Outpatient Oncology Settings

By Ahmed Sadek

The role of the built environment in maintaining patient sense of support

This study explores the role that the design of outpatient facilities plays in empowering and supporting patient undergoing chemotherapy. The study will investigate patient perceptions of support communicated by the built environment and the repercussions of such impressions on their satisfaction and wellbeing. The study will also determine architectural design features that contribute to patients’ sense of support and how such support may contribute to a positive climate of patient-centred care.

Taking an extra mile to transform the hospital environment into a pleasant experience to remember.

A growing body of research attests that the healthcare physical environment has a significant impact on patients’ recovery and satisfaction with care (Huisman et al., 2012; Timmermann et al., 2015; Ulrich et al., 2008). Cancer, as one of the most significant healthcare crises in the world today, burdens patients with various physical and emotional challenges (Mehnert et al., 2012; Wessels et al., 2009). Patients receiving chemotherapy may develop physical symptoms of nausea, dizziness and fatigue. They become more sensitive to temperature, smell and require frequent use of toilets. Long waiting times, crowding of patients in the treatment room, and noise levels may constitute further stressors for cancer patients. Designing the built environment with people in mind and providing solutions that are tailored to suit their actual needs and preferences may help patients cope with the emotional and physical aspects of the disease and its treatment (Fouts & Gabay, 2008), make the treatment more tolerable (Mullaney et al., 2012), and support a general climate of patient-centered care (Bromley, 2012).

Continuous advances in cancer treatment have prompted a trend toward delivering treatment in outpatient settings (Bloom et al., 2015), yet few studies have attempted to empirically investigate patient experiences and needs in such environments (Shepley et al., 2012; Timmermann et al., 2013; Ullán et al., 2012; Wang et al., 2011). Addressing the role of integrated building design in improving patient experience is critical to overcome the existing gap in the majority of previous studies that have mainly focused on investigating the effect of single design features on patient health outcomes (Annemans et al., 2012; Montacchini & Tedesco, 2015). The need for measurable outcomes for subjective attributes is warranted to help guide experience-related design decisions and support negotiating and implementing research findings in healthcare projects (Annemans et al., 2014; Kirkeby, 2009). This is further demanding in countries that face various economic challenges (e.g. developing countries) and in which patient perspectives might differ substantially according to their background and experiences. Little has been done in terms of comparing patient perspectives in different cultural contexts (Andrade & Devlin, 2015; Sherman et al., 2011), yet it is a critical aspect to look at (Timmermann et al., 2015).

Accordingly, the study adopts a cross-sectional questionnaire design to explore patients’ perceptions within two different medical and culture backgrounds—Australia and Egypt. The study develops its own questionnaire of the built environment and adopts previously developed tools to cover other aspects of climate of care and indicators of patient satisfaction including: willingness to return and recommend the facility, transient emotional wellbeing, and tolerability of the treatment.

Outcomes of this study will contribute to the existing body of knowledge by providing an evidence-base model that supports healthcare stakeholders’ decision-making when developing future facilities that aim to meet patient needs and improve their experiences. Additionally, the development of a standardized measurement instrument to assess cancer patient perception of supportive healthcare environments provides a common platform to explore the successes of current environments and point to areas that require additional improvements. It also provides the basis for conducting comparisons between different health care facilities which enables the detection and sharing of best-demonstrated practices in oncology health care environmental design.