WAITING ROOM PHYSICAL ENVIRONMENT AND OUTPATIENT EXPERIENCE: THE SPATIAL USER EXPERIENCE MODEL AS ANALYTICAL TOOL

WAITING ROOM PHYSICAL ENVIRONMENT AND OUTPATIENT EXPERIENCE: THE SPATIAL USER EXPERIENCE MODEL AS ANALYTICAL TOOL

ABSTRACT

Waiting to receive medical attention is universally present in outpatient health services and, therefore, is a critical experience for service satisfaction. Researchers find that the waiting room physical environment influences users, and it may reduce the adverse effects of waiting. In this study, we used the spatial user experience model framework in order to better understand the impact of waiting room features on patient experience. We developed and administered a questionnaire in waiting rooms at two Chilean medical centers. Responses from five hundred sixty-three outpatients and their companions were analyzed through structural equation modeling, concluding that the model is appropriate to describe the spatial user experience in waiting rooms. The dimensions of emotional reaction, spatial appreciation, physical compatibility, and spatial cognition had the most substantial influence on user experience. Furthermore, the user experience showed a strong influence on behavioral intentions desirable by the healthcare industry. Our study provides useful insights to managers and creative teams about the diversity of factors that should be taken into consideration to implement waiting rooms that facilitate positive experiences for patients and visitors.

INTRODUCTION

Healthcare providers prioritize advanced facilities to offer quality care and have adopted a patient-centered orientation emphasizing customer experience, a fundamental value of service design. Thus, identifying and understanding the factors that affect patients is essential to promote positive experiences.

In particular, the healthcare industry acknowledges the relevance of the physical environment to improve service quality. The role of the physical environment as a relevant component of what customers expect from the healthcare experience was highlighted, and the concept of atmospherics and the servicescape framework were adapted to propose the healthscape. Furthermore, there is a wide body of literature addressing the effects of specific environmental conditions on diverse patient outcomes.

Yet, the impact of the physical environment on the patient experience still needs further research. Whereas investigators addressed the environmental effects of healthcare facilities on inpatients, outpatient services have gained relevance in the healthcare industry, opening new research opportunities.

For the outpatient journey, the waiting room experience is critical to forming perception of quality of care and satisfaction. In this context, the physical environment could be used to counteract the negative effects of waiting. It was found that patients who gave high scores to the waiting room's comfort had more tolerance for waiting. It was observed that the waiting room environment had a stronger impact on service satisfaction than the actual waiting time. It was explained that, although it is not always possible to decrease waiting times, manipulating the environment is a feasible strategy to reduce the negative impact of waiting, influencing customers' affective responses and satisfaction. Consequently, studies contributing guidelines to improve the waiting room physical environment can be an important resource for service providers and creative teams.

... there is scant evidence of studies attempting to holistically measure the impact of diverse waiting room features on patients. It is also an open question whether certain spatial features have a stronger impact on the patient experience than others.

Nevertheless, literature addressing the impact of the waiting room's physical environment on outpatients is limited. Most researchers focused on evaluating the effects of specific environmental features on patients' levels of stress or satisfaction and on assessing patients' perception of diverse environmental features. Researchers have not measured overall user experience of the space, and there is scant evidence of studies attempting to holistically measure the impact of diverse waiting room features on patients. It is also an open question whether certain spatial features have a stronger impact on the patient experience than others.

In response to the complexity of the experiential phenomenon in the built environment, the spatial user experience model was proposed. The concept user experience has been widely applied in design to improve the quality of products and systems from a human-centered standpoint.

The spatial user experience model, defined from a design perspective, has multidisciplinary grounds. Based on contributions from business and marketing, environmental psychology, human factors/ergonomics, and design, the spatial user experience model consists of a multidimensional structure comprising ergonomic/instrumental and affective dimensions triggered by diverse components of the physical setting. These dimensions are the main factors that influence the user experience. Moreover, the user experience affects behavioral responses. Because most healthcare services are delivered in physical settings, the spatial user experience can be understood as a component of the overall patient experience.

The purpose of the present study was to analyze the influence of the waiting room physical environment on outpatient experience in a sample of Chilean waiting rooms on the basis of the spatial user experience model structure. Our specific goals were to one, explore whether the spatial user experience model is adequate to describe patients' waiting room user experience, two, identify which dimensions defined in the model have the largest influence on waiting room user experience, and three, evaluate whether the user experience affects behavioral responses that are desirable for healthcare services. Our study contributes to closing the literature gap regarding the outpatient waiting room user experience and provides useful insights in the design of waiting rooms that improve patient experience and well-being.

This article is structured as follows. First, we discuss the literature addressing the effects of the waiting room physical environment on patients. Second, we present the spatial user experience model and the research hypotheses, followed by the methodology applied and results from each stage of the study. In the last section, we examine the study findings, implications for managers and designers, limitations, and projections.