Waiting Area Research Articles

Evaluating Patients’ Preferences for Dental Clinic Waiting Area Design and the Impact on Perceived Stress

Evaluating Patients’ Preferences for Dental Clinic Waiting Area Design and the Impact on Perceived Stress

Health information and resources in hospital outpatient waiting areas may not meet the needs of older adults from culturally and linguistically diverse backgrounds: A cross-cultural qualitative study.

Health information and resources are often provided in hospital outpatient waiting areas but may not meet the cultural and health literacy needs of older adults from culturally and linguistically diverse (CALD) backgrounds. To explore the perspectives and experiences of Cantonese- and Vietnamese-speaking patients and carers in this setting. This qualitative interview-based study was conducted from December 2019 to March 2020 at a single outpatient rehabilitation service located at a tertiary public hospital. Four adult consumers (two older adult patients, two caregivers) from CALD backgrounds participated in semi-structured interviews with bilingual researchers. Data were transcribed, translated and analysed using reflexive thematic analysis. Five themes were developed which highlighted that older adults' language profiles shaped their health information needs and ability to access resources in waiting areas. Cultural factors such as filial responsibility may also influence health information preferences. Older consumers from CALD backgrounds did not have equitable access to health information and resources in the waiting area compared with English-literate older adults. Health information and resources in waiting areas warrant improving to better meet the needs of older patients from CALD backgrounds and their caregivers.

Anger Level of Patients in Outpatient Waiting Area and Related Factors

Aim: In this study, we aimed to detect the anger level of patients in the outpatient waiting area and related factors. We also aimed to contribute to the studies to be carried out to prevent violence in health caused by uncontrolled anger. Methods: Volunteer patients aged 18 and over who applied to outpatient clinics were included in the study. A survey consisting of 34 questions prepared by the researchers and Spielberger's State Anger Scale consisting of 10 questions were used. Results: In our study, it was detected that there was a statistically significant increase in state anger scale scores of patients who resorted to violence in health before, who are troubled with the priority patient practice, who cannot communicate with the doctor adequately, who cannot sit in the outpatient waiting area and those who wait for a long time, who have trouble making an appointment, who smoke and who have low income and education level. Conclusion: We believe that establishing effective communication between health professionals and patients, increasing the number of healthcare workers, organizing work environments, and creating an efficient appointment system will contribute to a decrease in patient anger and a reduction in violence in healthcare. Keywords: outpatient health services, anger, violence

The characteristics of the acoustic environment and the restorative benefits of soundscape in interventional therapy rooms

Coronary heart disease (CHD) has become one of the most serious health problems in the world. As a treatment environment for CHD, the acoustic environment in the interventional therapy room is crucial to patients and healthcare workers. To investigate the characteristics of the sound environment in interventional therapy rooms and the soundscape health benefits of the soundscape for patients, acoustic measurements and noise behavior observations were conducted in various areas of an interventional therapy room, and soundscape intervention experiments were performed on patients treated there. In this study, CHD patients were used as the research object. Results show that: 1) the background noise levels for waiting area (WA) and operation area (OA) under empty field conditions were 54.5 dBA and 52.8 dBA, and 66.43 dBA and 64.2 dBA, respectively, under conditions of usual use. 2) Patients perceived the acoustic environment as noisy and uncomfortable in both areas, with OA being more severe than WA. 3) Natural sounds from composite sources has a greater potential for restorative benefits than single-source soundscape.

Evaluating the Triage of Suspected COVID-19 Cases in Sudan's Emergency Settings: A Clinical Audit.

