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How is the Built Environment of a Contemporary Outpatient Department Experienced? A Systematic Review of Qualitative
Rona Inniss1,2, Daryia Palityka3, Susie M D Henley1
1Department of Neurology, Neurofibromatosis Service, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Abstract:
ObjectivesTo synthesise evidence on patient and staff experiences of the built environment in contemporary outpatient departments.BackgroundEvidence relating to experiences of outpatient department environments is scarce.MethodsData was retrieved by searches for qualitative studies published between 2012 and 2023. The searches were rerun in October 2025 to identify studies published since the initial search (no additional eligible studies were identified). Studies including adults (≥16 years) using qualitative data collection and analysis were included. Study design limitations were noted and considered during interpretation. No language limits were applied. Two reviewers independently screened and extracted data, resolving discrepancies through discussion before reflective thematic analysis was conducted by the lead reviewer.ResultsA total of 843 studies were screened and 48 studies were included for broad overview. Of these six (n = 461 participants) explicitly investigated patient or staff experiences of outpatient departments and met inclusion criteria for full analysis. Generalisability may be limited by absence of studies not in English or from lower-middle/low-income countries. Line-by-line coding preceded synthesis of concepts, second-order interpretations and five final interpretations. Outpatient departments can provoke anxiety and reduce perceived safety for patients and staff but can also provide positive experiences. Themes highlighted the complex and multifaceted nature of healthcare environments and showed that experiences of outpatient departments is underexplored particularly for people with additional needs.ConclusionsThe five final interpretations highlighted that the design of outpatient environments could and should facilitate social interaction and links to the wider community, create positive distractions, foster positive memories and ensure that spaces are accessible for people with additional needs.
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