To study the impact of design considerations on customer satisfaction in a dialysis facility of a super-specialty tertiary care hospital in Delhi, India

Abstract

Background: In recent times, patient focused hospital architecture is gaining attention. The current scenario demands to provide living spaces for families rather than ware houses for the sick. Attitudes, aspiration and values of the society must be clearly understood while planning a facility.

Methods: This prospective cross sectional observational study was carried out over a period of one year at the Dialysis unit of a tertiary care, super specialty hospital in North India with the objective to establish that minor structural changes can enhance customer delight which includes patients and their attendants of a chronic disease patient population visiting a health care facility and satisfaction of the staff of the facility. The tool used was a structured 5 point Likert scaled questionnaire including unstructured interviews. These were held with 200 patients availing treatment in the old and new dialysis unit each and who have at least had three dialysis treatments within 6 months in the both the units. Also, for staff satisfaction, 25 staff working for at least one month in the old unit and new unit each. Data was analysed using SPSS 17.0 software.

Results: Good design and quality of care were regarded important for patient experience. For patients, overall functioning and efficiency of the processes in the facility dependent on the design of the building was most important. Just over half of all surveyed patients felt that design impacted their relationship with their doctor and the quality of the care received. For attendants, waiting area including billing facility fetched the highest parameter for satisfaction. For staff the importance of access to support services, safety and provision of basic facilities resonated with the patient views presented above. Privacy, confidentiality and patient safety through careful design of waiting room, reception and consulting room were high staff priorities. Design that facilitated communication between team members also emerged as an important area although the change in design did not make much difference in emotional wellbeing and work life balance of the staff.

Conclusions: This study did not yield sufficient data to confirm or refute either concept, though clearly this merit further investigation. Some unexpected findings were reported. Specifically, the survey data rated privacy and the availability of comfortable physical conditions as the highest priority for both staff and patients.