Consultation room design and the clinical encounter: The space and interaction randomized trial

Julka R. Almquist, Caroline Kelly, Joyce Bromberg, Sandra C. Bryant, Teresa J H Christianson, Victor Manuel Montori

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective: The design of the consultation room remains largely unaltered despite major changes in clinical practice, such as the electronic medical record and patient-centered care. The value of redesigning the consultation room to accommodate these changes and the effect of a redesign on patient-clinician interaction are unclear. Methods: The authors randomly allocated 65 patient-physician dyads to consultations in a standard room (n = 30) or in an experimental room designed with a semicircular table around which the clinician and the patient sat, with equal access to the computer screen (n = 35). Participant responses to post-visit surveys, assessing patient experiences in these rooms, were compared in an intention-to-treat fashion. Results: The authors found no differences between the rooms in terms of patient satisfaction with the consultation, mutual respect, or communication quality. Compared to the standard room, patients in the experimental room were better able to interact with the computer monitor (24 [75%] vs. 17 [59%], P = 0.07) and had a greater ability to look at the screen at any time (22 [73%] vs. 8 [28%], P < 0.001); and they reported that clinicians allowed them to review the medical record on the screen (22 [71%] vs. 13 [45%], P = 0.012), shared information on the computer screen (24 [80%] vs. 18 [60%], P = 0.037), and reviewed information on the Internet with the patient (13 [43%] vs. 7 [26%], P = 0.010) more than those in the standard room. Conclusions: The design of the consultation room affects the clinical encounter. In particular, ready access to a computer screen using the electronic medical record and the Internet may enhance information sharing.

Original languageEnglish (US)
Pages (from-to)41-78
Number of pages38
JournalHealth Environments Research and Design Journal
Volume3
Issue number1
StatePublished - Sep 2009

Fingerprint

Referral and Consultation
Electronic Health Records
Internet
Patients' Rooms
Patient-Centered Care
Aptitude
Information Dissemination
Patient Satisfaction
Medical Records
Communication
Physicians

Keywords

  • Consultation room office design
  • Electronic medical record
  • Evidence-based design
  • Patient-physician communication
  • Randomized trial

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

Consultation room design and the clinical encounter : The space and interaction randomized trial. / Almquist, Julka R.; Kelly, Caroline; Bromberg, Joyce; Bryant, Sandra C.; Christianson, Teresa J H; Montori, Victor Manuel.

In: Health Environments Research and Design Journal, Vol. 3, No. 1, 09.2009, p. 41-78.

Research output: Contribution to journalArticle

Almquist, JR, Kelly, C, Bromberg, J, Bryant, SC, Christianson, TJH & Montori, VM 2009, 'Consultation room design and the clinical encounter: The space and interaction randomized trial', Health Environments Research and Design Journal, vol. 3, no. 1, pp. 41-78.
Almquist, Julka R. ; Kelly, Caroline ; Bromberg, Joyce ; Bryant, Sandra C. ; Christianson, Teresa J H ; Montori, Victor Manuel. / Consultation room design and the clinical encounter : The space and interaction randomized trial. In: Health Environments Research and Design Journal. 2009 ; Vol. 3, No. 1. pp. 41-78.
@article{71ecb1c1034e443fbe86a60d1a03b270,
title = "Consultation room design and the clinical encounter: The space and interaction randomized trial",
abstract = "Objective: The design of the consultation room remains largely unaltered despite major changes in clinical practice, such as the electronic medical record and patient-centered care. The value of redesigning the consultation room to accommodate these changes and the effect of a redesign on patient-clinician interaction are unclear. Methods: The authors randomly allocated 65 patient-physician dyads to consultations in a standard room (n = 30) or in an experimental room designed with a semicircular table around which the clinician and the patient sat, with equal access to the computer screen (n = 35). Participant responses to post-visit surveys, assessing patient experiences in these rooms, were compared in an intention-to-treat fashion. Results: The authors found no differences between the rooms in terms of patient satisfaction with the consultation, mutual respect, or communication quality. Compared to the standard room, patients in the experimental room were better able to interact with the computer monitor (24 [75{\%}] vs. 17 [59{\%}], P = 0.07) and had a greater ability to look at the screen at any time (22 [73{\%}] vs. 8 [28{\%}], P < 0.001); and they reported that clinicians allowed them to review the medical record on the screen (22 [71{\%}] vs. 13 [45{\%}], P = 0.012), shared information on the computer screen (24 [80{\%}] vs. 18 [60{\%}], P = 0.037), and reviewed information on the Internet with the patient (13 [43{\%}] vs. 7 [26{\%}], P = 0.010) more than those in the standard room. Conclusions: The design of the consultation room affects the clinical encounter. In particular, ready access to a computer screen using the electronic medical record and the Internet may enhance information sharing.",
keywords = "Consultation room office design, Electronic medical record, Evidence-based design, Patient-physician communication, Randomized trial",
author = "Almquist, {Julka R.} and Caroline Kelly and Joyce Bromberg and Bryant, {Sandra C.} and Christianson, {Teresa J H} and Montori, {Victor Manuel}",
year = "2009",
month = "9",
language = "English (US)",
volume = "3",
pages = "41--78",
journal = "HERD",
issn = "1937-5867",
publisher = "Vendome Group",
number = "1",