The inevitable coronavirus disease 2019 global pandemic has severely affected Sudan's fragile healthcare system. The authors share the experience of COVID-19 triage in the emergency departments of five public hospitals in Khartoum state, Sudan. A clinical audit was conducted in December 2020 using the Centers for Disease Control and Prevention Checklist and Monitoring Tool for Triage of Suspected COVID-19 Cases. The tool was categorised into 5 domains and 38 indicators. Only three hospitals had hand hygiene stations in their triage areas: Ibrahim Malik, Omdurman, and Al-Nau. Omdurman Teaching Hospital was the sole hospital with a designated respiratory waiting area. At Al-Nau and Omdurman Hospitals, all respiratory symptomatic patients wore a facemask or alternative. Ibrahim Malik and Bahri Teaching Hospitals had 60% and 50% compliance, respectively, while none at El-Tamayouz Hospital did. No posters or job aids were present in donning and doffing areas. Heavy duty gloves were worn only at Ibrahim Malik (50%) and Omdurman (20%). 100% of staff wore closed-toe footwear at Ibrahim Malik and Omdurman, 75% at El-Tamayouz, 63% at Bahri, and none at Al-Nau. The healthcare facilities displayed significant shortcomings in preparedness and response to COVID-19, with variations across hospitals in infrastructure, human resources, and procedures. To better combat future outbreaks, systemic improvements and a focused approach on consistent staff training, standard triage algorithms, and adequate PPE availability are imperative.

Evaluating the traffic safety performance of left-turn waiting areas at signalized intersections

Left-turn waiting area (LWA) is an innovative traffic design that is popularly applied to improve the traffic capacity of signalized intersections in China. The traffic safety impacts of the LWA, however, have not been fully discussed in previous studies. Thus, the study aims to evaluate the safety performance of the LWA by means of the traffic conflict technique. A field investigation was conducted to collect the post-encroachment time (PET) of conflicts and relevant variables at the signalized intersections in Jinhua, China. The Chi-square and two sample t-tests were adopted to examine the difference in conflict distribution between the intersections with and without LWA. The random parameter ordered logit model was employed to identify the factors contributing to the risks of vehicular collisions. Results indicate that (1) intersections with LWA are generally associated with more merging conflicts; (2) there are no significant discrepancies in the PET values between intersections with and without LWA; and (3) factors such as the number of left-turn lanes, number of receiving lanes, conflict type, vehicle type, driving direction, stopping outside LWA and overtaking behavior are identified to significantly impact the traffic conflicts. The findings serve to develop the countermeasures to ensure the safe operation of LWA.

FMAA: A Flexible Signal Timing Method for An Isolated Intersection with Conflicting Traffic Flows

Optimizing traffic signal timing can effectively alleviate urban traffic congestion. However, most of the existing signal timing methods struggle to deal with conflicting traffic flows in heavy traffic; therefore, more effective methods are urgently required. In this paper, we propose a flexible signal timing method that combines all-red control and adaptive timing (FMAA) to deal with conflicting traffic flows at an isolated intersection. First, we consider a Vehicle-to-Infrastructure (V2I) communication-based vehicular network environment, in which fine-grained traffic information can be collected by Road Side Units (RSUs) and uploaded to a cloud server for designing signal timing methods. Second, the congestion degree of Conflict Area (CA) is defined and utilized to trigger all-red control in congested cases. Third, the tolerance degree of the Waiting Area (WA) is defined and utilized to perform adaptive timing in other cases. Finally, simulations were conducted using SUMO, and the proposed FMAA method performed better than the comparative methods in terms of average speed, waiting time, and congested vehicles, thus improving traffic efficiency at an isolated intersection with conflicting traffic flows.

Seeking Choice to Fulfill Health Literacy Needs: Health Literacy Opportunities for Consumers in Hospital Waiting Areas.

In this research, we explore and theorize on the potential of hospital outpatient rehabilitation waiting areas to respond and contribute to the health literacy needs of consumers. Constructivist grounded theory informed the sampling and analytical procedures. Thirty-three consumers attending outpatient rehabilitation for a range of health conditions were recruited to this multi-site study. Semi-structured interview and participant observation data were collected and analyzed concurrently using the constant comparison method. The substantive theory of "seeking choice to fulfill health literacy needs" and five interdependent categories were developed. Results indicated that consumers sought choice reflective of their needs; however, the waiting area offered limited choice. Consumers shared ideas to address the lack of choice. Results provide insight into the health literacy needs of consumers in hospital outpatient waiting areas and how health services can appropriately respond to these needs. Future research should investigate the effect of health service environments on health outcomes.

