Building patient-centeredness: Hospital design as an interpretive act
Hospital designs reflect the sociocultural, economic, professional, and aesthetic priorities prevalent at a given time. As such, hospital buildings concretize assumptions about illness, care and healing, patienthood, and medical providers’ roles. Trends in hospital design have been attributed to the increasing influence of consumerism on healthcare, the influx of business-oriented managers, and technological changes. This paper describes the impact of the concept of patient-centeredness on the design of a new hospital in the USA. Data come from 35 interviews with planners, administrators, and designers of the new hospital, as well as from public documents about the hospital design. Thematic content analysis was used to identify salient design principles and intents. For these designers, administrators, and planners, an interpretation of patient-centeredness served as a heuristic, guiding the most basic decisions about space, people, and processes in the hospital. I detail the particular interpretation of patient-centeredness used to build and manage the new hospital space and the roles and responsibilities of providers working within it. Three strategies were central to the implementation of patient-centeredness: an onstage/offstage layout; a concierge approach to patients; and the scripting of communication. I discuss that this interpretation of patient-centeredness may challenge medical professionals’ roles, may construct medical care as a product that should sate the patient’s desire, and may distance patients from the realities of medical care. By describing the ways in which hospital designs reflect and reinforce contemporary concepts of patienthood and caring, this paper raises questions about the implementation of patient-centeredness that deserve further empirical study by medical social scientists.
Volume (Year): 75 (2012)
Issue (Month): 6 ()
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Glick, Peter, 2009. "How reliable are surveys of client satisfaction with healthcare services? Evidence from matched facility and household data in Madagascar," Social Science & Medicine, Elsevier, vol. 68(2), pages 368-379, January.
- Epstein, Ronald M. & Franks, Peter & Fiscella, Kevin & Shields, Cleveland G. & Meldrum, Sean C. & Kravitz, Richard L. & Duberstein, Paul R., 2005. "Measuring patient-centered communication in Patient-Physician consultations: Theoretical and practical issues," Social Science & Medicine, Elsevier, vol. 61(7), pages 1516-1528, October.
- Laws, Jennifer, 2009. "Reworking therapeutic landscapes: The spatiality of an 'alternative' self-help group," Social Science & Medicine, Elsevier, vol. 69(12), pages 1827-1833, December.
- Hopper, Kim, 2007. "Rethinking social recovery in schizophrenia: What a capabilities approach might offer," Social Science & Medicine, Elsevier, vol. 65(5), pages 868-879, September.
- van de Glind, Irene & de Roode, Stanny & Goossensen, Anne, 2007. "Do patients in hospitals benefit from single rooms? A literature review," Health Policy, Elsevier, vol. 84(2-3), pages 153-161, December.
- Atkinson, Sarah & Medeiros, Regianne L., 2009. "Explanatory models of influences on the construction and expression of user satisfaction," Social Science & Medicine, Elsevier, vol. 68(11), pages 2089-2096, June.
- Waring, Justin J. & Bishop, Simon, 2010. "Lean healthcare: Rhetoric, ritual and resistance," Social Science & Medicine, Elsevier, vol. 71(7), pages 1332-1340, October.
- Zandbelt, Linda C. & Smets, Ellen M.A. & Oort, Frans J. & Godfried, Mieke H. & de Haes, Hanneke C.J.M., 2006. "Determinants of physicians' patient-centred behaviour in the medical specialist encounter," Social Science & Medicine, Elsevier, vol. 63(4), pages 899-910, August.
- Lupton, Deborah, 1997. "Consumerism, reflexivity and the medical encounter," Social Science & Medicine, Elsevier, vol. 45(3), pages 373-381, August.
- Timmermans, Stefan & Almeling, Rene, 2009. "Objectification, standardization, and commodification in health care: A conceptual readjustment," Social Science & Medicine, Elsevier, vol. 69(1), pages 21-27, July.
- Mead, Nicola & Bower, Peter, 2000. "Patient-centredness: a conceptual framework and review of the empirical literature," Social Science & Medicine, Elsevier, vol. 51(7), pages 1087-1110, October.
- Evans, Joshua D. & Crooks, Valorie A. & Kingsbury, Paul T., 2009. "Theoretical injections: On the therapeutic aesthetics of medical spaces," Social Science & Medicine, Elsevier, vol. 69(5), pages 716-721, September.
- Hekkert, Karin Dorieke & Cihangir, Sezgin & Kleefstra, Sophia Martine & van den Berg, Bernard & Kool, Rudolf Bertijn, 2009. "Patient satisfaction revisited: A multilevel approach," Social Science & Medicine, Elsevier, vol. 69(1), pages 68-75, July.
- Sarah Curtis & Wil Gesler & Kathy Fabian & Susan Francis & Stefan Priebe, 2007. "Therapeutic landscapes in hospital design: a qualitative assessment by staff and service users of the design of a new mental health inpatient unit," Environment and Planning C: Government and Policy, Pion Ltd, London, vol. 25(4), pages 591-610, August.
- Beardwood, Barbara & Walters, Vivienne & Eyles, John & French, Susan, 1999. "Complaints against nurses: a reflection of 'the new managerialism' and consumerism in health care?," Social Science & Medicine, Elsevier, vol. 48(3), pages 363-374, February.
- Kearns, Robin A. & Ross Barnett, J. & Newman, Daniel, 2003. "Placing private health care: reading Ascot hospital in the landscape of contemporary Auckland," Social Science & Medicine, Elsevier, vol. 56(11), pages 2303-2315, June.
- Gesler, Wilbert M., 1992. "Therapeutic landscapes: Medical issues in light of the new cultural geography," Social Science & Medicine, Elsevier, vol. 34(7), pages 735-746, April.
- Potter, Sharyn J. & McKinlay, John B., 2005. "From a relationship to encounter: an examination of longitudinal and lateral dimensions in the doctor-patient relationship," Social Science & Medicine, Elsevier, vol. 61(2), pages 465-479, July.
- Hewett, David G. & Watson, Bernadette M. & Gallois, Cindy & Ward, Michael & Leggett, Barbara A., 2009. "Intergroup communication between hospital doctors: Implications for quality of patient care," Social Science & Medicine, Elsevier, vol. 69(12), pages 1732-1740, December.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:75:y:2012:i:6:p:1057-1066. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)
If references are entirely missing, you can add them using this form.