Awaiting A Better Future
Patients often view the waiting room as an unproductive space where they sit for a delayed appointment, while project teams and facility owners see a space that represents both construction and ongoing maintenance costs. This leads to the idea that it’s in everyone’s best interest to reduce time spent waiting as well as the amount of space programmed for waiting.
Not all waiting can be eradicated, however.
There are times in an ambulatory environment when there should be people in a waiting room, rather than in a clinical space. For example, some patients are driven to appointments by a neighbor or friend who they don’t want accompanying them into the exam room. Sometimes, it’s the clinician who requires time alone with a patient. For example, I recently took my teenage daughter to an urgent care center to make sure she hadn’t injured her leg, and the clinicians required a private moment with her to make sure she wasn’t either pregnant or abused (happily, no on both counts).
For times like these, when waiting is necessary or can’t be minimized, an increase in comfort can make a huge difference. Simple amenities, such as the installation of electrical and data outlets and desk-type tables for laptops, would be easy additions. Waiting areas should also provide a variety of seating options, including bariatric furniture and seating that supports a parent with young children (if they are likely to be there). And if Logan Airport in Boston can provide rocking chairs, why can’t a healthcare waiting area? Most importantly, remember that no one wants to sit next to someone they don’t know, making grouped seating arrangements preferable to rows of seats or pairs of rows facing each other. I also vote for no more TVs (unless I get to pick the station).
My observation over the past decade is that many large waiting areas in clinics have been over-programmed, in part because there’s been significant improvements in scheduling logistics and a renewed emphasis on efficiency. I’ve seen large waiting areas in some facilities with almost nobody sitting, even during prime time. Too much empty space, especially during peak business hours, may be better than overcrowding or standing-room only, but it may also suggest that something’s wrong with the practice if nobody else is in sight.
Facilities are also starting to introduce more interesting and engaging places to wait, such as cafés and gardens (both indoors and outdoors), leaving many traditional waiting areas underutilized. With the prevalence of cell phones, patients can quickly be called back when they’re ready to be seen. In order to rely on these types of spaces, though, there needs to be strong wayfinding that easily leads patients to the clinical areas when summoned.
This reality of reduced usage requires new thinking. From a design and experience perspective, it’s about making the best use of the space, especially if a jurisdiction still maintains a mandated ratio of seating to exam and procedure rooms. Rather than apply for waivers and the potential for denial and/or delay, we’ve planned consultation and conference spaces immediately adjacent to open waiting areas. These rooms can function as additional waiting space when necessary, such as for larger families or people with specific needs (i.e., crying children), all while meeting seating requirements and providing other functional areas. If designed with two doors, one to the waiting area and one to the clinical zone, these consult and conference spaces can serve different groups over the course of a day or year.
At the very least, it’s worth thinking about how to reabsorb a portion of a waiting area that turns out to be underutilized. For example, five years after opening Smilow Cancer Hospital at Yale New Haven Hospital (New Haven, Conn.), we added a new ophthalmic oncology suite because a third of the L-shaped waiting area lent itself to renovation for clinical space. I will never again design a waiting area that can’t easily be converted to another use.
So while most of us don’t like to wait, the waiting room will likely remain a necessity—but one that can be viewed as a “soft space” opportunity.
Jennifer Aliber, AIA, FACHA, LEED AP, is a principal at Shepley Bulfinch (Boston). She can be reached at firstname.lastname@example.org. Aliber chairs the examination committee of the American College of Healthcare Architects and has served on the board of the Academy of Architecture for Health.