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As the stories about yesterday's horrific bombing in Boston continue to emerge, I'm reminded of the critical role hospitals play in times like this.

Modern Healthcare reported that seven Boston area hospitals were treating at least 143 people, many of whom were critically injured or in serious condition.  The emergency department, of course, is the front line in situations like this, and I can only imagine how chaotic things were in the EDs at these hospitals yesterday afternoon.

Incidents like this also remind me how important waiting areas are for anxious family members and friends of the victims.  Many probably spent the night in the ED -- or at least a good portion of it. And you can bet that their experience will have an impact on the overall experience of their loved one when he or she eventually fills out the HCAHPS questions.

Very few studies have been done on the impact of the physical environment of ED waiting areas on anxiety, but there are some that come up in a search of The Center for Health Design's Knowledge Repository. Obviously, furniture is important to waiting spaces, but providing positive distractions, like artwork or access to nature and natural light has also been found to reduce anxiety.  Privacy is another issue.

I recently toured the University of Chicago's new Center for Care and Discovery (watch for my article in the June issue of Healthcare Design), where architects Rafael Vinoly & Associates had designed enclosed square "pods" in the the building's massive sky lobby to address privacy. Not every building has this type of space to work with, but it is an interesting concept.

Patient satisfaction expert Mary Malone thinks that waiting areas should be called "hospitality areas," because waiting is stressful. She's also questioned why we create rooms for waiting and has challenged those designing new or renovating existing healthcare facilities to re-think this concept.

I don't know what the waiting areas are like in the seven Boston hospitals that treated the bombing victims, but I do hope some of them had some design features that were able to provide some comfort.

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Angela Tilghman

11 years ago

Truly many hospital ED's do not address patient/guest comfort. In a 24/7 environment looked upon to a diverse array of health care needs with immediacy how do you accommodate that crucial component to care.
I have participated in the evaluation of an ED here in Washington DC that acurately describe the conditions you mention. Uncomfortable chairs, lack of privacy, stress, perceived wait times and NOISE were big concerns for staff, patients and visitor.
Our study was part of an initiative with the hospital to evaluate those issues described. We were able to create a new ED Waiting room and Nurse Core that addressed the concerns discussed. Kenetic lighting was used to maintain bio-rhythums, interactive projection screen, fish tanks, acoustic tiles and others to help combat the presented issues.
On a recent visit I some 3 years later the materials and finishes are holding up well and the people appear to be more calm. I think the biggest and most surprising outcome was the volume. The space was quiet for an ED.
Thank you for reminding us how important the culture of an environment as well as its use.

Sara Marberry

11 years ago

Thanks for sharing, Angela! Has your study been published?

Christie Mayer | Healthcare Designer

11 years ago

As a healthcare designer, former Bostonian, and sister-in-law to a Mass General nurse, Monday's tragedy has weighed heavily on my mind. It reminds us never to lose sight of why we design for healthcare. We have a unique opportunity to influence patient outcomes and personal experiences when people are in their darkest hours and most vulnerable.

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What's my story? I'm a healthcare and senior living design knowledge expert who writes and speaks frequently about trends and issues affecting these two industries. I'm also a strategic marketing consultant and content creator, working with companies and organizations who want to improve the quality of healthcare and senior living through the design of the physical environment. You can reach me at .

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