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CDS Member News and ArticlesProfessional News Articles : : ON PRACTICE MANAGEMENT by Janyce Hamilton : Decorating to calm nervous or hurried patients Decorating to calm nervous or hurried patientsOctober 15, 2009 When a dentist asked me whether or not changing the interior décor of the dental office from simple and modern to a natural landscape motif would bring a positive psychological outcome for his patients, I got help. The ADA Library’s Manager of Public Services, Ruth Schultz, and I found a handful of studies mostly limited to scent and noises. The authors of one study that surveyed patients in 70 dental practices found no significant structural differences (including design and general appearance) between the offices where patients reported care was “acceptable” and the offices where patients reported care was “less than acceptable.” 1 While a Mayo Clinic’s architecture representative told me only that their literature states that health and design are interrelated, I suspected that there was more; There had to be additional studies showing an existing relationship between environmental decor and patient outcome — if not in the dental literature, then in the medical literature. Located was the author of the bellwether report, 2009 Survey of Design Research in Healthcare Settings: The Use and Impact of Evidence-Based Design. Ellen Taylor, AIA, MBA, EDAC, is research associate and consultant with The Center for Health Design (CHD). With an architecture degree from Cornell University, she belongs to the American Institute of Architects (AIA), for which one has to be licensed as an architect and in good standing. She has two MBAs, one from Columbia University, New York City, and another from the London Business School in England. Her EDAC appellation stands for Evidence-Based Design Accreditation and Certification, which is CHD-issued. Below are highlights of our discussion on healthcare settings and their impact on patients. The InterviewJanyce Hamilton (JH): What décor will impact the patients’ experience? Ellen Taylor: There has been research on specific areas such as views of nature that can reduce both stress and pain. The seminal study in this area was conducted by Roger Ulrich, PhD, in 1984, where he found that patients recovering from abdominal surgery had better results when viewing nature through their window, than those viewing a brick wall. Pain was lowered, resulting in reduced pain medication, and they had shorter stays and better emotional well-being. This is also true for representational artwork of nature. Studies have also shown that the combination of nature scenery and classical music or nature sounds reduces pain, stress, anxiety, and even (the use of) self-administered sedation. Higher levels of natural daylight can also reduce pain. Noise can increase perceived pain. JH: Are these findings clinically proven by well-designed studies? Ms. Taylor: Studies in the area of pain management are quite rigorous. The studies referenced above are empirically based and appear in peer-reviewed journals. Many of the studies referenced above are randomized or otherwise controlled. The literature is reviewed in the Health Environments Research and Design (HERD) Journal and in a downloadable 2008 white paper. JH: How seriously should office décor be prioritized with other needs in the dental office? Ms. Taylor: If you can create an environment that makes staff able to do their job more efficiently through improved design, or create an environment that reduces staff turnover (and resulting training costs), these all become considerations for the return on investment. The findings of the 2008 study conducted by Frank Becker, PhD, and his colleagues published in both the HERD Journal and the Journal of Ambulatory Care Management indicated that the more attractive environments resulted in perceptions of reduced wait times, as well as perceptions of improved quality of care, improved staff interactions, and willingness to recommend the practitioner. JH: Any last compelling thoughts on dental office décor? Ms. Taylor: I can’t tell you how many nurses indicate they put the most serious patients in the room facing the mountain view, or in the room with the largest window. Through research studies, this is now part of the growing knowledge base of research that nature and daylight are in fact restorative. The 2004 report by Leonard Berry and coauthors, The Business Case for Better Buildings, projected on a 300-bed fable hospital costs for additional design features. They approximated the savings realized in one year from improved safety and staff turnover costs. ConclusionScale the findings down from Berry’s 2004 study of hospital design savings to a dental practice, and what it costs in creating new design décor could be offset in a relatively short period of time. Janyce Hamilton is an award-winning Chicagoland freelance dental writer and editor. Send suggestions for topics to be covered, or any comments on this column, to review@cds.org. © 2009, Chicago Dental Society Reference1. van der Wal CJ, Nakahata DT, Posl WM, Sheofsky RM, Field JF. Dental office structure and treatment outcome — related or independent? CDA J 1995;23(9):41-49.
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