Measuring the impacts of hospital nursing floor and patient room layouts on patients’ experience with care in a major teaching hospital
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While a growing body of literature suggests that the layout of inpatient hospitals impacts a range of outcomes such as noise, falls and mortality, the research has not yet established systematic association between layout and patient experience of care. Experience of care is of growing importance to hospitals with the adoption development of the 1995 Consumer Assessment of Healthcare Providers and Systems program (CAHPS). The CAHPS Hospital Survey tool (known as HCAHPS) has become the leading indicator for quality and as well as other patient satisfaction surveys which publically report the patient experience known as patient self-reported outcome. Previous research has focused on service excellence through staff development, improvement of key service behaviors, and understanding of the influence of patient characteristics. The purpose of this study is to identify associations between spatial variables in the room and unit and patient self-reported outcomes such as Press-Ganey and HCAHPS patient satisfaction scores. This retrospective research study examines 17 units with 81 inpatient room types over 2 to 5 years at a large teaching hospital. This study identifies spatial measures shown through previous research to influence layouts and explores their statistical associations with standard patient satisfaction measures including both HCAHPS and Press-Ganey patient satisfaction surveys. Five primary spatial measures were identified and analyzed: window width, room handedness, head of the bed location, distance to the nurse station, and location of first encounter. Two separate phases of analysis were conducted: a preliminary study of 3,751 respondents in a limited Disease Related Group (DRG) and a general study expanded to 4,615 respondents with a broader range of DRGs. Finding indicate that there are statistically significant relationships between all of the five spatial measures analyzed and specific questions in the surveys pertaining to perceived nursing, physician, individual care and overall room variables. The results emphasize the importance of hospital design on patient satisfaction outcomes of importance to healthcare systems.