Perceived Usability of Seating in an Outpatient Waiting Area: A Combined Approach Utilizing Virtual Reality and Actual Seating Prototypes.

This study proposed a combined methodology to evaluate the perceived usability of healthcare seats that were first selected in a virtual waiting room which provided the context of use for the seats. There has been an increased interest in using virtual reality (VR) for evaluation of seating in interior environments. Although VR offers a less expensive approach compared to evaluating seats in situ, using VR has limitations as users cannot experience the actual seat prototypes. Participants (N = 92) experienced a virtual waiting room with various seat groupings and were prompted with four task-based scenarios through which they selected a seat. After the VR phase, they experienced their selected seats in a lab and used an online questionnaire to evaluate the seating. Semi-structured interviews were conducted to garner similarities and differences in participants' experience of virtual and real seats. Three categories including comfort, support, and flexibility were extracted from the questionnaire. While support and comfort categories were highly ranked by participants, the category rankings varied depending on participants' age, gender, tasks, and seat types. Interviews revealed that there were differences in experience of the seating materials in VR versus reality, and therefore experiencing the real seats was useful in seating evaluation. The findings suggest that the combined methodology using VR and real seating in a lab is a reliable tool for designers and furniture manufacturers to obtain users' perceived usability evaluation of seating during the design process while the actual context is absent.

Signal Control Method for Through and Left-Turn Shared Lane by Setting Left-Turn Waiting Area at Signalized Intersections

This paper proposes a signal control method for the through and left-turn shared lanes at signalized intersections to solve traffic conflicts between left-turn vehicles and opposing through vehicles by setting left-turn waiting area (LWA). Delays and stops are weighted to form an integrated performance index (PI) in a vehicle-to-infrastructure cooperation system. The PI models pertaining to all vehicles are established based on the LWA intersection. In addition, an optimized method of signal timing parameters is constructed by minimizing the average PI. VISSIM simulation shows that the average PI decreases by 6.51% compared with the original layout and signal timing plan of the intersection, since the increased delay of the side-road left-turn vehicles is insufficient to offset the reduced delay of the side-road through vehicles after the improvement. The sensitivity analysis shows that the greater the traffic volume of the phase including the through and left-turn shared lanes, the higher the operation efficiency of the LWA intersection compared with the typical permitted phase intersection. When the left-turn vehicles of the shared lanes in each cycle are less than the stop spaces, the LWA intersection can effectively reduce the average PI of the shared lanes. Furthermore, the more the stop spaces in the LWA, the lower the average PI in the same traffic conditions.

Barriers, Enablers, and Consumer Design Ideas for Health Literacy Responsive Hospital Waiting Areas: A Framework Method Analysis.

The study aim was to (1) investigate the barriers and enablers experienced by consumers to accessing and engaging with health tools in hospital waiting areas and (2) evaluate consumers' ideas for designing a health literacy responsive waiting area. Health information, resources, and supports ("health tools") in waiting areas should be responsive to the health literacy needs of consumers. However, consumers' experiences of using health tools and their ideas for improving them are not known. Multicenter study was set in hospital waiting areas of outpatient rehabilitation services. Semistructured in-person interviews were conducted with 33 adult consumers attending appointments for various health conditions. Seven stages of the Framework Method were used to analyze data. Six themes were identified which explained barriers and enablers from the perspective of consumers. The barriers were accessibility issues; personal factors-physical condition, emotional state, and preferences; and poorly presented and outdated resources. The enablers were design suits consumer needs and preferences; usable in available time or portable; and compatible environment for engaging and sharing. Consumers shared design ideas which fit within four typologies. A range of barriers and enablers exist which have an impact on consumers' ability to engage with available health information, resources, and supports in hospital outpatient waiting areas. Practical insights from the perspective of consumers can be applied to future health service design. Consumer's design ideas suggest that partnerships with consumers should be formed to design health literacy responsive waiting areas.

