Do Fancy New Hospital Buildings Improve Paient Satisfaction
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1 Do Fancy New Hospital Buildings Improve Paient Satisfaction Zishan Siddiqui M.D. Assistant Professor of Medicine Division of General Internal Medicine/Hospitalist Program Department of Medicine Johns Hopkins School of Medicine October 24,
2 Satisfaction: Impact of a New Clinical Building Belief amongst leaders and frontline providers Halo effect Swan JE, Richardson LD, Hutton JD. Do appealing hospital rooms increase patient evaluations of physicians, nurses, and hospital services? Health Care Manage Rev. 2003;28(3): Zeis M. Patient experience and HCAHPS: little consensus on a top priority. Health Leaders Media website. Available at Accessed August 10,
3 Satisfaction: Impact of a New Clinical Building How would the appearance and characteristics of the hospital building impact patient satisfaction with care? 3
4 Satisfaction: Impact of a New Clinical Building 4
5 Satisfaction: Impact of a New Clinical Building 5
6 Satisfaction: Impact of a New Clinical Building 6
7 Satisfaction: Impact of a New Clinical Building 7
8 Satisfaction: Impact of a New Clinical Building 8
9 Satisfaction: Impact of a New Clinical Building Golisano Childrens Hospital 9
10 Satisfaction: Impact of a New Clinical Building Lurie Children s Hospital Chicago Chicago-ZGF-Architects-slideshow.asp?slide=2 10
11 Satisfaction: Impact of a New Clinical Building Cleveland Clinic Abu Dhabi 11
12 Global Hospital Construction Industry General Electric: New Hospitals Perspectives and Solutions- IHF Paris presenation 12
13 Patient-Centered-Design Features Same-handed design Use of sound absorbent materials Increased natural lighting Incorporation of natural elements Siddiqui, Zishan K., et al. "Changes in patient satisfaction related to hospital renovation: Experience with a new clinical building." Journal of hospital medicine 10.3 (2015):
14 Patient-Centered-Design Features Comfortable waiting rooms & visitor accommodations Hotel-like amenities (on-demand entertainment & room service) Siddiqui, Zishan K., et al. "Changes in patient satisfaction related to hospital renovation: Experience with a new clinical building." Journal of hospital medicine 10.3 (2015):
15 Impact of a New Clinical Building: Johns Hopkins Hospital /quiet/healing_gardens.html 15
16 Impact of a New Clinical Building: Johns Hopkins Hospital 16
17 Impact of a New Clinical Building: Johns Hopkins Hospital te/quiet/healing_gardens.html 17
18 Impact of a New Clinical Building: Johns Hopkins Hospital 18
19 Impact of a New Clinical Building: Johns Hopkins Hospital te/quiet/healing_gardens.html 19
20 Background: HCAHPS Measurement of Patient Experience Physician communication, Nursing communication, Pain Control, Responsiveness, Room cleanliness and Quietness, Discharge process, and Overall Satisfaction Siddiqui, Zishan K., et al. "Comparison of Hospital Consumer Assessment of Healthcare Providers and Systems patient satisfaction scores for specialty hospitals and general medical hospitals: confounding effect of survey response rate." Journal of Hospital Medicine 9.9 (2014):
21 Patient Satisfaction: HCAHPS Over 4500 acute-care facilities routinely use this survey Results publicly reported Patients can compare different hospitals on the measure 25% of incentive Payments to the hospitals are linked to performance on this survey Siddiqui, Zishan K., et al. "Comparison of Hospital Consumer Assessment of Healthcare Providers and Systems patient satisfaction scores for specialty hospitals and general medical hospitals: confounding effect of survey response rate." Journal of Hospital Medicine 9.9 (2014):
