Abstract: Evaluating Communication in Patient Room Design: Employing a Multidimensional Framework for Assessment

◆ Lindsey Fay, University of Kentucky
◆ Joshua Santiago, University of Kentucky
◆ Kevin Real, University of Kentucky

Background: The patient room is the primary site for communication between providers and patients/families within hospitals. Today, private rooms have become the industry standard and have been linked with improvements in patient care, patient and family satisfaction, social support, privacy, and enhanced communication (Nunes de Matos et al., 2019, Ulrich et al., 2008). Although there are a multitude of studies that examine the effects of patient rooms on patients, significantly less research has been done on the effects of these room types on healthcare professionals (Ulrich et al., 2010).
Purpose: This study aims to address several research questions including: What specific attributes of patient room designs are most beneficial to healthcare professionals? What are the implications of these attributes on communication? And lastly, do particular healthcare professionals hold certain beliefs about patient room attributes?
Method: Various patient room designs were analyzed as a cardiovascular service line in an urban, academic hospital moved to a new unit. This study employed a multimethod, pre and post-move, quasi-experimental research design to analyze staff perceptions of various patient room designs, including multibed and private rooms. Qualitative data were collected including fourteen focus groups and one interview among 74 healthcare professionals. A quantitative descriptive content analysis was conducted to reveal if the nature of the focus group statements was positive, negative, or neutral. Analysis of the data was guided by Pati et al. (2009) framework for assessing patient room designs.
Results: Findings indicate three emerging themes from the pre/post investigation that contribute to communication in the patient room: staff efficiency, patient safety, and respect for patient environment. The outcomes found a positive improvement with regard to staff efficiency, specifically as it relates to clearance around the patient bed (provider to provider communication) and access to data (enhanced communication with patient/family). Patient safety was widely discussed and revealed links between visibility and communication, particularly due to the specification of solid wood doors limiting visibility and improved caregiver access to provide patient centered communication. Respect for the patient environment involved auditory privacy, access to daylight, and views of the exterior, all of which contribute to better patient-provider communication. Prior published work by (authors, 2018) employed patient and staff questionnaires to determine that nursing staff and patients preferred the larger, private patient room settings in the post-move study, yet reported lower levels of satisfaction with regards to communication post-move. The healthcare professional groups that offered the greatest depth of information relative to patient room design were the nurse groups, therapists, and interdisciplinary members of the care team station.
Implications: Scholarship in patient room design contributes to our scholarly understanding of the importance of where most communication occurs within hospitals. It is increasingly important to consider a variety of stakeholder perceptions on how patient room configuration may impact communication and care delivery. Although the physical environment is often an invisible factor in communication research, this study provides further understanding of how patient room design affects communication and patient care processes in hospital settings.