Spatial Configuration and Staff Experience in Ambulatory Care: A Comparative Analysis of Linear and Onstage/Offstage...

ObjectiveThis study examined staff perceptions of design and patterns of work locations and activities across two different designs, linear design and onstage/offstage clinic design, to inform evidence-based facility design and planning decisions.BackgroundHealthcare industry trends indicate an increasing focus on outpatient facilities, which currently represent 42% of healthcare construction spending, necessitating research on optimal design approaches for staff efficiency and satisfaction.MethodThree types of data collection and analysis were employed. First, surveys were conducted with nursing, medicine, physician assistants, case managers, and medical assistants/technicians from linear design (N = 48) and onstage/offstage design (N = 50) clinics. Second, focus groups of 24 staff were employed across clinics. Third, staff shadowing utilized tablet-based applications to record patterns of work activities, participants, and locations (N = 6,604 observations; 150 h).ResultsSurvey results showed Onstage/Offstage clinic staff had significantly more favorable perceptions of Clinic Design Features (p = .000), Design Awareness (p = .001), and Satisfaction with Design (p = .001) than Linear Design staff. Open-ended survey comments provided staff preferences and issues with clinic design. Focus group analysis revealed two themes from Linear Design staff: (1) Distance, and (2) Onstage/Offstage clinic design was superior and one theme from Onstage/Offstage staff: Proximity. Shadowing data revealed distinct workflow patterns, with Onstage/Offstage clinic staff spending significantly more time in direct patient care while Linear Design staff allocated more time to paperwork and patient reception activities. Conclusions: Key implications for clinic designers include prioritizing centralized staff work areas, implementing acoustic privacy solutions with spatial zoning; and redesigning patient interaction points for enhanced privacy compliance.