Henize Adrienne W, Beck Andrew F, Klein Melissa D, Morehous John, Kahn Robert S
Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 7035, Cincinnati, OH, 45229, USA.
Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Matern Child Health J. 2018 Jun;22(6):779-785. doi: 10.1007/s10995-018-2508-z.
Introduction Children and families living in poverty frequently encounter social risks that significantly affect their health and well-being. Physicians' near universal access to at-risk children and their parents presents opportunities to address social risks, but time constraints frequently interfere. We sought to redesign our waiting room to create a clinic-to-community bridge and evaluate the impact of that redesign on family-centered outcomes. Methods We conducted a pre-post study of a waiting room redesign at a large, academic pediatric primary care center. Design experts sought input about an optimal waiting room from families, community partners and medical providers. Family caregivers were surveyed before and after redesign regarding perceived availability of help with social needs and access to community resources, and hospitality and feelings of stress. Pre-post differences were assessed using the Chi square or Wilcoxon rank sum test. Results The key redesign concepts that emerged included linkages to community organizations, a welcoming environment, and positive distractions for children. A total of 313 caregiver surveys were completed (pre-160; post-153). Compared to pre-redesign, caregivers surveyed post-redesign were significantly more likely to perceive the waiting room as a place to obtain help connecting to community resources and find information about clinical and educational resources (both p < 0.05). Families were also significantly more likely to report the waiting room as more welcoming and relaxing, with sufficient privacy and space (all p < 0.05). Discussion Waiting rooms, typically a place of wasted time and space, can be redesigned to enhance families' engagement and connection to community resources.
引言 生活贫困的儿童及其家庭经常面临严重影响其健康和福祉的社会风险。医生几乎能普遍接触到有风险的儿童及其父母，这为解决社会风险提供了机会，但时间限制常常造成干扰。我们试图重新设计候诊室，搭建起诊所与社区之间的桥梁，并评估这种重新设计对以家庭为中心的结果产生的影响。方法 我们在一家大型学术性儿科初级保健中心对候诊室重新设计进行了一项前后对照研究。设计专家向家庭、社区合作伙伴和医疗服务提供者征求了关于理想候诊室的意见。在重新设计前后，对家庭照顾者进行了调查，询问他们在社会需求方面获得帮助的感知情况、获取社区资源的情况、候诊室的友好程度以及压力感受。使用卡方检验或威尔科克森秩和检验评估前后差异。结果 浮现出的关键重新设计理念包括与社区组织的联系、温馨的环境以及对儿童的积极消遣方式。总共完成了313份照顾者调查问卷（重新设计前160份；重新设计后153份）。与重新设计前相比，重新设计后接受调查的照顾者更有可能将候诊室视为一个能获得与社区资源建立联系的帮助并找到临床和教育资源信息的地方（p均<0.05）。家庭也更有可能报告说候诊室更温馨、更放松，有足够的隐私和空间（p均<0.05）。讨论 候诊室通常是一个被浪费的时间和空间场所，可以进行重新设计以增强家庭与社区资源的互动和联系。
