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The physical environment and patient satisfaction ratings on social media: an exploratory study

Mariam F. Alkazemi (Robertson School of Media and Culture, Virginia Commonwealth University College of Humanities and Sciences, Richmond, Virginia, USA)
Sara Bayramzadeh (College of Architecture and Environmental Design, Kent State University, Kent, Ohio, USA)
Nouf B. Alkhubaizi (University of Leeds, Leeds, UK)
Ayman Alayoub (Gulf University for Science and Technology, Kuwait, Kuwait)


ISSN: 0263-2772

Publication date: 19 August 2019



The purpose of this study is to explore the role of the physical environment in patient satisfaction ratings as communicated in narratives on the social media platform such as Facebook.


Publicly available Facebook reviews (n = 4,502) of a reputable healthcare system in the USA were analyzed. A thematic analysis was conducted to explore architectural elements of the physical environment that play a role in patient satisfaction.


Facebook reviews were examined for the presence of design-related factors within the physical environment. Of the 627 posts (14 per cent) with relevant content, 56 involved factors related to the physical environment. The factors include: location, parking, cleanliness, privacy, waiting rooms, music and temperature. The results showed that environmental and design-related factors are part of patient satisfaction in hospitals.

Research limitations/implications

Not all Facebook reviews contain narrative information. Nevertheless, the impact of the built environment can manifest in online reviews of healthcare systems. Future patient satisfaction research should examine variables related to the built environment on social media ratings.

Practical implications

Social media feedback about the physical environment can help in understanding factors influencing patient satisfaction, which can have an implication for architectural design.

Social implications

The patient satisfaction is related to the physical environment of healthcare facilities. Some social media narratives reflect it and can be used to improve patient satisfaction.


Although some studies examine social media narratives on patient satisfaction, fewer studies examine these narratives in relation to the built environment. Created by a team of interdisciplinary researchers, this study provides a novel approach to examine social media ratings.



Alkazemi, M.F., Bayramzadeh, S., Alkhubaizi, N.B. and Alayoub, A. (2019), "The physical environment and patient satisfaction ratings on social media: an exploratory study", Facilities, Vol. 38 No. 1/2, pp. 86-97.



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