Livable and healthy cities rely on healthcare networks that deliver excellent and efficient services to their populations at every stage of the wellness process. Unfortunately, many modern cities include medical facilities that have been designed without consideration for patient needs, leaving these users frustrated with systems that fail to prioritize them. Spaces that are especially noted as being inadequately designed are waiting room areas, which have been found to contribute considerably to patient stress. To determine the degree to which factors in the built environment influence this stress, a two-part study was conducted in the spring of 2023 in an urban, academic teaching hospital emergency department waiting area. During stage one, 106 patients and caregivers were surveyed to provide demographic information, stress levels, and opinions concerning environmental qualities (sounds, temperature, views, lighting, etc.). Across all participants, results showed that there was a moderate correlation between total stress scores and mean environmental domain scores. Furniture layout, privacy, and sounds were noted as some of the most poorly rated qualities in this survey. During stage two, three virtual reality simulations were constructed using the results from the prior investigation to create proposed improvements to the waiting area. Twenty-four staff members and potential patients utilized additional surveys and qualitative feedback to provide pros/cons for each scheme, which revealed noteworthy contrasts between staff and patient needs, specific to urban locations. This data is able to act as a case study to inform modern inner-city emergency room stress reducing design solutions.
Lisa Phillips, NCIDQ is an Associate Professor of Interior Design at Thomas Jefferson University in Philadelphia. She has a Bachelor of Architecture degree and Master of Education degree, both from Temple University. Ms. Phillips has over twenty years of experience teaching in interior design and has won multiple teaching awards. She currently teaches design, textiles and materials, and capstone research and programming. Her areas of research include design pedagogy and the study of the senses as they relate to the user experience. A primary area of focus is design for wellness, particularly as it’s related to the remediation of stress.
Dr. Louis N. Hunter, PT, DPT is an Associate Professor of Health Science and Program Director of Health Sciences in the Jefferson College of Health Professions (JCHP) with a secondary appointment as an Associate Professor of Physical Therapy in the Jefferson College of Rehabilitation Sciences (JCRS) at Thomas Jefferson University. Dr. Hunter also serves as the Director of Global Strategic Initiatives for JCHP and JCRS. Clinically, Dr. Hunter is a pediatric physical therapist with twenty-three years of experience. Dr. Hunter’s research interests include community-based rehabilitation, local and global interprofessional service-learning, global health education, and physical therapy and the built environment.
Jenna Rieder is an Assistant Professor of Psychology at Thomas Jefferson University. She earned her PhD in the psychology subarea of Cognitive and Behavioral Neuroscience from the Graduate Center, The City University of New York. Her research has focused on stress, including both normative stress and more extreme or traumatic stress. In trauma-exposed populations, her work has explored how hormonal fluctuations relate to stress reactivity, affective experiences, and stress-related symptoms. Her research has also considered the role of the built environment in impacting normative stress within a variety of daily life settings, ranging from medical waiting rooms to college campuses.
Dr. Morgan Hutchinson, MD is a Clinical Assistant Professor within the Sidney Kimmel Medical College and an Assistant Medical Director at Thomas Jefferson University Hospital. She has been active in mobile health care initiatives through Thomas Jefferson University Hospital, serving as a collaborator and advisor to bring programs for cancer prevention, primary care and women’s health to underserved communities. More than clinical care, Dr. Hutchinson also oversees a multi-disciplinary team aimed at rethinking hospital spaces through the Health Design Lab, helping shape the future of health care delivery.
Patrick Moeller, MPH is the research manager at the Jefferson College of Population Health. He has nineteen years of experience in clinical research, biostatistics and epidemiology. Pat holds an MPH from the University of Pennsylvania and a BS in Physics from Carnegie Mellon University.
Savannah Spicher is a 2024 alumnus of Thomas Jefferson University. She earned her Bachelor’s degree in Interior Design, as well as a minor in Sustainable Design. Savannah also received an award for Academic Excellence in Interior Design from TJU. Throughout her education and research, she found her passion for environmental psychology, especially relating to the skill set of creating environments designed for human well-being. Savannah was an integral member of the research team through her roles in data collection, analysis and most notably, the development of the three-dimensional design proposals that were utilized in stage two of the study.
Alisha Agarwal is a current M.D. Candidate at Thomas Jefferson University’s Sidney Kimmel Medical College. She graduated Summa Cum Laude from The University of Pennsylvania with a Bachelor’s of Science in Engineering, Bioengineering and Biomedical Engineering and is interested in the intersection of design thinking and medicine. Alisha was a key member on the research team in her role of data collection.