had more positive attitudes toward the hospital signage systems than female participants. Additionally, consistent with previous findings, the older the age of participants, the less comprehension they had regarding signage graphic symbols. We also found that the more educated elderly participants were, the more understanding of signage they had. At the same time, however, they were less satisfied, which is possibly because the more educated they were, the more aware they were of signage issues.

A bibliometric analysis of published literature on healthcare facilities' wayfinding research from 1974 to 2020

Objectives

Wayfinding in complex environments is a public issue facing the world and has become a hot research topic in recent years. This article reviews and quantitatively analyzes the literature on wayfinding in healthcare facilities and collates the research trends and hotspots in this area.

Methods

The article used bibliometric analysis to search keywords in the Scopus database in the TITLE-ABS-KEY format. In total, 2359 articles were finally collated between 1974 and 2020 after three screening exercises, and a co-citation analysis was conducted by VOSviewer literature visualization analysis software.

Results

Research in the worldwide literature on wayfinding in healthcare facilities has grown steadily year on year since 2002. Computer science (21.5%) and social science (15.5%) are the most common subject categories, with the United States (N = 767) accounting for the largest proportion of research. “Lecture Notes In Computer Science Including Subseries Lecture Notes In Artificial Intelligence And Lecture Notes In Bioinformatics” is the most active journal in terms of publications (N = 169).

Conclusion

Wayfinding cognition, wayfinding behavior, and individual and group differences are currently the focus of research in the field of healthcare facilities. Future research on wayfinding in healthcare facilities will further investigate intelligent assistive technologies and universal designs such as universal signage systems. In addition, cross-cultural-based wayfinding research is a hot topic for future studies where the boundaries of research are broadened and have practical value.

Maternity Healthscapes: Conceptualization and Index Development

OBJECTIVES

This article provides a conceptualization and an index of the multidimensional concept of maternity healthscapes (MHS).

BACKGROUND

Healthscape has emerged as a potential key aspect to improve patient experience. Surprisingly, there has been little effort to delineate the concept of MHS from a design perspective, while maternity wards have unique characteristics and particular challenges. Indeed, patients in maternity wards are usually not acutely ill but can feel highly vulnerable due to the pain, stress, and the many uncertainties surrounding labor and delivery-which can heighten patients' need for intimacy, supporter comfort, and additional supporting services. Thus, healthscapes need to be designed to account for the specificities of childbearing and needs of those patients and their family.

METHODS

A multidisciplinary literature review and 39 in-depth interviews were conducted with various stakeholders-mothers, midwives, heads of midwives, and chief executives.

RESULTS

The authors develop a conceptualization to establish a comprehensive understanding of the dimensionality of MHSs. Based on that comprehensive conceptualization, the authors develop an index providing a census of the aspects in the MHS that various stakeholders-such as healthcare providers, designers, and architects-should take into account when conceiving MHS.

CONCLUSIONS

Healthcare providers, designers, and architects can use this conceptualization and index to closely monitor and measure for evaluations and further improvements of the MHS, thereby enhancing patient experience in maternity wards.

The Psychological Supportive Design Features in Hospitals: Case of a Public Jordanian Hospital in Amman

PURPOSE

The purpose of this study is to develop a practical framework that combines the psychological supportive design features in hospitals' healing environments, also, to examine the implementation of these features in a Jordanian public hospital.

BACKGROUND

Positive psychological feelings are the hidden powerful treatment in hospitals. Although that Jordan represents a third-world country, it is counted as one of the most sought-after healthcare locations in the Middle East for its distinguished healthcare serveries (Private Hospitals Association, 2019). Nevertheless, the architectural and interior design of the healthcare facilities in Jordan usually ignores the inpatients' psychological needs. Also, there is an absence of practicing a set of psychological supportive design features to guide the hospitals' design in Jordan.

METHOD

Design features are obtained from the main theories in the field of supportive healing environments. A large Jordanian public hospital was selected to be assessed in terms of these features within the developed practical framework. This study adopts a mixed methodology; data are collected using different methods, mainly literature review, site inventory, and inpatients' questionnaire.

RESULTS

The studied hospital remains moderately considerable in terms of the psychologically supportive design features. However, the nature connectivity aspect is not satisfactorily considered in the studied hospital design.

CONCLUSION

This study suggests a responsive design that fosters interaction and integration with surrounding nature in order to increase levels of connectivity with nature. The studied design features in this study could work as guiding principles for Jordanian hospitals' designers.

Examining the Business Case for Patient Experience: A Systematic Review

EXECUTIVE SUMMARY

Hospitals, physician groups, and other healthcare providers are investing in improved patient care experiences. Prior reviews have concluded that better patient care experiences are associated with less healthcare utilization and better adherence to recommended prevention and treatment, clinical outcomes, and patient safety within hospitals. No comprehensive review has examined the business case for investing in patient experiences. This article reviews the literature on associations between patient experience-measured from the perspective of patients and families-and business outcomes, including patient allegiance and retention, complaints, lawsuits, provider job satisfaction, and profitability. We searched U.S. English-language peer-reviewed articles from January 1990 to July 2019. We followed the preferred reporting items for systematic reviews and meta-analyses guidelines and undertook a full-text review of 564 articles, yielding the inclusion of 40 articles. Our review found that patients with positive care experiences are more likely to return to the same hospital and ambulatory settings for future healthcare needs, retain their health plan, and voice fewer complaints. Associations between patient experiences and profitability or provider job satisfaction were limited/mixed. This suggests that providers can pursue better patient care experiences for the intrinsic value to patients, while also recognizing it is good for intermediate business outcomes: specifically increased recommendations, better patient retention, and fewer complaints. Nursing and physician care, broadly defined, are the only specific aspects of patient experience consistently associated with retention, with evidence pointing to communication and trust as parts of care linked to the intent to return. These aspects of patient experience are also the largest contributors to the overall ratings of a provider or facility.

