The Role of Space in Patients' Experience of an Emergency Department: A Qualitative Study.

INTRODUCTION: Nurses are increasingly involved in the design of health care facilities. Although their experience differs from that of patients, they are often expected to represent patients in design processes. Especially in the context of an emergency department, patients' states of mind alter their experiences. Knowledge about the role of space in ED patients' experience is limited. Our study aims to gain insight into this role and thus provide ED nurses with information to better represent ED patients' perspectives in design. METHODS: We conducted qualitative interviews with 22 patients. The interviews were supported by visual material collected through ethnographic methods to facilitate participants' reflections on the role of space in their experience. Participants were selected during their stays at the emergency department by convenience sampling. Interviews were audio-recorded, transcribed, and analyzed in combination with the visual material through open and axial coding. RESULTS: We found that the role of space in ED patients' experiences is affected by their altered sensory awareness and shaped by material, social, and time-related aspects. These aspects are intertwined and influenced by the transient character of the emergency department. DISCUSSION: The study indicates that paying attention to the role of space yields a nuanced understanding of ED patients' experiences. The challenge for hospital designers and staff lies in taking into account patients' altered sensory awareness and in designing interventions that support staff in emphasizing a human approach without counteracting the medical-technical aspect of emergency care.

Being Wheeled or Walking: A Qualitative Study of Patients' Spatial Experience in Two Distinct Day Surgery Centers.

OBJECTIVE: In this article, we explore what a different way of moving-being wheeled versus walking-means for the spatial experience of day surgery patients. BACKGROUND: Day surgery centers can be conceived in very different manners. Some are organized similar to traditional hospital admittance; others are located in a specifically designed part of the hospital and receive patients as guests who walk through the entire procedure. METHODS: We conducted semistructured interviews with 37 patients at two distinct day surgery centers. RESULTS: Despite the different managerial concepts and corresponding spatial designs, in both centers, patients' spatial experience is shaped by the interrelation of material, social, and time-related aspects. However, the chosen concept results in a different experience throughout patients' journey. CONCLUSIONS: Based on an analysis of the different journeys, we conclude that patients' interpretation of a hospital's care vision is influenced not only by what the hospital communicates explicitly or how it educates its staff but also by what is implicitly told by the built environment.