Study of the Space Occupied by a Wheelchair User at Metro de Santiago Platforms by Laboratory Experiments

The objective is to study the space a wheelchair passenger would use in the preferential waiting areas of an urban railway platform. For this purpose, an analysis of the variables that interfere in the space occupied by a wheelchair user was carried out at Metro de Santiago platforms, to design a preferential prototype waiting area at the Human Dynamics Laboratory of the Universidad de los Andes (Chile). The prototype has a 3.0 m long and 2.5 m wide carriage, together with a preferential waiting area on the platform of the same length as the carriage, and 2.0 m wide. With this prototype defined, a detection method was developed using PeTrack software, to accurately identify the limits of the space occupied by a wheelchair user under two scenarios of different density levels in the preferential waiting area: medium-density (1.5 passengers/m2) and high-density (4.0 passengers/m2). It was observed that the space occupied by a wheelchair user decreased by 33% as the density increased from medium to high. On the other hand, for a high-density level, the space occupied by a wheelchair user was found to be 61% higher than that occupied by a passenger without reduced mobility. This variation occurred mainly because passengers increased their distance from the wheelchair user, which widened their area of influence. Further experiments are proposed as future research to extend this analysis using other density situations.

Mobile low-dose computerized tomography (LDCT): Three-year follow up of solution for early diagnosis of lung cancer in under-served populations.

6507 Background: Randomized trials have proven that screening high-risk patients with LDCT of chest reduces lung cancer mortality compared to screening with chest x-ray. Under-served patients lack access to this test due to geographic and socio-economic factors. We hypothesized that a mobile screening unit would improve access and increase survival in this group, which is most at risk of lung cancer deaths. Methods: We installed a BodyTom portable 32 slice low-dose CT scanner (Samsung Inc) into a 35 foot coach (Frazier Inc), reinforced to avoid equipment damage during road travel. It includes waiting area, high speed wireless internet connection for rapid image transfer, and electronic tablets to deliver smoking cessation and health education programs and shared decision-making video aids. We used LUNG RADS approach to lesion classification, yielding high sensitivity and specificity in assessment. All films were reviewed by a central panel. This is certified as a lung cancer screening Center of Excellence by the Lung Cancer Alliance. Protocol was approved by Advarra IRB. Medicare pts excluded as insurance covered them for LDCT, although this reduced potential number of cases diagnosed as this is highest risk population. Results: We screened 1200 uninsured or under-insured subjects, mean age 61 years (range 55-64), with average pack year history of 47.8 (30-150); 61% male; 18% Black, 3% Hispanic/Latino; 78% rural. We found 97 pts with LUNG RADS 4 lesions, 30 lung cancers (2.5%), including 15 at stage I-II treated with curative intent; 5 incidental non-lung cancers (renal CA 2, head & neck CA 1, pancreas CA 2); more than 50% with cardiovascular disease or COPD seen on LDCT. Of eligible first-screen subjects (J. Clin. Oncol., 2019, 37, 383S), 440 attended Year 1 repeat LDCT and 161 attended Year 2 LDCT. Only one pt with surgically resected CA lung has relapsed to date. Conclusions: Mobile LDCT yields higher screening rate for under-served pts than prior international studies, with strong protocol adherence and paucity of early cancer deaths in high-risk population with traditionally poor compliance.

Decoding Pigeon Behavior Outcomes during Goal-directed Decision Task by WSR Functional Network Analysis.

