Designing Palliative Care Facilities to Better Support Patient and Family Care: A Staff Perspective

Objective: To contribute staff perspectives on the design of palliative care facilities to better align with the philosophy of palliative care, in support of patient, family, and staff well-being. Background: The receipt of palliative care differs from other inpatient experiences owing to its distinct philosophy of care, longer lengths of stay, a greater presence of family members, and more frequent end-of-life events. While research regarding the optimal design of palliative care environments recognizes these differences, this knowledge has been slow to exert change on the guidelines and procurement processes that determine the design solutions possible within these settings. Sustained research attention is required. Methods: An online survey, comprising a series of open-ended questions, elicited the perceptions of palliative care staff regarding the relationship between the physical environment and the distinct philosophy of palliative care. Results: Responses from 89 Australian-based palliative care professionals confirmed the high value that staff place on environments that offer privacy, homeliness, safety, and access to gardens to assist the delivery of optimum care. Conclusions: Our findings illustrate that the implications of privacy and homeliness extend far beyond the patient room and that homeliness is about more than an aesthetic of comfort. This highlights a broader capacity for design to better support the philosophy of palliative care. Importantly, the data reveal a key relationship between staff well-being and the environments in which they work; environments that are unable to match the quality of care that staff aspire to deliver can engender frustration and distress.

Healing Architecture in Healthcare: A Scoping Review

Objectives: The purpose of this scoping review is to identify evidence on how characteristics of healing architecture in clinical contexts impact clinical practice and patient experiences. Based on these insights, we advance a more practice-based approach to the study of how healing architectures work. Background: The notion of “healing architecture” has recently emerged in discussions of the spatial organization of healthcare settings, particularly in the Nordic countries. This scoping review summarizes findings from seven articles which specifically describe how patients and staff experience characteristics of healing architecture. Methods: This scoping review was conducted using the framework developed by Arksey and O’Malley. We referred to the decision tool developed by Pollock et al. to confirm that this approach was the most appropriate evidence synthesis type to identify characteristics related to healing architecture and practice. To ensure the rigor of this review, we referred to the methodological guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Results: There are two main findings of the review. First, there is no common or operative definition of healing architecture used in the selected articles. Secondly, there is limited knowledge of how healing architecture shapes clinical and patient outcomes. Conclusions: We conclude that further research is needed into how healing architectures make a difference in everyday clinical practices, both to better inform the development of evidence-based designs in the future and to further elaborate criteria to guide postoccupancy evaluations of purpose-built sites.

Hospital Greenspaces and the Impacts on Wayfinding and Spatial Experience: An Explorative Experiment Through Immersive Virtual Environment (IVE) Techniques

Background: Navigating large hospitals can be very challenging due to the functional complexity as well as the evolving changes and expansions of such facilities. Hospital wayfinding issues could lead to stress, negative mood, and poor healthcare experience among patients, staff, and family members. Objectives: A survey-embedded experiment was conducted using immersive virtual environment (IVE) techniques to explore people’s wayfinding performance and their mood and spatial experience in hospital circulation spaces with or without visible greenspaces. Methods: Seventy-four participants were randomly assigned to either group to complete wayfinding tasks in a timed session. Participants’ wayfinding performances were interpreted using several indicators, including task completion, duration, walking distance, stop, sign-viewing, and route selection. Participants’ mood states and perceived environmental attractiveness and atmosphere were surveyed; their perceived levels of presence in the IVE hospitals were also reported. Results: The results revealed that participants performed better on high complexity wayfinding tasks in the IVE hospital with visible greenspaces, as indicated by less time consumed and shorter walking distance to find the correct destination, less frequent stops and sign viewing, and more efficient route selection. Participants also experienced enhanced mood states and favorable spatial experience and perceived aesthetics in the IVE hospital with visible greenspaces than the same environment without window views. IVE techniques could be an efficient tool to supplement environment-behavior studies with certain conditions noted. Conclusions: Hospital greenspaces located at key decision points could serve as landmarks that positively attract people’s attention, aid wayfinding, and improve their navigational experience.

