Hospitals as hotels are back in the news. Or at least in a blog post I came across this past week on Quartz, which bills itself as a "digitally native news outlet for the new global economy."

Titled, "Rather Than Turn Hospitals Into Expensive Resorts, Healthier Patients Require Happier Nurses," writer Jayson Marwaha (who also happens to be a medical student) states that the changes hospitals are making are focused on adding amenities and creating "luxury" environments. He argues that they should instead be "fixing the dismal culture of the employees patients see the most: nurses."

Environment Informs Culture

Now, no one can argue that how nurses, physicians, and others who come in contact with patients treat them is the most important factor in the patient experience.  That's the reason organizations like The Beryl Institute exist.

But I would argue that the design of the physical environment reflects the culture of the institution and affects employee morale.

If you're working in a crummy environment, you're going to feel crummy. You probably will even act crummy.

And what's the definition of a "luxury" environment? I've toured a lot of hospitals and looked at hundreds of project photos and am not sure I'd term any of them luxury. Well, okay, there was that unit at Memorial Hermann in Houston.

But it was specifically designed for VIP celebrity patients.

Integrative Therapies Aren't Just Cushy

Earlier this year, the Joint Commission opened the door for integrative therapies in hospitals by including non-pharmacologic strategies in its definition of pain management.  The "cushy services" like massage therapy, acupuncture, chiropractic therapy, relaxation therapy offered in many spas that Marwaha deems as expensive and frivolous.

The Joint Commission isn't always right, but usually when it adds things to its standards, there are good reasons for doing so -- like better quality care, reduced costs.

I agree with Marwaha's argument that it's dangerous to judge the quality of healthcare provided at a hospital with how it looks or the types of amenities it offers to patients.  Susan Mazer recently wrote an excellent post about this, too.

Using the Ritz-Carlton as an example, Marwaha argues that hospitals should follow hospitality's lead and focus on the culture of its employees rather than investing in costly amenities. But if those amenities do help improve the patient experience (and thus, probably saving money), why can't a hospital do both?

That's essentially what the Ritz does.

Planetree Got it Right

I think back to Planetree, which started the patient-centered care movement more than 30 years ago. It always included the design of the physical environment in its culture change formula.

Planetree's "amenities" were kitchens on the unit for patients, families, and staff to use; artwork on the walls; and a resource library.

Maybe some hospitals have gone too far into the hospitality model.

But I find it hard to believe that those who are doing it aren't also looking at ways to support the staff so that they can do their best work. And I don't think any hospital CEO in America has any intention of turning his/her facility into a Ritz-Carlton.

What do you think?

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