Blog: The #3 Priority in Healthcare Facility Planning: Patient Satisfaction

by Joyce Durham, RN, AIA

This post is the third in a series of posts on priorities in healthcare facility planning. As a brief recap, the priorities I identified are:

#1: Safety,

#2: Efficiency, and

#3: Patient Satisfaction.

Even though I have prioritized patient satisfaction as third, if one looked at the amount of coverage in the media, it would seem that facility designs to support patient satisfaction are the number one priority. But, unfortunately, many of these articles are based on opinion and, often, the opinions are inconsistent. Therefore, this blog post will be based on recent research regarding patient satisfaction and what impact it has on facility design.

In 2012, JD Powers and Associates conducted a study of the impact of facilities on patient satisfaction. The study found that only 19% of hospital patients indicated that facilities had an impact on their satisfaction. This is significantly lower than upscale hotel patrons of which 48% indicated that the physical facility impacted their satisfaction.

Figure 1:


So this data begs the question: if it is not facilities, then what impacts patient satisfaction. In the same JD Powers study, other factors were surveyed and, as illustrated in the figure below, doctors and nurses matter. More than a third up to a half of inpatients, outpatients and ED patients indicated that doctors and nurses had a significant impact on their satisfaction.

Figure 2:


Recently, patient satisfaction has been tied to a hospital’s HCAPS (Hospital Consumer of Healthcare Providers and Systems) score. This survey, administered to a random sample of adult patients within 48 hours of discharge, was developed using a rigorous scientific process, was endorsed by the National Quality forum and was approved for standardized national public reporting by the Office of Management and Budget in 2006. Most recently, incentive based payments have been tied to a hospital’s HCAPS score.

The HCAPS survey was designed to evaluate the patient experience but, interestingly, only two questions relate to facilities; one related to cleanliness and one related to noise. Therefore, one may derive that a clean and quiet hospital environment matters to patients. To me cleanliness is relatively straight forward but noise deserves further discussion.

Apparently, noise is a common complaint for hospitalized patients. A study by the University of Chicago Pritzker School of Medicine in 2012 found that the average sound level in hospitals is slightly less than 50 decibels while the recommended sound level is 30 decibels. So, there is clearly opportunity for improvement.

Figure 3:


A second study, evaluating what types of noise patients found as most disruptive, showed that the most disruptive noise was staff conversations (65%). This is important, as it must be addressed with behavioral changes as well as physical changes.

Figure 4:


Once the behavioral component of loud staff conversations has been addressed, other strategies to reduce noise levels that may be considered are:

  • Decentralizing staff
  • Enclosing staff congregating areas
  • Providing gentle curves in the design
  • Carpeting appropriate areas
  • Installing sound absorbing materials on walls and ceilings
  • Providing ceiling baffles
  • Utilizing silent communication systems
  • Equipping carts and movable equipment with “silent” wheels

In conclusion, a beautifully designed facility is certainly something that will be enjoyed by patients and family, but in the end, the key things that matter to patients are the doctors and nurses, a clean facility and a quiet facility. Being aware of this research will help hospitals prioritize how they spend money allocated to improve patient satisfaction with the facility.

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