A Patient’s Perspective

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By Bruce Knepper, AIA

I am an Architect. My specialty is healthcare.

My formal education and 35 year career have taught me many lessons about healthcare design and construction. Some classic architectural lessons hold true like:  “Form ever follows function.”  There are lessons like the effects of color, texture, and light on the human mind. Lessons about basic structure and even the fundamentals of electrical and mechanical engineering have come my way. Those lessons, and all that experience, pale when compared to what I learned when I entered the hospital as a patient.  I was admitted to my client’s facility – a facility that I helped design.

Truth be known . . . I did not want to be a patient – anywhere. I think most people feel that way.  Short of a planned pregnancy, who would want to stay in a hospital?

As a designer I used to believe that all a patient needed was a well thought-out and appointed environment. The spaces should be clean, well lit, and the temperature comfortable – so simple.  As a patient I expected those basic attributes but I also wanted so much more.

To put my feelings in today’s terms . . . “It was all about me.”

What is wrong with ME? How is this illness or condition going to affect ME and my family? Maybe a bit self-centered (my wife loves me but she does not like me as a patient) but I think many patients act the same way I do and the hospital staff that understands this routinely score high on patient evaluations.

Before I even arrived at the hospital my journey was riddled with fear, concern, anxiety, and questions . . . dozens of questions.  Where do I park? Did I remember the forms? Where is the entrance? Where is the department? Who do I see?

Once inside and registered, I soon realize that I am no longer in control of my day.  I am told where to go, who to see, what to wear, what forms to complete and sign. I am asked and answer multiple times who I am and why I am here.  I am then told where to wait.  Yes . . . the dreaded wait. As I navigated my way through this maze my training would often kick-in.  These spaces and this time spent waiting would be a great opportunity for creative distraction.  Is there something that can distract me from my day, my immediate issues, my turn in line? WIFI comes to mind.

Now, inside the department, I am somewhat settled. Or am I?  I would like to know who invented the backless hospital gown. This person most certainly was not a patient when they dreamed this up.  I understand that it makes the job of getting to my surface easier but my legs are cold.  Where is that draft coming from? Can I have a warm bathrobe? I know this may sound picky but for heaven’s sake I’m a grown man wearing a drop cloth with a slit up the back. Where’s the respect?

I am now completely under the control of the staff. To some patients this may be comforting, for me this is a real problem.  I have developed an “I Want List”.

  1. I want to know where my doctor is.
  2. I want to know where my nurse is.
  3. I want to know when my procedure begins.
  4. I want to know who that person with that tray of needles is.
  5. I want to know what happens next.
  6. I want to know where the bathroom is.

Communication is powerful and yet, at the most crucial times, so elusive.  Information gives me some sense of control – it will make me a better patient.  I have learned in my life that schedules are merely “targets of time”.  I understand delays.  But if there is a delay – please tell me why and when we get to it.

When the procedure is complete – talk with me about it.  Tell me what you saw. Show me what you did.  Use the technology available to help me understand.  Be direct and honest.  Talk with me about where WE (you and I) go from here and when I get my life back.  What do WE do next?

I know that if you help me with my health issue, communicate clearly, and care about me – I will appreciate your splendid facility.

Now about this hospital gown—can I take it home and use it as a drop cloth?

Bruce Knepper is a registered architect and Vice President of Healthcare East at Stantec.

Bruce works out of the Butler, Pennsylvania Office and can be reached at bruce.knepper@stantec.com.