Evidence-based design and transformative service research for the healthcare in hospitals

A Conceptual Framework for Sustainable Evidence-Based Design for Aligning Therapeutic and Sustainability Outcomes in Healthcare Facilities: A Systematic Literature Review

Objective: The aim of this systematic review was to identify which aspects of evidence-based design (EBD) and sustainable design principles overlap based on evidence in the peer reviewed academic literature. By doing so, the study enables hospital infrastructure design decisions that prioritize both sustainability outcomes (sustainable hospital infrastructure design) and therapeutic (EBD) outcomes. Background: Healthcare facilities need to adapt to the future demands from a changing climate, demographic shifts, and economic restraints. Facilities need to be designed in ways that better support patients, staff, and the environment to ensure their long-term success. Methods: A systematic literature search was conducted through searches in SCOPUS and Web of Science. All studies in acute care settings were included in the review except those investigating EBD in the context of specific health conditions, which were excluded. Themes that overlap were identified to form a conceptual framework for sustainable EBD. Results: Sixty-five articles were included in the final analysis. Identified sustainability features were related to: Sociocultural and functional, Indoor environmental quality and wellbeing, Energy and atmosphere, Water, Materials and resources, Waste, Sustainable sites, and Facility design. EBD thematic analyses were categorized into Indoor environmental quality, Design, Sociocultural, and Functional performance and safety. Conclusions: Key areas of synergy include Indoor environmental quality and wellbeing and Energy and atmosphere. The development of the conceptual framework enables scholars and practitioners to identify design features that align both priorities and through future research, refine the framework.

Stakeholder experiential knowledge as evidence in redesigning health-care facilities for improved usability

Purpose

Evidence-based design (EBD) is traditionally limited to using empirical research findings based on randomized controlled trials. The purpose of this study is to explore stakeholder experiential knowledge as alternate credible evidence in redesigning health-care facilities for improved usability.

Design/methodology/approach

This research, based on critical participatory action research, involved a case study of redesign and post-occupancy evaluation (POE) of an emergency department (ED) at Holy Family Hospital, Techiman, Ghana. Observation, interviews and document analysis were used to collect data in the redesign and POE. The data was analyzed through directed content analysis.

Findings

Findings indicate that the redesign interventions, generated from stakeholder experiential knowledge, led to improved effectiveness, efficiency and satisfaction in the ED. This presents stakeholder experiential knowledge as alternate credible evidence in EBD. Furthermore, the POE revealed that open and flexible spatial arrangement, zoning care areas according to severity, and providing staff-support amenities are some redesign interventions for improving ED usability.

Practical implications

Compared to the hard and controlled nature of experimental research knowledge, the soft and fluid experiential knowledge of stakeholders could be more useful for health-care redesign process, especially in iteratively structuring design thinking and making choices.

Originality/value

This paper contributes to theory by validating and illustrating stakeholder experiential knowledge as credible evidence for EBD. Practically, it provides strategies, based on POE findings, for designing EDs to improve usability.

Factors influencing a long-term relationship between healthcare providers and patients – perspectives of patients at a public regional hospital, Ghana

Purpose

The purpose of this paper is to determine the factors that influence patients’ long-term relationship with healthcare providers in healthcare delivery at hospitals.

Design/methodology/approach

Data were gathered using 170 patients in a cross-sectional survey with quantitative research methods at a public regional hospital. Results were obtained using descriptive analysis and regression analysis.

Findings

Generally, the study found that the health-related factors (the reception of staff, providers’ attitude, waiting time, competence and expertise and the hospital environment) that influence patients’ long-term relationship with the healthcare providers/hospital were statistically significant (p < 0.001). The findings showed that overall 90.0 per cent of the patients were very satisfied with the overall healthcare services at the hospital.

Research limitations/implications

Limited sample size, lack of examination of healthcare providers’ perspectives and non-application of qualitative methods make it difficult to give a true picture of how these can enhance patients’ intent to keep a long-term relationship with the healthcare providers/hospital.

Practical implications

The paper suggests that health policymakers and practitioners need to enhance measures that will make patients satisfied leading to their long-term commitment and cordial relationship with the healthcare providers/hospital.

Social implications

The study demonstrated how health-related factors will be associated with the patients’ agreement/intent to keep a long-term relationship with their service providers at hospitals. Thus, the overall hypothesis was true that there is a relationship between patients’ satisfaction with the healthcare experienced and their long-term relationship with healthcare providers/hospital.

Originality/value

This is one of the few studies conducted on the topic in the context of Ghana’s health sector. It recommends that there should be a good interpersonal relationship between healthcare providers and patients, as patients’ satisfaction is not based on only receiving treatment at the health facility.