Regardless of what medical situation takes us to a hospital, one absolute exists: no one wants to be there. People want the outcome of going to a hospital—improved health for themselves or their loved ones—but they really do not want to be there. One of the primary reasons people do not want to be in hospitals is the significant amount of wasted time that passes between service activities: waiting to be admitted, waiting for the doctor to make her rounds and see a patient, waiting for the discharge process to begin, waiting for meals.
Although it may be obvious, so much waiting occurs because—unlike many other services—people’s bodies are an essential part of every aspect of the service, both medically and administratively. In contrast, when dropping off your car for service at your mechanic’s, some waiting may occur while your car gets worked on, but you can leave the garage. You can arrange for someone to pick you up or decide to take a leisurely walk. You can go about your life as you normally do, with just the one minor inconvenience of not having your car. However, at a hospital, our physical presence is an integral part of every healthcare service that we receive, which makes people feel imprisoned by hospitals. Hospitals can alleviate this feeling if imprisonment by improving the waiting experience for patients and their visitors through the integration of technology and the creation of empathetic spaces and transparent human interactions. This is the topic that this column explores.
Using Technology to Eliminate Waiting
One approach to preventing patients and visitors from feeling imprisoned in a hospital is to decrease or even eliminate the need to wait altogether using technology. New applications such as MASH for the iPad, from NIT Healthcare Technologies, let patients check themselves into a hospital. Future versions will allow patients to communicate their symptoms to hospital staff in advance of their admittance, using 3D body-imaging technology. Couple such pre-admission innovations with existing technology that helps monitor people’s health, including their heart rate, blood pressure, and oxygen levels, and hospitals can streamline many administrative and medical monitoring processes, allowing patients to take a walk or get a coffee, so they won’t feel confined to hospital waiting rooms. [1] Yet, if anything unexpected should arise when monitoring a patient’s health remotely, the patient would still be on the hospital grounds and could be instructed to return to his room or go directly to the nearest nurse’s station. Unfortunately, until hospitals and patients more widely adopt mobile devices, such innovations will remain unused, and hospitals will need to rely on more rudimentary technology solutions to enhance the user experience.?
For example, hospitals are beginning to use monitors to show visitors who are waiting to see patients after their surgery when they arrive in recovery, so they’ll know when they can visit their loved ones. Although this technology solution is not as freeing as something like MASH, such displays prevent people from feeling confined to a particular waiting room, because they do not have to fear missing an update from a doctor or staff member. Also, many hospitals are now posting their emergency room waiting times online, via SMS, or on digital roadside billboards, giving people realistic expectations for how long they’ll have to wait and, in some cases, enabling them to choose a different hospital based on that information. [2] According to the Chicago Tribune, with these technologies, “patients may feel more in control, because they learn before they head to a hospital or clinic that doctors are delayed. They then can try a different place, or wait more comfortably at home until minutes—instead of hours—before they’ll be treated.” [3]
Creating Empathetic Spaces
When such technologies as I’ve described are not feasible solutions, creating empathetic spaces can be another design option. Here is an example: Recently, a colleague was in a general-surgery waiting room, waiting for her husband, who was undergoing some minor surgery. Although she obviously hoped that her husband’s surgery would have no complications and would be completed safely, she wasn’t particularly concerned. But, as she looked around the large, open space, she saw people who were likely waiting for loved ones whose surgeries were more serious. On their faces, she could see the anxiety, concern, and subsequent relief when the hospital staff notified them that the patient was in recovery. She had wanted to do some work on her iPad, but felt guilty doing so, because she thought it might trivialize the situations of the others around her. But then something happened that was incredibly bizarre: a harpist began playing in the waiting room.
Since a hospital must accommodate so many diverse medical and, often, emotional scenarios, it’s difficult for patients and their loved ones to wait in a single, large space with others. In such situations, it is better to divide the space and create private areas, even if it’s just with large planters, furniture, or room dividers. Doing so allows those people who don’t want to lose their connection with their lives outside the hospital to use their iPad, watch TV, or read without feeling guilty; and it lets those people who can’t pretend to mimic normal life until they know their loved ones are safe to have some privacy.
Some hospitals are doing more to increase the comfort of their physical spaces than just creating more privacy with room dividers. At Mount Sinai Hospital in New York, a geriatric patient arrived in the emergency room and noticed, “There were no beeping machines or blinking lights or scurrying medical residents. A volunteer circulated among the patients like a flight attendant, making soothing conversation and offering reading glasses, Sudoku puzzles, and hearing aids. Above them, an artificial sun shined through a skylight imprinted with a photographic rendering of a robin’s-egg-blue sky, puffy clouds, and leafy trees.” The skylight did more than just provide a calming effect; it helped to alleviate sundowning, which occurs when the elderly confuse day and night. The patient satisfaction ratings for Mount Sinai’s redesigned geriatric experience are “off the scoreboard.” [4]
