1. Strek, Sharon MSN, Ed, RNC-OB

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In an effort to increase market share and patient satisfaction ratings, hospitals are entertaining the idea of creating hotel-like maternity units. Equipped with attractions such as waterfalls, room service, wireless Internet, and big screen televisions, the new concept is, in my opinion, the latest attempt to dazzle patients with a glitzy presentation. It is an expensive trend that I believe will fail to meet the needs of hospitals, patients, and nurses.


Environment is important in healthcare, but I don't think the plush hotel-like unit provides a significant boost to patient satisfaction for hospitals. Swan, Richardson, and Hutton (2003) found a small positive effect reflected in the perception of caregivers and services if the patient was in a plush room, but is that effect worth the effort? Garman, Garcia, and Hargreaves (2004) showed that the most significant factors in a patient's choice to return to a particular hospital were related to perceptions of nurse and physician attentiveness to patient needs. They chose to invest dollars into care providers rather than hotel-type services and extravagant physical spaces.


Patient satisfaction is an inexact science with very little research to support most of its claims. Categories such as housekeeping, dietary, nursing, and the appearance of the room are often rated as equally important in achieving an overall satisfaction score. Spooner (2003) studied satisfaction rates at a hospital from a mail survey that had a 34% response rate. The analysis demonstrated that persons who responded to the survey were different from the total patient population and that decisions at the hospital level were made based on this nonrepresentative sample. The total population of mothers may not be as interested in couches for family or room service but may be more concerned with other factors such as quality nursing care, NICU availability, and lactation services.


Inpatient maternity care has evolved from a medical model in which the mother and her newborn were separated from family and from each other. Now that a family-centered model is the norm, we need to be sure that nursing care is not lost among other "services" to be requested on demand rather than an integral part of the experience. I believe that instituting hotel services for postpartum families could create a sense of isolation and distance from nursing staff while sending the message that mothers need to rest away from their babies more than they need to spend time with their newborns and develop skills in self- and infant care.


The current family-centered care model with its comfortable, home-like rooms functions as a collaboration between the family and the healthcare providers. Shorter stays require that the mother needs time with her nurse to begin learning to care for herself and her newborn while she is in the hospital, especially because extended family support may not be available after discharge. This continuous education and role modeling may not fit into a hotel-style schedule; a baby who needs to breastfeed cannot be held off by a do-not-disturb sign.


Karl, Beal, O'Hare, and Rissmiller (2006) point out that the nurse/new mother/infant relationship may be particularly important for individuals who are socially disadvantaged and lack a good maternal role model in their lives. Distracted by the "amenities" in a hotel-like unit, some mothers may find it difficult to form a relationship with the nurse or concentrate on the role modeling and education that are offered.


In my opinion, the hotel-like maternity unit concept will not provide the desired return on investment, significantly increase satisfaction scores, meet the expressed needs of most patients, or facilitate nursing care on a unit. I believe it is a fad and not a necessary or needed part of postpartum care.




Garman, A., Garcia, J., & Hargreaves, M. (2004). Patient satisfaction as a predictor of return-to-provider behavior: Analysis and assessment of financial implications. Quality Management in Health Care, 13, 75-80. [Context Link]


Karl, D., Beal, J., O'Hare, C., & Rissmiller, P. (2006). Reconceptualizing the nurse's role in the newborn period as an "attacher". MCN The American Journal of Maternal-Child Nursing, 31, 257-262. [Context Link]


Spooner, S. (2003). Survey response rates and overall patient satisfaction scores. Journal of Nursing Care Quality, 18, 162-174. [Context Link]


Swan, J., Richardson, L., & Hutton, J. (2003). Do appealing hospital rooms increase patient evaluations of physicians, nurses, and hospital services? Health Care Management Review, 28, 254-264. [Context Link]