1. The Best interest of the patient is the only interest to be considered 1 William & Charles Mayo, MDs

2. 2  Behaviors that stick with the “patient first” credo  Disseminate and sustain the value New hire selection Story-telling in training and on the job Celebration (Heritage Week)

3. 3  Integrated healthcare Medical, psychological, social, spiritual, financial needs  Non-territorial  No “star physicians”  IT integration (e.g., EMR)

4. 4 Business attire (1)Business attire (2)Dirty shoelace storySocial workers

5. Affect patients’ trust, compliance, loyalty, and readiness to discuss social, sexual, and psychological problems 5

6. 6

7. 1. Offer a place of refuge ( 避風港 ) 2. Create positive distraction ( 分散注 意力 ) 3. Convey caring and respect 7

8. 4. Minimize the impression of crowding 5. Facilitate way- finding 6. Accommodate families 7. Symbolize competence 8

9. 9

15. 15 http://www.mayo.edu/center-for-innovation/

16.  Findings Armrests make seating more difficult for wider patients Chairs with no armrest are difficult for some patients to get in and out Chairs with one arm do not convey the necessary sense of stability and security 16 There must be at least enough patient seating for 3 adults in exam. room

17. 17  Leanings Need for adjustable chairs esp. exam. room Emotional role of seating: Chairs that provide ways of connecting with the physician or with other family members could be of value

18. 18  Findings The larger the table space interpreted as shared between the physician and the patient, the more engaged ( 專心參與 ) the patient is Patient note pads give a visual cue to the patient’s space and boundaries

19. 19  Leanings Patients with their own table space encourage doctor-patient interaction The concept of patient space could be expanded to include other areas, both in and out of the exam room

20. 20  Findings Round/soft edges on tables encourage participation Sit next to each other rather than across from each Rolling desk chairs allowed physicians to move themselves in relation to the patient. Moving the exam table to the back of the room de- emphasized the physical portion of the visit.

21. 21  Leanings Tables with rounder edges can soften the physical boundaries ( 界線 ) that separate the physician and the patient

22. 22  Findings Monitor position affects the physician’ willingness to share digital information with the patient Movable screens make it easier

23. 23  Leanings physicians will also often provide/share a printout of the information Information sharing may encourage patients to take a more active role in their health care

24. 24  Findings Offering patients multiple activities that correspond to their waiting need increases satisfaction Four categories: Entertainment, education, administration, and meditation ( 沉思 / 默想 )

25. 25  Leanings It is difficult to predict a patient’s needs or wants around a waiting experience All waiting rooms should feature activities from each of the four main categories

26. 26  Patient seating  Patient sense of space  Patient/physician communication space  Sharing digital information with patients

27.  Consultation and examination spaces are separated 27

28. 28 Internal sources External sources Needs Search Experience Credence Evaluation Rationality Bounded rationality Emotional Decision Making

29. 29 Customer Behavior Pre-encounter stage