It is a hot research direction to reveal the working mechanism of brain by measuring the connection characteristics of brain function network. In this paper, to decode pigeon behavior outcomes in goal-directed decision task, an experiment based on plus maze was designed and the nidopallium caudolaterale (NCL) of the pigeon was selected as the target brain region. The local field potential (LFP) signals in the waiting area (WA) and turning area (TA) were recorded when the pigeons performed the goal-directed tasks. Then, the brain functional connection networks of the LFPs were constructed and the extracted features were applied to decode pigeon behavior outcomes. Firstly, continuous wavelet transform (CWT) was used to carried out time-frequency analysis and the task-related frequency band (40-60 Hz) was extracted. Then, weighted sparse representation (WSR) method was used to construct the functional connectivity network and the related network features were selected. Finally, k-nearest neighbor (kNN) algorithm was used to decode behavior outcomes. The results show that the energy difference between TA and WA in 40-60 Hz band is significantly higher than those in other bands. The selected features have good discriminability for the representation of the differences between WA and TA. The decoding results also suggest the classification performance of the different behavior outcomes. These results show the effectiveness of the WSR to construct the function network to decode behavior outcomes.

A Playroom Internal Waiting Area Improves Productivity in the Pediatric Emergency Department.

IntroductionPediatric emergency department (PED) volume is often constrained by the number of available treatment rooms. In many PEDs patients occupy treatment rooms while awaiting test results or imaging, thereby delaying care for patients who arrive after them.MethodsWe opened a PED where selected patients were moved to a playroom when they did not actively require a treatment room. The treatment room was then available for the next patient. We measured the effect of using the playroom on time from arrival to rooming and length of stay (LOS) using proportional hazards regression and the odds of being roomed within 30 minutes of arrival using logistic regression. We adjusted for the number of the previous eight patients who were “playroom eligible”; age; triage category; provider; the number of patients who arrived within the preceding hour; prior census; and testing ordered in the preceding eight patients.ResultsWe analyzed 43,634 patient encounters, of which 10,134 (23%) were playroom eligible. The adjusted hazards ratio for the next patient being roomed was 1.14 (95% confidence interval [CI], 1.10–1.18) per prior playroom eligible patient. The adjusted odds ratio of the next patient being roomed within 30 minutes was 1.46 (95% CI, 1.33–1.56) per prior playroom eligible patient. The playroom typically decreased median rooming time by four to 42 minutes and LOS by two to 40 minutes depending on patient volumes and acuity. The benefit of the playroom was maximal at busier times.ConclusionImplementing a playroom in the PED for selected patients generally decreased time to rooming of the next patient and LOS.

The Therapeutic Waiting Room: Therapist and Service User Perspectives on the Psychologically Supportive Dimensions of Architectural Space.

Waiting areas in healthcare settings play an important role in reassuring or potentially further distressing service users. The effects of the designed environment on mental health service users specifically are regarded by health professionals as having a considerable influence on treatment outcomes, experiences, and perceptions of care. The purpose of this article is to explore service user and practicing therapist perspectives of waiting areas in mental health service settings and how the design of these spaces affects anxiety levels, comfort, therapeutic relationships, outcomes, and perceptions of care. The methodology for this exploratory phenomenological study was developed in order to preserve the integrity of participant voices in the essences of experiences, during explorations of their encounters with therapeutic waiting areas. Fieldwork undertaken by the author involved a series of focused in-depth interviews with service users of mental health services and practicing therapists, counselors, and psychologists. Key themes identified through data analysis include (1) space acting as symbolism, (2) interpersonal relations which are threatening, and (3) sensory modulation. Design implications in relation to each theme are presented. This study uncovered a set of findings in relation to symbolic content inferred by spatial design aspects and the ways in which design can afford, or mitigate, development of interpersonal agencies, psychological safety, and negative stigmas. Future transdisciplinary research directions are suggested, including (1) examination of other relationships, beyond the service user-therapist dyad, which may influence waiting area experiences and (2) examination of the applicability of design suggestions to different contexts.

Discarding IVF embryos: reporting on global practices.

