Comment: Making Hospitals More Welcoming

29-Apr-2013

Exploring how changes to estates and facilities can enhance the experience of hospital patients

In this article, Capita Symonds’ business development director of health, Simon Corben, looks at how hospital estates and facilities teams can contribute towards improving the patient experience

Welcome centres, such as this one currently being built at Bristol Royal Infirmary, can vastly enhance the experience of patients visiting a hospital

Welcome centres, such as this one currently being built at Bristol Royal Infirmary, can vastly enhance the experience of patients visiting a hospital

As Florence Nightingale wrote in 1863: “The very first requirement in a hospital is that it should do the sick no harm”.

Knowledge of patients’ perceptions and expectations of, and preferences for, particular facilities and estates provision in NHS hospitals has important implications for capital development teams, clinical staff, managers and estates personnel

One hundred and 50 years later, after the grim failures of an ailing NHS trust have been painfully exposed in the 290 recommendations of the Francis Report , the perception that hospitals can be dangerous places where bad things may happen is still with us.

The Francis Report recognises that hospitals must be made safer, becoming welcoming environments that are once again a much-loved part of their local communities. To achieve this, improving ‘patient experience’ will be key. As Francis himself noted in a letter to the Secretary of State for Health: “If there is one lesson to be learnt, I suggest it is that people must always come before numbers. It is the individual experiences that lie behind statistics and benchmarks and action plans that really matter.”

But what can healthcare estates and facilities specifically contribute to those much-needed improvements in patient experiences?

A good starting point for those responsible for commissioning and providing healthcare facilities is to work in partnership, often on a regional basis, to quickly develop an estates transformation plan. There’s no need to throw out ‘tried and trusted’ but you can’t improve if you don’t embrace change.

There’s no need to throw out ‘tried and trusted’ but you can’t improve if you don’t embrace change

There is also a growing body of research to draw on. Studies show that patients perceive the hospital as a supportive environment, identifying the need not just for personal space but also for welcoming, homely facilities for themselves and their visitors that promote health and wellbeing. Such knowledge of patients’ perceptions and expectations of, and preferences for, particular facilities and estates provision in NHS hospitals has important implications for capital development teams, clinical staff, managers and estates personnel. A welcoming atmosphere, good physical design, access to external areas and provision of facilities for recreation and leisure are all key requirements identified by patients.

A hospital’s design, therefore, has a vital role to play in the patient experience as it can affect a visitor’s social, psychological, and environmental impressions within just a few minutes, inasmuch as entering a hotel can create an instant sense of the overall experience ahead. Some hospitals are already learning from the hospitality industry about the importance of creating a positive first impression.

A carefully-located and effectively planned ‘Welcome Centre’ at a hospital’s first point of entry, for example, can provide the visitor with comforting orientation, more space, and a range of quality retail and information services. Friendly, well-informed reception staff and good wayfinding signage pave the way for a positive experience that promotes the health and wellbeing of staff, patients and visitors alike.

The convenience of a mix of high-quality catering and retail outlets, sports, health and beauty and other similar provisions can even assist trusts with staff recruitment and retention. Welcome centre facilities can also be particularly valuable for those patients whose care pathways necessitate many visits to the hospital site. Enhanced facilities at the main entrance can assist links to transport services, improve security, and provide attractive atria that can be used for arts and other cultural and community events.

A carefully-located and effectively planned ‘Welcome Centre’ at a hospital’s first point of entry can provide the visitor with comforting orientation, more space, and a range of quality retail and information services

Nevertheless, it’s also important to remember that the all-important patient experience begins the moment they step onto the site – not just through the doors of the hospital. Access requirements for healthcare sites are similar to those for any major public facility used 24/7. Take airports, for example. You don’t have to be BAA to see the benefits of zoning carparks, with appropriate solutions for short medium and long-stay parking. So much can be done to improve sustainable public transport provision by working in collaboration with local authorities. Take the stress out of car parking for a patient with a long-term chronic condition who often needs to get to and from their local hospital as quickly and cheaply as possible, and you do a lot to improve the overall standard of their care. The little things count for a lot.

Such continuous improvement in healthcare estates can even be financed off balance sheet – through joint ventures and other commercial partnerships. It can be delivered by reducing waste and maximising income per square metre, and by making efficiency gains throughout facilities while reducing the overall footprint required. Innovations such as welcome centres, which are already under construction at hospitals in Bristol and Oxford, are actually self-financing, being funded through the income derived from the retail operations.

Florence Nightingale could not have predicted quite how our new technologies could help to reshape services for people with long-term conditions. She would not have foreseen that improving healthcare could mean moving it from the hospital site and providing it closer to home. What she was absolutely right about – much of what she wrote in 1863 still holds good today – is that hospital facilities should be used most effectively and efficiently to deliver complex acute care in safe, clean, fit-for-purpose, welcoming environments.

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