What Matters, Not What is The Matter

: A Novel Approach to Empathising and Understanding the Third Space of the Healthcare Waiting Room

Abstract

This study uniquely applied a novel design-based lens to healthcare contexts to unveil many subtleties of the patient-space milieu, furthering debate and dialogue on this important topic.
The NHS operate under complex pressures including budgetary, resourcing, global pandemics and an ever-ageing population. In response, recent governmental drives to modernise operations include the 2019 ‘Health Infrastructure Plan’ that seeks to make improvements, where the intention is to address ‘what matters to someone’ and not just ‘what’s the matter with someone’. There is a need to ensure such developments meet the stated goals of world-class facilities and well-designed spaces to speed up recovery and ensure the appropriate treatments. Outside of these pockets of innovation however, a sizeable legacy remains of outdated facilities that will continue to impact patients. Notwithstanding the intentions of the architects and service designers in the planning of health centres, the micro-level facets of the patient experience still need to be fully understood, since there lacks an emphasis on listening to the voice of the patient.
Through a deeply empathetic ‘design thinking’ lens, this research identified the multiplicity of barriers and enablers of person-centred care with hospital waiting spaces. Following a comprehensive review of literature, an initial conceptual framework was developed. This was then tested, initially via a pilot study for feasibility, before a main study conducted through a novel two-stage exploratory design. This incorporated ethnographic observation in a real NHS setting to portray situated happenings, followed by a series of semi-structured case interviews providing rich insights from the patients’ perspectives.

The results indicated important patient considerations: whilst the physical characteristics (sounds, décor, wayfinding, etc) contributed, it was revealed that ‘what mattered’ included a sense of choice, agency and dignity, and this clearly impacted well-being. As a result, an innovative theoretical framework was developed that identified the key barriers and enablers of positive patient experiences. Finally, guide for practice emerged: a discussion checklist for including multiple patient-centred considerations for future projects.

Date of Award	28 Oct 2024
Original language	English
Awarding Institution	University of Winchester
Supervisor	John Richardson (Supervisor) & James Faulkner (Supervisor)