In October 2022, research presented at the Scientific Forum of the American College of Surgeons (ACS) Clinical Congress 2022 demonstrated how a patient’s hospital room set-up may affect their recovery and even their risk of dying after surgery.
Andrew M. Ibrahim, MD, an assistant professor of surgery, architecture, and urban planning at the University of Michigan and a co-author of the study, told Verywell that the team found that the features of a room for postoperative high-risk surgical patients were associated with differential outcomes after surgery.
“We need a better collective way to systematically evaluate design across many more hospitals with specific, granular clinical data at the patient level while applying appropriate techniques,” he said.
Figuring out how hospital architecture could affect patient care will help with planning future spaces and optimizing existing ones.
What Makes a Hospital Room Better for Recovery?
The new study expands on previous findings by exploring how different combinations of room design features—for example, having a single room near the nursing station versus a double room away from the nursing station—affect patients’ mortality rates after high-risk surgery.
Between 2016 and 2019, the researchers studied the room setups of 3,964 patients who were admitted to the University of Michigan Hospital for one of 13 high-risk surgeries (e.g., a colectomy, pancreatectomy, or kidney transplant).
The hospital rooms were on one of two hospital floors, and the researchers categorized the rooms by features such as:
WindowsSingle-occupancy roomDouble-occupancy roomDistance from the room to the nursing stationRoom visibility to nurses and providers
A Safe Room
Having a call button in your room isn’t just for your convenience and comfort—it’s actually a crucial patient safety mechanism. When you press the button, one variable that affects how long it will take to get a response is your location in relation to the person on the other end.
The study found that patients in rooms a short distance away from a nursing station or whose rooms were easily visible to staff had a lower risk of dying after surgery than patients who had been roomed farther away.
This finding supports evidence from a 2014 study showing that severely ill patients in the intensive care unit (ICU) were less likely to die while hospitalized if they were assigned to rooms that were in the line of sight of a nurse’s station.
According to Ibrahim, it makes sense that being visible to medical staff matters, as “nurses could more readily assess the patient’s condition and intervene more quickly in severe events.”
A Room Of Your Own
Being in a room by yourself rather than having a roommate also appears to affect your post-op outcomes.
Dak Kopec, PhD, an architectural psychologist and architecture professor at the University of Nevada, Las Vegas, told Verywell that getting a single room gives you some control over your circumstances and a sense of privacy.
“We all pass gas, but we don’t always like to do it in front of other people,” said Kopec. “If you’re sharing a room with somebody else in the hospital, you’re either letting it happen or keeping it inside, which is not allowing your body to do what it naturally does.”
Additionally, having a single room allows you to speak freely with your providers without worrying that a roommate or visitor will overhear your personal medical information.
Kopec added that having a single room also reduces the stress of hearing and seeing medical equipment.
“We’ve seen this in hospitalized children getting dialysis,” said Kopec. “When dialysis machines came in, we see the child’s respiratory and heart rate go up, which are signs of stress.”
For all of these circumstances, the reverse is also true—try as you might to give them privacy, you’ll likely hear, see, and potentially smell your roommate, too. Witnessing their illness and pain, being in the room while they receive medical treatment (which could be frightening), and learning intimate details about them can be stressful, overwhelming, and even traumatic.
Even something as relatively harmless as having a chatty roommate or one who gets lots of visitors can make it harder to rest and focus on your own recuperation.
A Room With a View…
Your hospital room’s features (or lack thereof) also seem to affect your recovery.
The study found that patients in rooms with at least one window had a 20% lower mortality rate compared to patients in a windowless room. The researchers calculated that patients in rooms with no windows had a 10% higher chance of dying within 30 days of having surgery.
Kirk Hamilton, PhD, a professor of health facility design at Texas A&M University’s School of Architecture who was not involved in the study, told Verywell that windows are also important for mental health, not just physical recovery.
Being out of your normal surroundings and routine while hospitalized makes it a lot harder to keep track of the past, present, and future. Simply glancing out a window to know whether it’s day or night helps hospital patients maintain a sense of time.
“If I’m closed in this room without windows and I don’t know what time it is, I can easily lose track of my own place in time and space,” said Hamilton, adding that people in isolation in windowless rooms are at a higher risk for ICU psychosis—a type of delirium where a patient becomes disoriented and has symptoms like anxiety, paranoia, and hallucinations.
In that way, Kopec said a window in a hospital room “provides a psychological escape.” It’s similar to snagging a window seat on a 12-hour-long flight where being able to see the outside world helps you feel less trapped in your current situation.
…But Not Just Any View
What you can (or cannot) see from your hospital room’s window matters, too. Whether it’s seeing trees or clouds in the sky, research has consistently linked exposure to nature with decreased levels of the stress hormone cortisol.
In 1984, one of the first studies looking at the relationship between hospital rooms and patient outcomes found that patients who had access to a window with a view of nature had shorter hospital stays after surgery than patients who did not have a natural view. Shorter hospital stays weren’t the case for patients with a window that only had a view of a brick wall.
Along those same lines, Kopec added that staring at an empty parking lot also won’t be much help. If you’re able to take in some nature, you’ll see its rhythmic movements—the swaying of trees or birds flying around—which can have a calming effect on the brain.
“Once you calm the person down, they’re not as anxious or in fight-or-flight mode, giving the body time to heal better,” said Kopec.
Natural light exposure is another bonus, which can improve a hospital patient’s quality of sleep and overall happiness during their stay.
Should Hospitals Rebuild Rooms?
Ideally, every hospital room would have a combination of these recovery-promoting features. Some hospitals like the Mayo Clinic have already achieved this and, in fact, gone so far as to create luxury hotel-style suites for patients who can afford them.
That said, many patients wouldn’t be able to pay out of pocket for a world-class hospital stay.
Many healthcare systems are still reeling from the COVID-19 pandemic and don’t have enough money to stay open, let alone invest in new, high-end accommodations. Even if they could afford to make upgrades, expecting hospitals to relocate thousands of patients while they tear down and remodel buildings would be impractical, if not impossible.
Prioritize Patients Who Will Benefit Most
There’s no perfect solution, but experts suggest giving patients who are in active recovery and rehabilitation the rooms that are most conducive to healing.
“The people that are going to be released within a relatively short time and who will seek the services of physical or occupational therapists would probably benefit the most from these design ideations,” Kopec said.
For example, a patient in the ICU who is drifting in and out of consciousness would not be able to take advantage of a window in a room as much as a patient who is awake and recovering from surgery after a car accident.
Children are another group that should get priority, since they’re more vulnerable to psychological distress, anxiety, and trauma when they feel helpless and not in control.
Should I Ask For a Better Room?
If you wake up in a less-than-ideal hospital room after surgery, don’t assume you’re doomed. There are a lot of factors that contribute to your recovery and risk for complications. Your environment is certainly one of them, but it’s not the only one.
Also, don’t assume you got shafted—while you might have been assigned to whatever room was available, it’s also possible that you’re in the room you’re in for a reason. Ask your provider to explain the choice and find out if it’s temporary (for example, they might be planning to move you once you’re stable).
That said, if you’re uncomfortable in your hospital room, speak up. Even if you can’t be moved, there are probably things that the people taking care of you can do to help you adjust.
If you’re allowed to have visitors, consider asking your loved ones to stop by. Not only will having them around help you feel more supported and comforted, but they can also advocate for your needs during your stay. At the very least, they can open the curtains if you’re stuck in bed.
While you won’t have a lot of control over a hospital admission, speak up if you’re having a hard time adjusting. It also helps to have a loved one with you to advocate for your needs.
