The influence of the consultation environment on the patient experience

An experiment on the position of furniture suggests that simple changes can produce beneficial effects on the quality of the patient experience

This study, conducted by Australian researchers and published in 2019, was designed around 12 filmed consultations, during which a patient-actor was received by a doctor for a consultation reason agreed in advance. The doctor was warned that he was dealing with six actors, but none of the participants knew the purpose of the exercise.

Each consultation took place in a similar setting, except for the position of the two chairs and the visibility or not of a stethoscope on the doctor’s neck. In half of the cases, the patient was seated in the large chair, while the doctor was seated on a small chair, and vice versa. The 12 consultations were filmed and recorded for later evaluation.

The assessment of the quality and results of the consultation was then independently assessed using three measurement tools: the Patient Enablement Index (PEI), the Leicester Assessment Package (LAP) and a matrix of assessment of nonverbal communication (Non-Verbal Communication (NVC)). The IEP is considered a reliable measure of outcome evaluation for a primary care consultation for patient satisfaction and has been measured with stakeholders. The LAP, a measure of the quality of the consultations, was applied by an expert to the videos of the consultations, while the nonverbal communication was evaluated by a specialist using a grid. The two experts were also not aware of the purpose of the experiment.

The results of this study show consistent results in the LAP test, which primarily measures physician performance. On the other hand, a significant improvement in patient empowerment and nonverbal communication was demonstrated in cases where the patient was in the chair. In addition, the visibility of the stethoscope has no measurable impact on the indicators observed.

In conclusion, placing the patient in the large chair while placing the doctor on a small chair, improves objective indicators of the patient experience during the consultations. Thus, simple changes, putting the patient in a more active, central situation, and not symbolically subject to the doctor, allow to obtain positive results for the patient experience.

Jiwa, Moyez; Krejany, Catherine; Gaedtke, Lee; Kanjo, Epi; Nagendran, Ruthra; O’Shea, Carolyn; and Greenlees, Iain (2019) “Can doctors improve the patient experience by rearranging the furniture and equipment in their office? A video recorded simulation,” Patient Experience Journal: Vol. 6 : Iss. 1 , Article 6. Disponible ici :

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