Chair placement in hospital rooms might seem trivial, but its influence on patient care is profound. In a study conducted at a county hospital in Texas, researchers tested how the strategic positioning of a chair near a patient’s bedside could change physicians’ behavior and, in turn, impact patient satisfaction.
Hospitalist physicians were randomly assigned to two groups: one where a chair was placed within three feet of the bedside, and another where the chair remained in its usual location. The study aimed to see if this subtle environmental change could encourage physicians to sit more often during patient consultations. The results were clear.
Encouraging Sitting Behavior Of the physicians who had a chair placed near the bedside, a significant 63% chose to sit during their encounters with patients. In contrast, only 8% of physicians in the control group sat. This simple intervention increased the odds of sitting by more than 20-fold. Dr. Avery Young, a researcher on the team, stated, “We knew that sitting would have a positive impact, but we were surprised at just how substantial the change was.”
This increase in sitting was not just a change in behavior for the sake of it. Sitting during consultations is linked to better communication, and patients often perceive their physician as more engaged and caring when they take the time to sit down. As Dr. Jenny Kim explained, “When physicians sit, the patient feels heard. It’s a small gesture, but it makes a big difference.”
Impact on Patient Satisfaction The effects of this nudge extended to patient satisfaction scores. Patients in the group with chair placement rated their care higher on the Tool to Assess Inpatient Satisfaction with Care from Hospitalists (TAISCH) survey. The intervention led to a 3.9% increase in satisfaction scores. This may seem modest, but in healthcare, even small gains can have significant implications for patient experience.
One patient reported feeling “more comfortable” when their physician sat during the consultation. Another remarked, “It felt like the doctor was really listening to me.”
Improved Communication Sitting also appeared to improve how well patients understood their care plans. In the intervention group, patients were more likely to feel informed about their medical treatment and expressed greater confidence in their doctor’s recommendations. Dr. Courtney Newman reflected on the significance of this finding, noting, “Effective communication is the cornerstone of patient care. If sitting down helps bridge that gap, it’s worth making it a standard practice.”
However, the study found no significant difference in the actual time physicians spent in the room, nor in how long patients or doctors perceived the consultation to last. This suggests that the act of sitting, rather than the length of the visit, contributed to the improved perceptions of care.
No Extra Costs, Big Benefits One of the most compelling aspects of this intervention is its cost-effectiveness. Chair placement is a no-cost, low-tech solution that requires minimal effort to implement. Unlike many healthcare interventions that come with significant financial or operational challenges, this nudge is simple and accessible for hospitals of any size.
Dr. Andrew Sumarsono, the study’s lead investigator, emphasized this point: “Often, we think improving care requires expensive technology or elaborate training. This study shows that small, thoughtful changes in the environment can have a large impact on patient outcomes.”
Future Implications While the study had some limitations—such as its single-center design—it provides strong evidence that subtle environmental changes can shift behavior and improve patient satisfaction. The researchers believe that future studies could explore similar low-cost nudges that may influence other aspects of patient care.
According to Dr. Do Park, “This is just the beginning. We are eager to explore other ways that choice architecture can enhance the healthcare experience for both patients and providers.”
In conclusion, chair placement serves as a simple yet powerful tool to encourage more meaningful patient-physician interactions, demonstrating that small adjustments in the physical environment can yield significant improvements in care quality.
Citation:
Iyer R, Park D, Kim J, Newman C, Young A, Sumarsono A. Effect of chair placement on physicians’ behavior and patients’ satisfaction: randomized deception trial. BMJ. 2023;383. doi:10.1136/bmj-2023-076309.
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