22 Impact of a New Clinical Building: Methods Natural experiment: 12 Clinical units moved to the New Clinical Building- Sheikh Zayed Tower (Exposure group) Similar number of units remained in the old hospital (Control Group) Siddiqui, Zishan K., et al. "Changes in patient satisfaction related to hospital renovation: Experience with a new clinical building." Journal of hospital medicine 10.3 (2015):
23 Impact of a New Clinical Building: Methods Natural Experiment 12 months of baseline data prior the move 7.5 months of data after the move 4600 patients Exposure group :New Clinical building Siddiqui, Zishan K., et al. "Changes in patient satisfaction related to hospital renovation: Experience with a new clinical building." Journal of hospital medicine 10.3 (2015):
24 Impact of a New Clinical Building: Results Table 3. Changes in Press Ganey Patient Satisfaction Scores From Baseline to Postmove Period By Unit Status Moved Units Unmoved Units p Value of the Difference in Odds Ratio Between Moved and Unmoved Units % Top Box % Top Box Satisfaction Domain Pre Post Adjusted Odds Ratio* (95% CI) Pre Post Adjusted Odds Ratio* (95% CI) FACILITY RELATED Room Pleasantness of room décor ( ) ( ) < Room cleanliness ( ) ( ) < Room temperature ( ) ( ) Noise level in and around room ( ) ( ) < Visitor Related Accommodations and comfort of visitors ( ) ( ) < Siddiqui, Zishan K., et al. "Changes in patient satisfaction related to hospital renovation: Experience with a new clinical building." Journal of hospital medicine 10.3 (2015):
25 Impact of a New Clinical Building: Beyond Satisfaction Table 2. Changes in HCAHPS Patient Satisfaction Scores From Baseline to Postmove Period By Unit Status Moved Units Unmoved Units p Value of the Difference in Odds Ratio Between Moved and Unmoved Units % Top Box % Top Box Satisfaction Domain Pre Post Adjusted Odds Ratio* (95% CI) Pre Post Adjusted Odds Ratio* (95% CI) FACILITY RELATED Hospital environment Cleanliness of the room and ( ) ( ) 0.03 bathroom Quietness of the room ( ) ( ) < NON FACILITY RELATED Nursing communication Nurses treated with courtesy/respect ( ) ( ) 0.92 Nurses listened ( ) ( ) 0.26 Nurses explained ( ) ( ) 0.43 Physician communication Doctors treated with courtesy/respect ( ) ( ) 0.77 Doctors listened ( ) ( ) 0.68 Doctors explained ( ) ( ) 0.49 Siddiqui, Zishan K., et al. "Changes in patient satisfaction related to hospital renovation: Experience with a new clinical building." Journal of hospital medicine 10.3 (2015):
26 Impact of a New Clinical Building: Results Table 3. Changes in Press Ganey Patient Satisfaction Scores From Baseline to Postmove Period By Unit Status Moved Units Unmoved Units p Value of the Difference in Odds Ratio Between Moved and Unmoved Units % Top Box % Top Box Satisfaction Domain Pre Post Adjusted Odds Ratio* (95% CI) Pre Post Adjusted Odds Ratio* (95% CI) OVERALL Staff worked together to care for you ( ) ( ) 0.30 Likelihood of recommending hospital ( ) ( ) 0.10 Overall rating of care given ( ) ( ) 0.03 Siddiqui, Zishan K., et al. "Changes in patient satisfaction related to hospital renovation: Experience with a new clinical building." Journal of hospital medicine 10.3 (2015):
27 Media and Industry Response
28 Media and Industry Response
29 Hospital Construction: Reasons Beyond Patient Satisfaction Aging Infrastructure Improve workflow Improve Patient Safety: Acuity adaptable room decrease med error Decentralized nursing station: increased patient visibility and decreased falls Lower fractures from fall with wood subflooring* Improve Employee Satisfaction *Joseph, Anjali, and Mahbub Rashid. "The architecture of safety: hospital design." Current opinion in critical care 13.6 (2007):
30 Take home message Improving Satisfaction Human factor is the KEY!! Return on investment for pricey features incorporated in hospital design solely aimed at improving patient experience? 30
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