Make it Pretty and They Will Come: The Role of Aesthetics in Patient Satisfaction

Woodwinds Health Campus

Garden bench at Woodwinds Health Campus, photo courtesy of Woodwinds Health Campus

Like most people, I’ve had my fair share of unpleasant experiences in doctors offices and hospitals. And looking back, I realize that many of my most worst memories had to do with the way the place looked. The one that took the cake was a doctor’s office in a windowless clinic with one potted plant in the waiting room. And that plant, a Poinsettia from Christmas-time (this was in February) was dead. Even if only on a subliminal level, we perceive that something is wrong with this picture: “If they can’t even take care of one houseplant, how the heck are they going to take care of me?” I have heard many people, when talking about the gardens in a hospital, clinic, or nursing home or other place of healing, express the opposite sentiment: “They take such good care of the gardens, and that reassures me that they will take good care of me, too.”

I’m reading an article from an old (2008) issue of Healthcare Environments Research & Design Journal (HERD), titled “Ambulatory Facility Design and Patients’ Perceptions of Healthcare Quality,” which completely reinforces what we all know in our hearts to be true: That places of healing work better when they look and feel like…places of healing. And I’m talking, of course, about a more holistic idea of healing than just “isolate, sterilize, and medicate.” Squeaky white linoleum floors that reflect buzzing fluorescent lights attached to low ceilings in long, windowless corridors is an old model that has been proven to be anything but good for our health.

So, let me just share a few nuggets from this article. First, its conclusion, as stated in the abstract: “This study is consistent with other studies that examined the relationship among the physical attractiveness of healthcare settings, patient satisfaction, and quality of care.” Patients reported better care, service, and staff and doctor interactions in the more attractive waiting rooms. The authors cite several other related studies about patient satisfaction: Leitner and colleagues (1998) found that “patients in hospital units where nurses felt that their work was meaningful were more satisfied with their hospital stay” and that “…patients on units where nurses felt more tired and more frequently expressed their intention to quit were less satisfied with their care.” Mallak, Lyth, Olsen, Ulshafer, and Sardone (2003) found that “…job satisfaction [among healthcare providers] and patient satisfaction were significantly and positively correlated with culture strength and ratings of the built environment.” They also cite interviews with patients and families about what they want. Douglas and Douglas (2004) “found that patients reported the need for personal space, a homey welcoming atmosphere, areas for visitors, access to external areas, and provision of facilities for recreation and leisure.” Gardens in places of healing can fulfill many of these criteria, and a well-designed garden should address all of them.

I once got an email from someone recommending that his local hospital’s healing gardens (Woodwinds Health Campus, pictured above) be added to the TLN’s list of exemplary gardens in healthcare facilities. The gardens made a strong positive impression on him, and influenced how he felt about the entire hospital. And it probably provided a great incentive for him to visit for regular check-ups rather than waiting for emergencies. Think about how much people’s health would improve if they adhered to the preventative care model!

The article mentioned above explores the role of the built environment in influencing patient (consumer) satisfaction. Another article, which I’ll blog about soon, discusses the role of the built environment in influencing patient health and safety. There are so many reasons for healthcare providers to focus not just on the medicines and the machines, but on the places that house what all that stuff is there for: The patients and their families. All of those places have outdoor space – be it a parking lot and drop-off area or a designed “healing garden,” and all of those outdoor spaces could and should be considered as part of the aesthetic package that influences patient satisfaction, health, and well-being.

Full citations:

Becker, Franklin, Bridget Sweeney, and Kelley Parsons (2008). “Ambulatory Facility Design and Patients’ Perceptions of Healthcare Quality.” Healthcare Environments Research & Design Journal (HERD), Vol. 1, No. 4, pp. 35-54.

Douglas, C. H., and M. R. Douglas (2004). “Patient-friendly Hospital Environments: Exploring the Patient’s Perspective.” Health Expectations, Vol. 7, No. 1, pp. 61-73.

Leiter, M. P., P. Harvey, and C. Frizzell (1998). “The Correspondence of Patient Satisfaction and Nurse Burnout,” Social Science Medicine, Vol. 47, No. 10, pp. 1611-1617.

Mallak, L. A., D. M. Lyth, S. D. Olsen, S. M. Ulshafer, and F. F. Sardone (2003). “Culture, the Built Environment and Healthcare Organizational Performance.” Managing Service Quality, Vol. 13, No. 1, pp. 27-38.

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2 Responses to “Make it Pretty and They Will Come: The Role of Aesthetics in Patient Satisfaction”

  1. Naomi Sachs says:

    Please do keep me posted about your progress! Sounds like a wonderful project. We get many inquiries about “how to get it done,” including funding, so your story may be a really good one for others to learn from. We can also add your project, once it’s been completed, to the TLN’s list of Gardens in Healthcare (http://www.healinglandscapes.org/healthcare-gardens/a.html). You can email directly at nsachs at healinglandscapes dot org. Best, Naomi (TLN Director)

  2. Mary Ellen Masciale says:

    Our hospital is in the middle of establishing a healing garden: an idea that came out of our Go Green committee, funded 100% by employees and donations right down to the benches and pavers. It was important to us as staff of our community hospital to have a place where staff, patients and visitors can go to refresh themselves, get a breath of fresh air, and take a respite. It’s a small garden, stuck in between 2 wings, that had nothing but grass there before. I’m sure we’ll have positive feedback about it; now I’ll be on the lookout to see if we can get improved patient satisfaction documented!