Better hospitals begin with better design

For many patients, the encounter with the hospital begins long before their first conversation with a doctor or nurse. It starts in the car park, at the entrance, or in the long corridors where they try to find their way. It is here that first impressions are formed – impressions that shape the patient’s sense of safety, control and trust, and which may be crucial in determining how they enter into a course of treatment.
According to architect and Associate Professor at Kolding School of Design, Sofie Kinch, it is precisely in these first encounters with the hospital’s physical environment that trust can either be strengthened or undermined.

- The physical setting of hospitals is never neutral. It communicates values and priorities – or the lack of them. Unfortunately, many patients experience arriving at hospital through confusing underground car parks and entrance areas that appear worn and unwelcoming. Inside, the impression often continues with long, uniform corridors that can make it difficult to find one’s way – particularly if you are already feeling anxious or worried,” says Sofie Kinch, emphasising that this does not mean staff fail to deliver high professional standards.

Patients most often encounter friendly and highly competent staff. Yet the physical surroundings play an independent role in shaping the overall experience of the hospital.

- You could say that design constitutes a quiet or silent form of communication between the hospital and the patient, she adds.

The hospital seen through the patient’s eyes
Researchers from Helse Fonna, Western Norway University of Applied Sciences and the University of Stavanger have recently examined how patients experience hospital design, functionality and sensory qualities. More than 600 patients from two hospitals were asked about their first impressions and their experience of the surroundings.

The results show that patients are generally “slightly satisfied” with colours, interiors and architecture, and “moderately satisfied” with the hospitals’ physical condition. The same applies to signage, information and the experience of being able to find one’s way around.

- This is not about grand architectural gestures, but about everyday details. Together with architect and Senior Researcher Carlo Volf from Bispebjerg Hospital, I am part of an interdisciplinary team with the Norwegian researchers, where we are investigating how light, materials and spatial qualities become parameters that also influence patients’ treatment experiences in hospital, says Sofie Kinch, who leads the research programme Playful Care at Kolding School of Design.

There may be many reasons why some hospital environments appear neglected. Limited budgets for maintenance and cleaning over many years are one explanation. When resources are tight, technical installations and medical equipment are often prioritised over entrance areas, shared spaces and visual qualities.

However, Sofie Kinch points out that even small initiatives and deliberate design choices can make a crucial difference to patients’ experience of quality and professionalism – and may help reduce the cognitive strain on both patients and relatives who are already ill or concerned:

- It could be better lighting, updated and consistent signage, a review of information materials, and greater attention to order and maintenance in the areas patients encounter first.

The researchers behind the study therefore encourage hospitals to occasionally view their facilities through the patient’s eyes: What does the entrance look like? Is it tidy? Is the information up to date? Are the clocks accurate? Is it easy to find your way?

- Small improvements can have a significant impact – not only for patients, but also for staff. When the surroundings signal care, order and quality, they support the expertise and professionalism that hospital employees already deliver every day. Design cannot replace good treatment, but it can help underpin it, Sofie Kinch concludes.

Background
In a joint contribution to the Norwegian medical journal Dagens Medisin, the researchers argue that hospital environments should reflect the professionalism embodied by healthcare professionals.
Read the full article: Førsteinntrykket betyr meir enn du trur

Authors:
Eva Biringer, Medical Doctor and Senior Researcher, Helse Fonna HF / Associate Professor, Western Norway University of Applied Sciences
Morten Nordal, Medical Doctor, Helse Fonna HF
Heiko Bratke, Consultant Paediatrician and Researcher, Helse Fonna HF / Associate Professor, University of Bergen
Carlo Volf, Architect and Senior Researcher, Psychiatric Centre Copenhagen / Competence Centre for Affective Disorders, Capital Region of Denmark, Copenhagen University Hospitals, Copenhagen, Denmark
Sofie Kinch, Architect and Associate Professor, LAB for Play Design, Kolding School of Design, Kolding, Denmark
Heidi Bringsvor, Intensive Care Nurse and Postdoctoral Research Fellow, Helse Fonna HF / Associate Professor, Western Norway University of Applied Sciences