What matters to patients? A mixed method study of the importance and consideration of oncology patient demands

Background

A patient-centred approach is increasingly the mandate for healthcare delivery, especially with the growing emergence of chronic conditions. A relevant but often overlooked obstacle to delivering person-centred care is the identification and consideration of all demands based on individual experience, not only disease-based requirements. Mindful of this approach, there is a need to explore how patient demands are expressed and considered in healthcare delivery systems.

This study aims to: (i) understand how different types of demands expressed by patients are taken into account in the current delivery systems operated by Health Care Organisations (HCOs); (ii) explore the often overlooked content of specific non-clinical demands (i.e. demands related to interactions between disease treatments and everyday life).

Method

We adopted a mixed method in two cancer centres, representing exemplary cases of organisational transformation: (i) circulation of a questionnaire to assess the importance that breast cancer patients attach to every clinical (C) and non-clinical (NC) demand identified in an exploratory inquiry, and the extent to which each demand has been taken into account based on individual experiences; (ii) a qualitative analysis based on semi-structured interviews exploring the content of specific NC demands.

Results

Further to the way in which the questionnaires were answered (573 answers/680 questionnaires printed) and the semi-structured interviews (36) with cancer patients, results show that NC demands are deemed by patients to be almost as important as C demands (C = 6.53/7 VS. NC = 6.13), but are perceived to be considered to a lesser extent in terms of pathway management (NC = 4.02 VS C = 5.65), with a significant variation depending on the type of non-clinical demands expressed. Five types of NC demands can be identified: demands relating to daily life, alternative medicine, structure of the treatment pathway, administrative and logistic assistance and demands relating to new technologies.

Conclusions

This study shows that HCOs should be able to consider non-clinical demands in addition to those referring to clinical needs. These demands require revision of the healthcare professionals’ mandate and transition from a supply-orientated system towards a demand-driven approach throughout the care pathway. Other sectors have developed hospitality management, mass customisation and personalisation to scale up approaches that could serve as inspiring examples.

Psychological impact of covid-19 crises on students through the lens of Stimulus-Organism-Response (SOR) model

The present outbreak of the Covid-19 pandemic has affected 28,584,158 people world-wide as of 13th September 2020 (WHO, 2020b). This crisis has created an atmosphere of uncertainty and fear. Due to the unavailability of the evidence based medical treatment, non-pharmaceutical interventions (NPIs) are the best options at the present moment. Lockdown was one of such measures to control the spread of the Covid-19 disease. Due to lockdown measures, many countries across the globe followed the complete closure of shopping malls, transport networks, schools, universities, etc. This study aims to investigate the behavioural psychological changes among university students due to covid-19 crises and lockdown. Stimulus-Organism-Response (SOR) model has been adopted to develop a theoretical foundation for the research. Qualitative research methodology including a combination of personal interviews and focus groups has been adopted in the study to develop the themes with the help of computer-assisted qualitative data analysis software, Atlas.ti 7. It has been found that students are suffering from academic anxiety, fear, Mysophobia, etc. As far as behavioural responses are concerned following behavioural changes have been found; Panic buying, e-learning, community support, support for prime-minister, etc.

Visioning a hospitality-oriented patient experience (HOPE) framework in health care

Purpose

This paper considers the question: what would happen if healthcare providers, like their counterparts in the hospitality industry, adopted the principles of customer experience management (CEM) in order to facilitate a more holistic and personalized patient experience? It proposes an alternative vision of the patient experience by adding to an emerging hospitality–healthcare literature base, this time focusing upon CEM. A hospitality-oriented patient experience (HOPE) framework is introduced, designed to enhance the patient experience across all the touchpoints of the healthcare journey.

Design/methodology/approach

This is a conceptual paper that draws upon three distinct literatures: hospitality literature; healthcare literature; and CEM literature. It utilizes this literature to develop a framework, the HOPE framework, designed to offer an alternative lens to understanding the patient experience. The paper utilizes descriptions of three unique patient experiences, one linked to chronic pain, a second to gastro issues and a third to orthopedic issues, to illustrate how adopting the principles of hospitality management, within a healthcare context, could promote an enhanced patient experience.

Findings

The main theoretical contribution is the development of the HOPE framework that brings together research on CEM with research on cocreative customer practices in health care. By selecting and connecting key ingredients of two separate research streams, this vision and paradigm provide an alternative lens into ways of addressing the key challenges in the implementation of person-centered care in healthcare services. The HOPE framework offers an actionable roadmap for healthcare organizations to realize greater understanding and to operationalize new ways of improving the patient experience.

Originality/value

This paper applies the principles of hospitality and CEM to the domain of health care. In so doing it adds value to a hospitality literature primarily focused upon extensive employee–customer relationships. To a healthcare literature seeking to more fully understand a person-centered care model typically delivered by a care team consisting of professionals and family/friends. And to a CEM literature in hospitality, which seeks to facilitate favorable employee–customer interactions. Connecting these separate literature streams enables an original conceptual framework, a HOPE framework, to be introduced.