Impact of Design on Patient Participation in Healthcare in a Rural Health Clinic in Appalachia: A Qualitative Pilot Study

A pilot study exploring how elderly patients of a rural outpatient health clinic in Appalachia perceive design elements of the facility as imposing barriers to healthcare participation. Outpatient clinics play a critical role in the delivery of healthcare in rural settings in Appalachia. While the concept of patient participation in healthcare does not enjoy a widely adopted, standardized definition, it is believed that patients who are more actively engaged in their healthcare will potentially realize improved health outcomes. This study examines the role facility design could play in participation. A pilot qualitative study was conducted involving focus groups with a targeted elderly population of a rural outpatient clinic in southern West Virginia. The goal was to assess the perceptions of impacts of clinical design elements on participation. Patients identified and characterized 10 design-related elements they felt impacted participation. The design of the outpatient clinic has the potential to impact the level of engagement of patients in the healthcare process, thus providing another leverage point for improving population health in rural settings