The Built Environment as a Component of Quality Care: Understanding and Including the Patient’s Perspective

Fowler, E.; MacRae, Susan K; Stern, Amy; Harrison, Teresa M.; Gerteis, Margaret; Walker, Jan; Edgman‐Levitan, Susan; Ruga, W

doi:10.1016/s1070-3241(16)30450-3

Cited by 20 publications

(14 citation statements)

References 9 publications

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“…Interviewees expressed their desire to be able to have a sense of control over their actions, facilitated by good design to enable them to move around the ward area, open and close curtains, control lights and temperature, and access external areas of the building facilitated by good design which aided rather than hindered their ability to retain a sense of normality. This finding supports previous studies, which have reported how fostering a sense of control, providing information and allowing patients to take responsibility for aspects of their care reduces helplessness and improves other outcomes 8,11,23–26 . This is an area requiring further research in respect of the potential to improve patient outcomes through introducing innovative design ideas that support and increase patients personal control.…”

Section: Discussionsupporting

confidence: 88%

“…In one of the earliest studies of the important role of hospitals as healing environments, Ulrich 9 suggested that stress was a major obstacle to healing and that the wellbeing and recovery of patients was directly related to the physical environment of the hospital and its health care facilities. Later studies suggest that the hospital environment is itself a ‘healing landscape’ that has a distinct effect on the health and recovery of patients 10,11 …”

Section: Literature Survey and Research Reviewmentioning

confidence: 99%

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Patient‐friendly hospital environments: exploring the patients’ perspective

Douglas

2004

Health Expectations

125

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Objective To investigate the perceptions and attitudes of patients to the built environments of NHS Trust hospitals, in order to inform design excellence so as to make future hospitals places and spaces responsive to patient needs.Design An exploratory study of patients perceptions based on qualitative semi-structured personal interviews.Setting and participants Fifty one-to-one interviews held with hospital in-patients across the four directorates of surgery, medicine, care of the elderly and maternity at Salford Royal Hospitals NHS Trust, Salford, UK.Results The research found that there was much similarity in the priorities, issues and concerns raised by patients in each of the four directorates. Patients perceived the built environment of the hospital as a supportive environment. Their accounts in each area pointed to the significance of the factors that immediately impacted on them and their families. Patients identified having a need for personal space, a homely welcoming atmosphere, a supportive environment, good physical design, access to external areas and provision of facilities for recreation and leisure. Responses suggest that patient attitudes and perceptions to the built environment of hospital facilities relates to whether the hospital provides a welcoming homely space for themselves and their visitors that promotes health and wellbeing.Conclusions The findings have important implications for capital development teams, clinical staff, managers and NHS Estates personnel. Although the study has immediate relevance for Salford Royal Hospitals Trust, findings and recommendations reported provide NHS Estates and other relevant stakeholders with evidencebased knowledge and understanding of patients' perceptions and expectations of and preferences for particular facilities and estates provision in NHS hospitals.

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Section: Discussionsupporting

confidence: 88%

Section: Literature Survey and Research Reviewmentioning

confidence: 99%

Patient‐friendly hospital environments: exploring the patients’ perspective

Douglas

2004

Health Expectations

125

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“…Home time might represent proactive hospice enrollment near end of life or mask difficulty of seeking appropriate medical care due to socioeconomic barriers. Nevertheless, time spent at home is generally acknowledged to provide individuals more psychological comfort and improved quality of life than time at a healthcare facility . Second, the home time measured in this study encompassed the calendar year of 2011 (January to December); however, patient‐centered outcomes were measured during the interviews conducted in the fall.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, time spent at home is generally acknowledged to provide individuals more psychological comfort and improved quality of life than time at a healthcare facility. 19,20 Second, the home time measured in this study encompassed the calendar year of 2011 (January to December); however, patient-centered outcomes were measured during the interviews conducted in the fall. Thus, the survey may have not captured changes in patient-centered outcomes after the 2011 fall survey.…”

