Impact of healthcare design on patients' perception of a rheumatology outpatient infusion room: an interventional pilot study

Evidence-based healthcare design is a concept aimed at reducing stress factors in the physical environment for the benefit of patients and the medical staff. The objective of this study was to examine the impact of room modifications on patients' perception of an outpatient infusion room used for treating rheumatologic diseases. Patient and nurse interviews, a staff workshop and field observations were performed to identify environmental room factors important for the patients, and the room was modified accordingly. The changes included the colours, atmosphere and functionality of the room. Artificial plants and a water bubble wall were added to the room. Forty-four patients receiving intravenous biologic therapy for inflammatory arthritis completed a questionnaire before and after the intervention. The agreement with 25 statements regarding the environmental room factors was scored (range 0-4). A total score was calculated as the sum of all 25 scores (range 0-100). The median (range) age was 55 (28-78) years. Seventeen out of 25 scores improved significantly (p < 0.000-0.050), none deteriorated. The amount of decorating and room colours, for example, was scored significantly higher after the intervention (p < 0.000), and the atmosphere was considered significantly more comfortable and "safe" (p < 0.005). The total score increased from 63.0 (34-88) to 81.0 (48-100) (p < 0.000). The study suggests that room modifications according to the principles of evidence-based healthcare design may have the potential to improve patients' perception of outpatient infusion rooms used for treating rheumatologic diseases.