Transforming the Doctor's Office: Principles from Evidence-based Design
by Ann Sloan Devlin, Sadowski Professor of Psychology
A visit to a doctor's office can stress out even the healthiest among us. And the design of the office can make it worse. Even locating an office for the first visit can be challenging, given the lack of adequate signage.
In her latest book, Devlin examines the ways in which physicians and those who design their offices can improve the outpatient experience. She follows the flow from parking lot to examination room, using research to illustrate the features — some as small as clothing hooks — that can make a difference in a patient’s state of mind and even state of health.
"As an environmental psychologist, one of my interests is the way in which we begin to make judgments about aspects of care, starting with the exterior appearance of a facility, in much the same way we do with people," Devlin said.
And her interest in art and architecture, coupled with a family background in health care, led her to focus on improving the experience of patients by focusing on the oft-overlooked designed environment. The research reported in the book reflects the current evidence-based design movement in health care, in which design decisions to improve healthcare outcomes are based on credible evidence.
"I wanted to look at how design issues for physicians' offices had changed over 100-plus years," said Devlin, who includes historical material about the office practice of physicians at the beginning of the 20th century that reveal design has been an issue for more than a century. These early practitioners were encouraged to work in rooms that were well-lighted, with windows on two walls - recommendations which Devlin notes foreshadowed the importance of natural light in today's medical facilities.
The book covers extensive territory, but when asked to identify major areas of concern, Devlin narrows them down to three: positive distraction, such as providing art and music to distract patients and help reduce anxiety; social support, which can include providing sufficient seating in exam rooms for relatives who accompany the patient; and perceived control, which entails providing ways for a patient to modify the environment through, for example, adjustable lighting in the waiting room.
"The presence of television - an element of positive distraction - is a contentious issue," said Devlin.
The research suggests that having television may increase anxiety because it is not controllable, but practitioners continue to think of television as a positive distraction. There are alternatives to television such as loops of nature images that are far more appropriate than is television, but practitioners often seem to choose an easy and familiar solution, i.e., television.
- Ann Sloan Devlin
The book has both practical advice and research support, but the research citations are provided through endnotes to avoid interrupting the text. While the book will be of assistance to health care designers and practitioners, "I think it would be interesting reading for a general audience and might help people evaluate whether the offices of their healthcare providers 'measure up.'" Devlin said.
This book is available for purchase on amazon.com