Section: Discussionmentioning

confidence: 99%

Home Time as a Patient‐Centered Outcome in Administrative Claims Data

Lee

Shi

Kim

2018

J American Geriatrics Society

131

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BACKGROUND Home time, the number of days alive and spent out of hospital and skilled nursing facility, has been proposed as a patient‐centered outcome that can be readily calculated in administrative claims data. OBJECTIVES To compare home time against existing patient‐centered outcome measures. DESIGN Retrospective cohort study. SETTING Community. PARTICIPANTS A total of 4594 Medicare beneficiaries 65 years or older with complete survey and claims data in the Medicare Current Beneficiary Survey 2010 to 2011. MEASUREMENTS Home time was calculated from the 2011 claims data (range, 0‐365 days). The 1‐year incidence of patient‐centered outcomes (poor self‐rated health, mobility impairment, depression, limited social activity, and difficulty in self‐care) was measured. The minimum clinically important difference (MCID) was derived by contrasting the mean home time between those who experienced functional decline or death and those who did not. RESULTS The mean home time was 355.8 days (SD, 42.1 days); 84.1% had a home time of 365 days, and 5.7% had a home time of 336 days or fewer. The incidence of poor self‐rated health ranged from 2% (home time, 365 days) to 21% (home time, less than 337 days). Similarly, the corresponding incidence risks were 11% to 59% for mobility impairment, 5% to 19% for depression, 17% to 67% for limited social activity, and 13% to 68% for difficulty in self‐care. The risk of mobility impairment, depression, and difficulty in self‐care increased steeply after home time loss of 15 days or greater. The MCID of home time was 18.6 days. CONCLUSION A loss in home time is associated with decline in several patient‐centered outcome measures in community‐dwelling Medicare beneficiaries. These results provide empirical evidence to promote adoption of home time and its clinical interpretation for database studies of medical interventions. J Am Geriatr Soc 67:347–351, 2019.

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“…tangibles dimension) can have an influence on client perceived quality of care (29). For instance, homely environments that promote acquaintance between client and care providers and those that promotes a sense of well-being, have been deemed by patients as satisfying with regard to the quality of the care received (30). Appealing health-care built environment may also result in a more favorable evaluation of service providers by patients (31).…”

Section: Discussionmentioning

confidence: 99%

The Quality Gap in the Services Provided by Rural Maternity Units in Southeast of Iran

et al. 2015

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Background:Providing high-quality maternity services is crucial to increase utilization of these services and reduce maternal mortality. The quality of the maternity services provided to pregnant women in rural areas of Iran is poorly understood. Objectives: This study aimed to investigate the quality gap in the maternity care services provided by Rural Delivery Facilities and Safe Delivery Posts in Sistan and Balouchestan Province, southeast of Iran, as expressed by the difference in women's perceptions and experiences of services. Patients and Methods:In this cross-sectional study a total of 438 pregnant women who gave birth in rural maternity unit were recruited between February and May 2013. The SERVQUAL questionnaire was used for data collection. The Wilcoxon Signed-Rank test was used to compare the quality gap as expressed in the mean of differences in the expectation and perception scores. The quality gap was compared between demographic groups using Kruskal-Wallis tests. Results: There was a negative gap in all dimensions of the quality of services provided. The highest quality gap was found for the reliability dimension followed by tangibles, empathy, assurance and responsiveness. The participants' age, levels of education and the type of maternity unit were found to be associated with the clients' perceived quality of services. Conclusions:The quality gap in the services provided by maternity units showed that these units are not able to meet pregnant women's expectations completely. The negative quality gaps can be used as a guideline to improve the maternal health care quality and reduce maternal mortality, particularly in high-risk women such as those living in rural areas.

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The Built Environment as a Component of Quality Care: Understanding and Including the Patient’s Perspective

Cited by 20 publications

References 9 publications

Patient‐friendly hospital environments: exploring the patients’ perspective

Patient‐friendly hospital environments: exploring the patients’ perspective

Home Time as a Patient‐Centered Outcome in Administrative Claims Data

The Quality Gap in the Services Provided by Rural Maternity Units in Southeast of Iran

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