Evaluation of Infectious Disease Prevention and Control Ability of Medical Buildings in Harbin, China

Objective: Entrusted by the Harbin Municipal Government, evaluation medical building system for prevention and control of sudden infectious diseases in the city has been established. Background: China, as a country that found the COVID-19 earlier, has taken strict control measures. However, as the medical building system is not perfect enough to prevent and control sudden infectious diseases. Method: First, expert group methodology was used and evaluation index of ability of prevention and control of sudden infectious diseases in medical building system was selected; then fuzzy comprehensive evaluation was adopted to establish index set and to set weight and medical building system evaluation model for prevention and control of sudden infectious diseases was constructed; finally, it’s to modify the indicators and weights in the evaluation set and to make an evaluation of the ability of Harbin medical building system to prevent and control sudden infectious diseases in accordance with the current management mode of system. Results: The medical building system in Harbin is significantly unbalanced in its ability to prevent sudden infections where there are low indicators for response monitoring and forecasting terminals, there are high indicators for the construction of emergency center. Conclusions: The evaluation model of the ability of medical building system to prevent and control sudden infectious diseases was constructed. The model is adopted to make practical evaluation of infectious disease prevention and control ability in Harbin and to form the evaluation method of the direct connection between the theoretical research of medical architecture and medical building design.

Music in Waiting Rooms: A Literature Review

Objective: We aim to review existing literature on the effects of background music in waiting rooms on patients. Furthermore, we examine existing neurobiological research for potential mechanisms by which music may affect patients. Background: Music has been studied in healthcare in various forms, from formal interventions such as music therapy to passive listening as therapy. However, music is also present in the healthcare environment in the form of background music in waiting rooms. There has been interest in whether background music in such a setting may have beneficial effects on patient anxiety in order to potentially inform healthcare workers whether and what type of music may be suitable for waiting rooms. Methods: We reviewed existing literature on music in healthcare waiting rooms and the neurobiological mechanisms by which music affects anxiety. Results: We located several small studies performed in a range of settings, including physician office waiting rooms and preoperative waiting areas. The studies generally reported that most patients viewed music in these areas positively; some, but not all, studies showed positive effects on patient anxiety. A variety of theories by which music may impact patient anxiety was noted. Conclusions: We conclude that there exists some evidence to support an anxiety-reducing effect of background music on patients, though studies vary widely in methodology and music selection. A small amount of neurobiological research into the pertinent mechanisms has been conducted, but further research will be required to elucidate the exact mechanisms by which this intervention may reduce anxiety.

Commissioning Clinical Spaces During a Pandemic: Merging Methodologies of Human Factors and Simulation

Objectives: The objective of this case study is to demonstrate the value of applying tabletop and simulation techniques to highlight high-risk, high-impact outcomes and organizational recommendations in the commissioning of a new clinical spaces. Purpose/Aim: Generalizability of lessons learned from this case study aim to support other health organizations in commissioning of clinical spaces during communicable disease outbreaks. Background: COVID-19 challenged our healthcare system, requiring teams to prepare in a short span of time. Bridging expertise of human factor and simulation teams provided a novel, interdisciplinary, and timely approach to evaluate and commission spaces. Methods: Human factors and simulation teams were enlisted to conduct an evaluation of a new space prior to readiness for delivery of safe patient care. An adapted tabletop evaluation and subsequent systems integration simulation was conducted. The goal of the tabletop exercise was to identify and define processes and risks to tested in the physical space using simulation. Results: Applying both human factors science and systems simulation proactively identified the highest risk, highest impact outcomes, validated existing processes and allowed for refining of potential solutions and recommendations of the new space. A strong working relationship between teams fostered an opportunity to share information, debrief, evaluate, and adapt methods while applying timely changes based on emergent findings. Conclusions: These combined methodologies are important tools that can be learned and applied to healthcare commissioning of new clinical spaces in the identification of high-risk, high-impact outcomes affecting staff and organizational preparedness and safety.