Published by: The Center for Health Design
Research Coalition
File Size: 3.5 MB

Abstract:

The catalyst for this study was the need to establish research agenda for healthcare environments. A critical step prior to selecting the important research questions, is establishing criteria and methods for the selection process. However, the choice of topics to be researched and the selection of interventions to be tested in healthcare environments are often determined by investigators and sponsors in a pre-scientific way.

This study focused on critical problem areas and unresolved issues as the universe of topics from which viable, important research questions can be generated. These questions can form a systematic, problem-driven research agenda. Ultimately, the research information will lead to more informed design, improved environments, and better healthcare.

The objective of the project was to identify and describe critical issues in three healthcare environments—hospital, ambulatory, and long-term care settings, specifically focusing on issues and problems which have a bearing on the physical environment.

The survey findings addressed four themes: critical issues, locations where problems occur, the relationship between problems across facility types, and how different stakeholders responded. Over 100 most critical issues in healthcare environments were identified. Top ranked problems included patient care and safety issues, such as hospital acquired infection (HAI), errors, and falls; patient and user satisfaction issues, such as reducing stress, increasing physical, social, and psychological comfort; and operational efficiency issues, focusing on patient care flow and care procedures. Specific places associated with either more or greater problems—or both—in all facilities were generally spaces where the most significant patient care was delivered, such as patients’ rooms, treatment and exam rooms, diagnostic and treatment spaces, preoperative and recovery spaces, and staff work areas. Waiting areas and parking areas were places where user satisfaction issues also became evident along with outdoor activity areas in long-term care. All settings shared many issues, but the extent and focus of shared problem areas varied significantly among care settings. In addition, each setting type had its own unique issues. The study revealed that different groups of stakeholders assessed differently many problems in healthcare environments.