}

TY - JOUR

T1 - Consultation room design and the clinical encounter

T2 - The space and interaction randomized trial

AU - Almquist, Julka R.

AU - Kelly, Caroline

AU - Bromberg, Joyce

AU - Bryant, Sandra C.

AU - Christianson, Teresa J H

AU - Montori, Victor Manuel

PY - 2009/9

Y1 - 2009/9

N2 - Objective: The design of the consultation room remains largely unaltered despite major changes in clinical practice, such as the electronic medical record and patient-centered care. The value of redesigning the consultation room to accommodate these changes and the effect of a redesign on patient-clinician interaction are unclear. Methods: The authors randomly allocated 65 patient-physician dyads to consultations in a standard room (n = 30) or in an experimental room designed with a semicircular table around which the clinician and the patient sat, with equal access to the computer screen (n = 35). Participant responses to post-visit surveys, assessing patient experiences in these rooms, were compared in an intention-to-treat fashion. Results: The authors found no differences between the rooms in terms of patient satisfaction with the consultation, mutual respect, or communication quality. Compared to the standard room, patients in the experimental room were better able to interact with the computer monitor (24 [75%] vs. 17 [59%], P = 0.07) and had a greater ability to look at the screen at any time (22 [73%] vs. 8 [28%], P < 0.001); and they reported that clinicians allowed them to review the medical record on the screen (22 [71%] vs. 13 [45%], P = 0.012), shared information on the computer screen (24 [80%] vs. 18 [60%], P = 0.037), and reviewed information on the Internet with the patient (13 [43%] vs. 7 [26%], P = 0.010) more than those in the standard room. Conclusions: The design of the consultation room affects the clinical encounter. In particular, ready access to a computer screen using the electronic medical record and the Internet may enhance information sharing.

AB - Objective: The design of the consultation room remains largely unaltered despite major changes in clinical practice, such as the electronic medical record and patient-centered care. The value of redesigning the consultation room to accommodate these changes and the effect of a redesign on patient-clinician interaction are unclear. Methods: The authors randomly allocated 65 patient-physician dyads to consultations in a standard room (n = 30) or in an experimental room designed with a semicircular table around which the clinician and the patient sat, with equal access to the computer screen (n = 35). Participant responses to post-visit surveys, assessing patient experiences in these rooms, were compared in an intention-to-treat fashion. Results: The authors found no differences between the rooms in terms of patient satisfaction with the consultation, mutual respect, or communication quality. Compared to the standard room, patients in the experimental room were better able to interact with the computer monitor (24 [75%] vs. 17 [59%], P = 0.07) and had a greater ability to look at the screen at any time (22 [73%] vs. 8 [28%], P < 0.001); and they reported that clinicians allowed them to review the medical record on the screen (22 [71%] vs. 13 [45%], P = 0.012), shared information on the computer screen (24 [80%] vs. 18 [60%], P = 0.037), and reviewed information on the Internet with the patient (13 [43%] vs. 7 [26%], P = 0.010) more than those in the standard room. Conclusions: The design of the consultation room affects the clinical encounter. In particular, ready access to a computer screen using the electronic medical record and the Internet may enhance information sharing.

KW - Consultation room office design

KW - Electronic medical record

KW - Evidence-based design

KW - Patient-physician communication

KW - Randomized trial

UR - http://www.scopus.com/inward/record.url?scp=79952113067&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952113067&partnerID=8YFLogxK

M3 - Article

C2 - 21165880

AN - SCOPUS:79952113067

VL - 3

SP - 41

EP - 78

JO - HERD

JF - HERD

SN - 1937-5867

IS - 1

ER -