Decor or Design?

The latest Roundtable Report from the NEJM Catalyst, Measuring What Matters and Capturing the Patient Voice, details their 'Taxonomy of the Patient Voice' in the design of care and as an input to care.  While including patient-participants during physical design is not new to our community, it was good to see that notion reflected 'in the design of care'. More telling, however, is this quote from the editor, Namita Seth Mohta, MD:

"What gets put on that [hospital] dashboard conveys a strong message about what leadership thinks is important. If you spend more time evaluating whether the patients liked the décor of a hospital room than evaluating how effectively a discharge coordinator came in and talked to a patient about their discharge options … you’re sending a certain message.”

Let us consider the antecedents to effective discharge coordination:
  • Sufficient/supportive space such that the family is part of the care process and present to implement the plan
  • Seating such that the discharge coordinator might not convey 'being in a hurry'
  • Writing/communication tool support for sharing information and note-taking

Discharge coordination is a communication marathon, and corresponding impact of the physical environment is well-documented.  These factors are designed, part of the physical design, and yes, form the structure of decor.  Decor impacting discharge coordination?  Debatable.  Design?  Absolutely yes.