Does the redesign of a psychiatric inpatient unit change the treatment process and outcomes?

OBJECTIVE: This study investigated whether ward atmosphere mediated the associations between the physical and therapeutic characteristics of an inpatient ward and patient outcomes. METHODS: Individuals (N=290) receiving inpatient care for mood and anxiety disorders before and after an extensive renovation project were surveyed about ward atmosphere, quality of life, and treatment satisfaction. Global functioning at admission and discharge and other clinical characteristics were obtained from patients' charts. RESULTS: After the redesign, participants perceived improved ward atmosphere, and the improvement was associated with greater treatment satisfaction and quality of life. Change in global functioning was independent of ward atmosphere. CONCLUSIONS: Efforts to improve the inpatient environment by supporting patient autonomy, peer support, and practical skill development may be expected to meet with improved outcomes, at least for quality of life and satisfaction with treatment. These findings are consistent with patient-centered design as well as with broader perspectives on recovery-oriented services.