Applying Maslow’s Hierarchy of Needs to Human-Centered Design Translating HCAHPS Results into Designs that Support Improved Care Delivery

In this paper, we apply Abraham Maslow’s hierarchy of needs to the hospital setting to offer insights to health care organizations seeking to improve their Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results. Positive survey results have a direct financial impact on hospitals; the Patient Protection and Affordable Care Act of 2010 ties their value-based incentive payments to their HCAHPS scores. The HCAHPS survey contains two questions that relate directly to a hospital’s physical environment. All remaining questions require patients to assess the quality of the care provided by caregivers—doctors, nurses, and hospital staff. The survey thus presents a difficult challenge to healthcare administrators and architects working on new construction or renovation projects: How to translate the information gleaned from these surveys into designs that facilitate improvements in healthcare delivery—and thus, better survey results.

As a conceptual response, we propose a “human-centered design hierarchy of needs,” based on Maslow’s hierarchy of needs, as a way to conceptualize a hospital stay and illuminate ways in which healthcare facility design can support more responsive patient care delivery. We conclude that facility design provides an essential foundation for the delivery of excellent patient care, which, in turn, supports the optimal patient experience. We also conclude that a lean design that promotes staff efficiency by locating support spaces and staff and physician work areas near patient rooms on inpatient care units supports improvements in both the efficiency and the efficacy of care.