Health Care Environments and Patient Outcomes

Devlin, Ann Sloan; Arneill, Allison B.

doi:10.1177/0013916503255102

Cited by 295 publications

(240 citation statements)

References 63 publications

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“…The interconnections between the characteristics of the physical environment and patient health outcomes emphasise the importance of the physical environment design in creating a healing environment [3][4][5]. Moreover, physical environment factors during both design and operation of buildings are important for sustainability [6], as well as for meeting the needs and expectations of stakeholders.…”

Section: Introductionmentioning

confidence: 99%

Patients’ Perspectives on the Design of Hospital Outpatient Areas

Zhao

Mourshed

2017

Buildings

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There is a growing interest among healthcare managers and designers in moving towards a 'patient-centred' design of health and care facilities by integrating patient perceptions and expectations of the physical environment where care takes place. Increased interests in physical environments can mostly be attributed to our improved understanding of their role in patients' health outcomes and staff productivity. There is a gap in the literature on users' perspectives on physical settings in the context of healthcare. Moreover, the connection of care services with the design of the facility is often overlooked partly due to the lack of evidence. This research was aimed at filling the gap by exploring outpatients' perspectives on design factors related to the areas frequented by them, e.g., hospital waiting areas. A 16-item questionnaire was conducted among randomly selected outpatients in two hospitals in Qingdao, China, with a response rate of 84.3%. Five principal factors were identified: sensory; lighting and thermal; facilities; spatial; and seating design, which agreed with the literature. Non-parametric tests were applied to assess variances in constructed principal dimensions concerning demographic variables. Female outpatients were found to be more perceptive of the 'sensory design' factors than males. The number of previous visits to the hospital was found to be associated with 'spatial' and 'seating design' factors, while respondents' age had an association with 'sensory' and 'seating design' factors. Respondents ranked 'noise' and 'air freshness' and 'cleanliness' as highly important.

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Section: Introductionmentioning

confidence: 99%

Patients’ Perspectives on the Design of Hospital Outpatient Areas

Zhao

Mourshed

2017

Buildings

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“…The impact of the built environment on dementia care outcomes Previous research has demonstrated: the importance of physical environments on the QoL of people living with dementia (Kovach et al, 1997;Lawton, 1997;Brod et al, 2000;Day et al, 2000;Calkins, 2004;Reimer et al, 2004); and that physical environment design features can be associated with quality of care, and behavioural and clinical outcomes (Kovach et al, 1997;Marshall et al, 1999;Day et al, 2000;Devlin and Arneill, 2003;Gitlin et al, 2003;Zeisel et al, 2003;Calkins, 2009). Research has related the built environment and its design features to most dementia related symptoms.…”

Section: Indirect Costsmentioning

confidence: 99%

A built environment response to the rising costs of dementia

Pantzartzis

Price

Pascale

2016

JFMPC

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Purpose This paper aims to identify costs related to dementia care provision and explore how purpose-built environment investments can help control these costs and improve quality of life and clinical outcomes. Design/methodology/approach This research adopts a multi-method approach where the findings of a literature review drove the analysis of data obtained from the 115 pilot projects funded by the Department of Health England’s National Dementia Capital Investment Programme. Findings Under the UK Government’s new productivity challenge, it is fundamental to identify actions that provide value for money to prioritise policy and practice. This paper identifies healthcare spaces (e.g. bathroom) where the impact of the built environment on healthcare costs are most evident and building elements (e.g. lighting) to which these costs can be directly associated. The paper advocates the development of evidence and decision support tools capable of: linking built environment interventions to the healthcare costs; and helping the healthcare and social care sectors to develop effective and efficient capital investment strategies. Research Limitations/implications Further work needs to develop more systematic ways of rationalising proactive and timely built environment interventions capable of mitigating dementia (and older people) care cost escalation. Originality/value This research takes an innovative view on capital investment for care environments and suggests that appropriate built environment interventions can have a profound impact on costs associated with dementia care provision.

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“…By contrast, the walls of a heart ward in secondary care are often painted a light shade of green because this colour appears to slow the function of the heart, reduces heart rate and enables the heart to more effectively recover its normal regulated function [113]. Patients who are exposed to a natural environment [113][114][115][116][117][118] recover more quickly than those who remain in an artificial environment [119]. Our behaviour and by implication our physiology, is continuously influenced by the sensory input which we continuously receive from our environment [117].…”

Section: Colour Perception As a Diagnostic Modalitymentioning

confidence: 99%

The Framework of a Mathematical Model of the Autonomic Nervous System and Physiological Systems: Using the Neuroregulation of Blood Glucose as an Example

Ewing¹

2015

J Comput Sci Syst Biol

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IntroductionOur sense perception enables us to eat the correct amounts of food and, under normal circumstances, we cease eating when we have eaten sufficient food, and we drink sufficient to sati sfy the body 's need for liquid. We breathe at the normal expected rate, our heart pumps at the expected rate and maintain the normal level of blood pressure, our body maintains the normal levels of acidity and temperature, we sleep for 7-8 hours per night, etc. This suggests that the body is being regulated by a biological control mechanism of enormous sophistication and complexity, which has an enormous processing capacity; however as we age, and particularly as we age beyond 50 years, the mechanism which maintains our function become increasingly less able to sustain the levels of oxygen, blood glucose, blood cell content and a myriad of other biological components which the brain requires to function [1]. The i nnate g enetic c apacity o f key o rgans d eclines a nd r esults in shortages of proteins, hormones, etc. This h as a k nock-on e ffect affecting one biological sequence after another.The cumulative effect of our lifetime of experiences, due to environmental and biological factors, influences the function and/ or stability of the autonomic nervous system and ultimately the function of our DNA and genes [2]. The level of genetic expression of the proteins (genotype) which we require to sustain our function declines and the rate at which these expressed proteins subsequently react (phenotype) also declines i.e. the ability of the body to cope with extreme events declines.There are two fundamentally significant biological issues at play: (i) the genetic ability to express proteins (ii) the body's physiological demand i.e. the phenotype or influence of the environment. In the case of diabetes, in particular type 2 diabetes, this is the regulation of Blood Glucose. The greater the level of hyperglycaemia the greater is the associated demand for insulin. The development of a medical condition occurs when the environmental demand exceeds the body's innate capacity [3] i.e. the prevailing supply and/or level of insulin is insufficient to metabolise the excess of blood glucose. By contrast, the lower the level of hypoglycaemia, which occurs in type 1 diabetes, the lower is the demand/need for insulin. If there is insufficient blood glucose the excess of highly reactive insulin will seek an alternative substrate and ultimately results in damage to the peripheral blood vessels e.g. in particular to the brain, eyes, legs and feet.The evidence suggests that this regulatory process is performed by the brain via the process of neuroregulation [4][5][6]. This is a best-fit process which takes into account the prevailing state of development or physiological damage to a part of the brain, degeneration or damage to an organ (or limb), and the prevailing inter-cellular environment i.e. the feedback of biochemical signals from the viscera. AbstractDespite the immense advances of medical research there remains a fundamental theo...

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Health Care Environments and Patient Outcomes

Cited by 295 publications

References 63 publications

Patients’ Perspectives on the Design of Hospital Outpatient Areas

Patients’ Perspectives on the Design of Hospital Outpatient Areas

A built environment response to the rising costs of dementia

The Framework of a Mathematical Model of the Autonomic Nervous System and Physiological Systems: Using the Neuroregulation of Blood Glucose as an Example

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