To provide a global scale report on a representative sample of the clinical embryology community depicting the practice of discarding supernumerary IVF embryos. A web-based questionnaire titled "Anonymous questionnaire on embryo disposal practices" was designed in order to ensure anonymous participation of practicing clinical embryologists around the world. During a data collection period of 8 months, 703 filled-in questionnaires from 65 countries were acquired. According to the data acquired, the majority of practitioners, dispose of embryos by placing them directly in a trash can strictly dedicated for embryo disposal for both fresh and frozen cycles (39% and 36.7% respectively). Moreover, 66.4% of practitioners discard the embryos separately-case by case-at different time points during the day. Over half of embryologists (54%) wait until day 6 to discard the surplus embryos, while 65.5% do not implement a specially allocated incubator space as a designated waiting area prior to disposal. The majority of 63.1% reported that this is a witnessed procedure. The vast majority of embryologists (93%) do not employ different protocols for different groups of patients. Nonetheless, 17.8% reported the request to perform a ceremony for these embryos. Assessing the embryologists' perspective, 59.5% of participants stated that the embryology practice would benefit from a universally accepted and practiced protocol. This study uniquely provides insight into global embryo disposal practices and trends. Results highlight the divergence between reported practices, while indicating the significance on standardization of practice, with embryologists acknowledging the need for a universally accepted protocol implementation.

Assessing the seasonality of occupancy number-associated CO2 level in a Taiwan hospital.

This study enabled the assessment of indoor CO2 levels and evaluated the relationship between occupancy numbers with CO2 levels in a Taiwan hospital. The measurements were conducted over four seasons for five working days (Monday to Friday), with sampling conducted simultaneously from 09:00 am to 5:00 pm and across six locations (for spatial variability): hall (H), registration and cashier (RC), waiting area (WA), occupational therapy room (OT), physical therapy room (PT), and outdoors (O). Based on the analysis, three of the five indoor sampling sites showed significant differences in seasonal CO2 concentrations (p < 0.0001). Based on our result, the physical therapy room had the highest level of CO2 concentration that exceeded the IAQ standard in Taiwan Environmental Protection Agency (EPA) in all seasons, in that the number of occupants contributing to nearly 40% of the variation in CO2 measured. Our results also showed that the indoor/outdoor (I/O) ratios of CO2 concentration for all locations and seasons exceeded 1 in ~ 100% of those locations. The median I/O ratio at sites WA and OT was 2.37 and 2.08 during four seasons, respectively. The highest median I/O ratio was found at site PT, with a calculated range of 2.69 in spring to 3.90 in fall. The highest correlation of occupancy number and CO2 concentration also occurred in PT which correlation coefficients were estimated at 0.47, 0.65, 0.63, and 0.40 in spring, summer, fall, and winter. The findings of the present study can be used to understand occupancy number and its effect on CO2 levels in a hospital environment, as well as the effect of time of day (Monday to Friday) on the number of patients admitted.

Control Method for Signalized Intersection with Integrated Waiting Area

To alleviate traffic congestion in the city, an integrated waiting area is introduced to the signalized intersection in this paper. After the design idea and the typical form of the integrated waiting area is proposed, the control method at the signalized intersection is discussed. The coordination control process of the main and pre-signal at the signalized intersection with the integrated waiting area is analyzed and modeled. To assess the operational performance of the integrated waiting area at intersections, a microscopic traffic simulation software (VISSIM) is utilized to simulate intersections with and without integrated waiting areas. Key issues concerning signal timing plans are then discussed. With comparisons between the operation of intersections with and without integrated waiting areas, the implementation effect is quantified based on the statistical data of the simulation result. The results confirm the potential benefits of the integrated waiting areas at the signalized intersections and show that integrated waiting areas work best in heavy traffic demand.

Morning in the Surgical Waiting Area.

We drove through darkness, sky spread thickwith constellations, stories of immortalsstolen by artificial light. Now this glareinstalled without thought of our need to moveslowly toward illumination—to witness facestired as ours, magazines crumpled by multitudes,furniture scuffed and dull, burdened by so muchwaiting. For as long as possible we delayclosing our eyes, moments when blindnessrenders us better listeners. Around the roomlullabies hum, names of patients calledto endure another kind of sleep.I love you…I love you…I love youtrails like stars falling, landing lightlyon our laps, scattering our histories,legends of mortals left in our keeping.