My mother was a nurse—the increasingly rare Florence Nightingale kind, I must add. Growing up with a nurse as a mother, one tends to have a special relationship with hospitals. One’s life becomes so interwoven with hospitals that one eventually develops a love-hate relationship with these health facilities. Hospitals bring back some of your fondest memories while at the same churning some of your most unpleasant childhood recollections.
To your young mind, the hospital “took” your mother away every morning—when you wish she stayed at home—and kept her till late in the afternoon. However, that same hospital was where you went when you fell sick. It was not as if those visits were even pleasant. In the midst of helping you get better, the hospital still managed mete out some pain. Who loves bitter medications and painful injections? Not the nurse’s child, I can tell you.
For those who did not grow up with doctors or nurses, the experience with hospitals are quite different. These individuals do not have to worry about their parents being called to work in the night. As children, they do not have to deal with being given a medication for the slightest ailment. They visit health facilities just one thing—to help get their health back. To do this successfully, however, health facilities must possess certain qualities.
One of the key assets needed in every hospital is the presence of well-trained doctors, nurses and other medical professionals. All health facilities must have experts who know what they are about. This is why when there are issues with patient’s health, we take up issues with those into whose arms we have entrusted our lives. The many court cases of medical malpractice brought up against health facilities provides a clear indication of customer expectations for these service providers.
Another necessary attribute of a good health facility is the facility’s physical state or condition. The importance of the tangible attributes of the service encounter has been widely studied, and this holds true regardless of the kind of service. A popular model for evaluating the quality of an organisation’s services is the RATER Model. The importance of the physical setting of service is captured by this metric. RATER is an acronym for Reliability, Assurance, Tangibles, Empathy, and Responsiveness. Studies after studies have shown that the tangibles or physical component of service has a direct effect on the experience of customers.
In this vein, one can see how important the design and facilities of a health facility are to the perceptions of service quality of patients (read, customers). It is therefore not surprising that many modern hospitals have started looking more like hotels than hospitals. The hospitals with this kind of ideology are rivalling some of the best hotels in terms of their amenities and services.
There are two ways hospitals and hotels are gradually merging. The first is that of hospitals designed to look more like hotels. In the second instance, hotels are specially built for the sick. In both scenarios, there is a blurring of the lines of what constitutes a hospital and what constitutes a hotel.
One hospital is reported to have a gazebo patio for smoke breaks, monogrammed towels, a fancy gym, a pool and espresso machines. There are hospital wards and private recovery rooms that are being put up with materials that reduce noise and offer natural light to aid in patient recovery. Hospitals with hotel-like amenities such as free Wi-Fi, 24-hour room service, etc., are now becoming the norm in some cities. There are even hospitals that have spas. In terms of services, some of these hospitals have uniformed valets and professional greeters welcoming patients.
In August 2015, a new hotel was opened on the campus of the Copenhagen-based specialist hospital, Rigshospitalet. Called the Patient Hotel, this hotel provided much-needed accommodation for individuals who had travelled from far for check-ups or for treatments. However, the hotel also provided patients undergoing long-term medical care an alternative from the wards in the hospital complex.
The award-winning Danish architecture firm that designed the building was particular about things such as the flow of daylight into the rooms as well as the colours and kinds of materials used for the interior decorations. The intention was to create a place that was welcoming, pleasant and comforting for individuals going through a very tough time in their lives.
The concept of hotels built specifically for patients is not a recent phenomenon. As far back as the 1980s, the concept was already in existence, especially in the Scandinavian countries. From the onset, there have always been arguments against such a direction. It was therefore unsurprising that in 2015, a study was conducted by Johns Hopkins Hospital in Baltimore on the phenomenon of providing patients with hotel-like facilities. The study, published in the Journal of Hospital Medicine, was conducted in the 355-room Sheikh Zayed Tower of the Hospital. The study ultimately claimed that the design of hospitals did not contribute to patients’ satisfaction with the quality of care they receive from their healthcare providers.
According to the researchers, although patients responded positively to the new facilities, they still dissociated the facilities from the actions of the nurses and doctors. In other words, patients were smart enough not to confuse the quality of service the received with the beauty of the new surroundings. The researchers, led by Dr. Zishan Siddiqui used the results of that study to advise hospital administrators not to use the state of their outdated facilities as an excuse for poor performance which will lead to patient dissatisfaction.
It is interesting to note that another study undertaken a couple of years after the Johns Hopkins Hospital research came out with different findings. Published in the Cornell Hospitality Quarterly, the study was titled “Restorative Servicescapes in Health Care: Examining the Influence of Hotel-Like Attributes on Patient Well-Being”. It involved more than 500 patients with different health conditions. There were a number of conclusions from the study.
One finding was that health centres that offer hotel-like products and services were more likely to enhance patients’ perceived well-being. This led to more favourable behaviours from these patients. It was further discovered that less-healthy patients were more likely to derive greater restorative benefits from hotel-like hospital rooms. The effect of this is that such patients would be more likely to pay higher out-of-pocket expenses for such rooms.
These two studies alone show that there is no conclusion on this matter. This debate was brought to the fore in an August 2016 publication of the New York Times. Regardless of the stance of those whose views were sought, there was a general agreement that health facilities had a lot to learn from the hospitality industry. The need to place patients’ experiences at the centre of a facility’s operation was something that few debated on. The consensus was that patient-centrism was lacking in many hospitals and this had to change.
However, beyond this point of agreement, there were those who were of the view that hospitals should never be made to feel like hotels. One motion for this stance was that hospitals were dangerous places therefore making patients feel too comfortable in a hospital could backfire. For one, it was argued that, in health facilities, patients had a greater risk of being infected with new ailments.
Costs was raised as another issue by those against the notion of hospitals becoming like hotels. The argument was that in a hotel, individuals paid for their individual experiences during their stay. Hospitals have a slightly different costing model. In a hospital, costs are distributed among all consumers rather than just on one individual patient. Therefore, a patient “overstaying” in the facility could affect the amount that other patients will have to pay.
There are however those who believe that patient hotels should be encouraged because they end up freeing up much-needed beds for those who critically need them. In many developing countries, the lack of adequate number of beds in hospitals is a real challenge. It is therefore argued that if there is a select number of patients who can pay to live in hotel-like conditions, then the practice should be encouraged.
According to another of those against the hotel-isation of hospitals, “a hospital patient’s primary goal is to get better, not to take a vacation.” She further added, “Uniformed valets and flat-screen TVs will not improve patient health.” To this individual, what hospitals need to do is to rather employ more nurses because the nurse-to-patient ratio was one of the main causes of patient dissatisfaction.
With all the valid points raised against turning hospitals into hotels, one wonders why the practice does not seem to be dying out. Since demand normally precedes supply, one can confidently surmise that patients are demanding these concierge services. It is entirely possible that patients are coming to the realisation that the challenge with hospital services might actually not be the fault of the individuals working in these facilities. The challenge might be with the physical space within which these individuals work.
Regardless of where one stands on this issues, I believe, the call by the patient hotel advocates for a second look at the servicescapes of hospitals must, in the very least, be considered—even the most ardent critics of the idea. Without necessarily turning hospitals into hotels, administrators and managers have to review the kind of physical environment they operate in. Patients are primarily customers. They must therefore enjoy the same, if not better, quality of facilities as customers receive from hotels and other hospitality facilities. If in improving the hospital’s facilities, the place begins to look like a hotel, then, well, so be it.
