Understanding Patient Experience during Extended Isolation: The Role of the Built Environment

Zorana Matic (SimTigrate Design Lab, Georgia Institute of Technology)

The 2014 Ebola virus disease outbreak brought to focus some major challenges of caring for patients with highly infectious diseases in biocontainment units (BCUs). The long incubation period combined with concerns of spreading lethal pathogens has resulted in keeping Ebola patients in isolation for several weeks with minimal human interaction. Previous studies on the design of BCUs have looked at ways to prevent self- and cross-contamination, but very few have examined how the built environment can support improved experience for patients in isolation. BCUs are artificial, highly restrictive environments, where patients have limited control, resulting in their reduced autonomy and self-determination, and disrupted human interaction.

This qualitative study looks at the unique needs of patients with highly infectious diseases treated in BCU and their experiences while held in isolation. We conducted in-depth interviews with patients treated for Ebola and the healthcare personnel who cared for them in BCUs in the U.S. Using their responses we created a Patient Journey Map documenting points of interaction between patient, healthcare staff, family, and physical environment and identified specific areas for improvement. While the individual responses to containment care differed, some major topics and opportunities emerged: the effects of design on self-esteem and sense of control, human and social interactions, among other things.

Finally, we propose a framework of specific interventions in the physical environment that can contribute to the physical and psychological welfare of persons treated in BCU. Design of isolation units improves the patient experience during their critical care by engaging human and social interaction, empower patients through space flexibility and personalization, and supporting a more holistic approach to isolation care.