Neglected spaces: UK general practice surgery waiting rooms

The literature Using the key phrases ‘healthcare’ and ‘waiting rooms’, and discounting those studies that addressed issues such as length of waiting times, the following databases were searched: CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, Health Management Library, HMIC (Health Management Information Consortium), and PubMed. An iterative process was used to select 24 studies that were concerned with the way patients were affected by their surroundings while they waited to see a GP. Although not comprehensive, this literature search has found a broadly representative sample of the existing writings, the points of which are summarised below. Few people look forward to waiting and therefore the acknowledgement of patient anxiety and the value of stress-reducing ‘positive distractions’ is frequent. Positive distractions include views of nature, music, and visual art. It is argued that perceptions of the quality of care taken over the appearance of a waiting room can be a proxy for care taken over a patient’s health and the literature has addressed seating arrangements, smell, decoration, with a view to conveying a sense of ‘homeyness’ that that according to Goelitz and Kahn ‘helps the space feel more like a living room’. Dilani sums up this approach by suggesting the adoption of a ‘salutogenic’ approach to health waiting spaces which focuses on ‘the factors that keep us well, rather than those that make us unwell’. The waiting period is, in the words of Sherwin et al,a ‘key, yet neglected segment in health care’. A few writers have given thought to what Tsai and colleagues in their study of a hospital out-patient waiting area, term the ‘atmospherics’ of place. Gillespie’s study of the relationship of architecture and a waiting room in a family planning clinic is one example and another is that of Evans et al, that explores the use of artwork in hospital waiting rooms in a discussion of the ‘therapeutic aspects of medical spaces’. Just as the waiting period is underexplored, the surroundings in which this happens are equally neglected. Neuwelt and colleagues have drawn attention to this and call for greater exploration of the ‘complex but under-recognised internal geographies’ of waiting rooms. Finally, there was a lack of a discussion of the content (images and text) of the health education materials and general wall displays. One study discussed the presence of potentially stress-inducing displays such as alarming images of cancers.