Photo Courtesy of HKS Inc.

Photo Courtesy of HKS Inc.

Influence of Positive Distractions on Children in Hospital Waiting Areas

Read the journal paper here


Debajyoti Pati (PI)

Upali Nanda, Former Director of Research, American Art Resources
Laurie Waggener, Director of Research, WHR Architects

American Art Resources, Catherine Meyers Fine Art, Henry Domke Fine Art, Mohawk Carpets

WHAT was the aim

The study objective was to examine the influence of positive distraction on the behavior and activity of children in two clinic waiting areas. Specific aims were to conduct a comparative analysis of five positive distraction conditions to assess their impact on (a) the behavior of children waiting for treatment and (b) the waiting experience of accompanying family members.

Why is it important 

People spend a considerable proportion of time waiting in hospitals. Studies show that the quality of waiting environments influences the perception of quality of care and caregivers, that perception of waiting time is a better indicator of patient satisfaction than actual waiting time, and that the waiting environment contributes to the perception of wait time. In fact, the attractiveness of the physical environment in waiting areas has been shown to be significantly associated with higher perceived quality of care, less anxiety, and higher reported positive interaction with staff. Can positive distractions in waiting areas improve the waiting experience, as indicated by the behavior and activities of children waiting for treatment?


Five distraction conditions were randomly introduced in the waiting area of the dental and cardiac clinics of a major pediatric tertiary care center through a single plasma screen intervention. The attention, behavior, and activities of waiting children were recorded. Data on 158 pediatric patients were collected over 12 days during December 2008 and January 2009.

What did we find

Data analysis shows that the introduction of distraction conditions was associated with more calm behavior and less fine and gross movement, suggesting significant calming effects associated with the distraction conditions. Data also suggest that positive distraction conditions are significant attention grabbers and could be an important contributor to improving the waiting experience for children in hospitals by improving environmental attractiveness.

What is next

Considering the potential impact of positive distractions in waiting areas, replication of this study is essential in other clinical settings and other positive distraction media. The use of elec-tronic media in this study is also relevant. Be-cause more and more distractions are anticipated to be provided via electronic media in the future, testing the comparative performance of different distraction conditions on a flat-screen plasma TV monitor was considered to be timely. Given the increasing use of flat-screen monitors in patient areas today, comparing these conditions was expected to inform their more effective use. The three categories of distraction conditions in this study had essentially nature-based themes. Future studies should compare other content, such as movies, cartoons, news, and so forth, which are typically projected on TV screens in hospital waiting areas. Finally, this study focused on pediatric patients. The influence of positive distractions on adult patients and their waiting experience is an important topic that needs to be explored.