טכניון מכון טכנולוגי לישראל
הטכניון מכון טכנולוגי לישראל - בית הספר ללימודי מוסמכים  
M.Sc Thesis
M.Sc StudentErez Eytan Esti
SubjectThe Primary Care Clinic: Characterization of the Physician-
Patient Interaction Space and Design Concepts for
its Improvements
DepartmentDepartment of Architecture and Town Planning
Supervisors Ms. Noemi Bitterman
Dr. Michael Kaffman
Full Thesis text - in Hebrew Full thesis text - Hebrew Version


Abstract

The majority of the patient-physician encounters take place at communal primary care clinics. For many, this encounter is tainted with stress and the physician-patient interaction has important implications. Positive interactions entail better history taking, patient compliance with the medical treatment, results and even a lesser incidence of malpractice claims. Moreover, the prototypical encounter is limited in time. In the current settings these goals are frequently not accomplished and the design of the interaction space between the patient and the medical team is lacking - the standard design does not aid in achieving these goals and even promotes a sense of alienation between the patient and the medical team. The goals of this research were to characterize the patient-physician interaction space in the primary care clinic, to define the set of actions taking place within it, to locate processes and design elements that squander precious time and that may disrupt the inter-personal interaction. To that goal, observations in several clinics, examinations of guidelines published by Clalit health services and interviews of the medical provider's chief architect and family physicians were conducted. The main bulk of the current work and results stem from an internet-based especially designed questionnaire aimed at primary care physicians from a diverse demographic background. This questionnaire was answered by 219 physicians. All the data collected underwent extensive statistical analysis. The results of the questionnaire shed light on the time resources allocation during the visit by the physician, the role of the computer (and screen) during the visit and their effect on the patient-physician relationship. Clinically relevant data on the effect of the design on the above relationship, physical examination and hygiene habits of the physicians were collected and analyzed, both as a homogenous group and by demographic properties of the responders. After comprehensive analysis of the questionnaire's results we proposed a new design to the clinic space using existing spatial and reasonable expense limitations. The main contribution of the current research is in understanding the relationship between an optimal and correct design and a good outcome of the patient-physician encounter. The results of this work can serve as a basis for future designs which reflect the change in outlook in that the different stages of the visit are supported by the various design elements which also mutually serve to facilitate the flow of the encounter.