Hospitality, healthcare, and design

More than a quarter century ago, Bitner (1992) put forth the classic servicescapes framework, which illustrates how stimuli present in a service organization’s physical, built environment influence consumers’ behaviors and attitudes toward the organization. Since that influential article, other researchers have expanded on the servicescapes framework by showing how consumers, as well as service providers, respond to stimuli other than the physical realm that are often present in service organizations and that influence consumers and employees alike. For example, research has shown that environmental stimuli such as social (e.g. customers, employees, volunteers), natural (e.g. landscaping, water display), and cyber (e.g. websites, in-store kiosks) aspects all influence consumers and employees during service exchanges (Rosenbaum & Massiah, 2011).

The servicescapes framework represents a formal theory (Glaser & Strauss, 1967) in the sense that its postulations apply across all service industries. That is, hospital patients, airline passenger, hotel guests, restaurant diners, library patrons, and Internet users shopping on an e-commerce site are all affected by varying types of servicescape stimuli present during their service exchanges. On the one hand, investigatory findings revealing that environmental stimuli influence both customers and employees during service exchanges are not necessarily novel. On the other hand, investigations revealing novel insights into specific types of stimuli that influence specific customer segments housed in certain contexts or when certain conditions are present remain fascinating and relevant for service researchers, environmental psychologists, and marketing and service design practitioners.

The goal of this special issue, titled ‘Hospitality, Healthcare, and Design’, is to illustrate substantive applications of the servicescapes framework rather than general applications. Each article presented in this special issue investigates specific types of environmental stimuli, along with the contexts and conditions, that affect consumers or service employees during service exchanges. These articles provide original insights into the confluence of theories and frameworks housed within the hospitality, healthcare, and service marketing (design) disciplines.

The special issue commences with innovative work from Evangelia Chrysikou, Chariklia Tziraki, and Dimitrios Buhalis regarding a village-type residential accommodation for people experiencing dementia. The village comprises a town square, supermarket, hairdressing salon, theater, clubroom, and café in an enclosed, gated, and safe environment for its residents living with some form of dementia. In contrast with the drab, institutional hospital wards that often house people with dementia, this type of village accommodation brings a sense of normalcy, of community, and of being at-home to dementia care. Village residents experience life as they are accustomed to, retaining a sense a dignity, which dementia often erodes. In this village, physical, social, and natural aspects come together in a residential setting replete with modern physical structures and landscaped greenery, vivified by the presence of other residents, doctors, staff, and volunteers. The impact of this village on residential well-being is profound, with some residents experiencing ‘rementia’, or a state in which people return to some form of mental capability. Dementia villages remain in their infancy stage, and some problems exist, such as blending differing age segments into an enclosed setting. Despite these problems, as global populations age, an increasing number of people will confront dementia, and these villages may be a means for many to live comfortably with lessening mental capabilities.

Similar to the first article, in the sense that dementia is often an offshoot of aging, the second article from Lingqiang Zhou, Jibin Yu, Mao-Ying Wu, Geoffrey Wall, and Philip Pearce focuses on the transformative benefits (Anderson et al., 2013) that traveling to leisure destinations offers to senior and elderly adults. The authors conclude that therapeutic landscapes result from the merging of physical, social, and symbolic stimuli in a specific leisure destination. In this investigation, symbolic stimuli refer to a sense of togetherness, a sense of renewed vitality, and a sense of community – a genius loci that travelers experience by being together, by encouraging each other, and by celebrating their lives. This research reveals that it is not the place per se that results in a transformation of human health; rather, it is the union of buildings, landscape, people, and a spirit for life that profoundly enhances tourist well-being.

The third article from Ranvir Rai continues the theme of how to improve the lives of the older-aged and elderly through non-medical services. In particular, this novel research explores how electronic pill dispensers can help older-aged consumers and perhaps people with the beginning stages of dementia organize their medical dosages. These self-service medicine dispensers come equipped with reminder alarms and automatic dispensing of required pills on a set timetable. In doing so, they help protect users from overdosing or from forgetting to take their prescribed medication. Although the studied consumers spoke highly of the usefulness of medicine dispensers, this technology is not free from problematic issues. The authors reveal that dispenser malfunctions, due to dead batteries or mechanical issues, may be detrimental to some users. Even dispenser users admitted that these self-service devices work best if users retain some control in their daily lives; that is, medical dispenser technology is simply not fail-safe. Thus, physical stimuli alone cannot replace the need for constant human intervention regarding patient well-being. Despite some negative aspects of self-service medicine dispensers, these appliances may become widespread in many homes, especially as people live longer and become increasingly dependent on pharmaceutical interventions as part of their daily routines.

Building on many of the issues in the previous article, the fourth article from Yu Mu, Bart Bossink, and Tsvi Vinig highlights the importance for frontline healthcare employees and senior management to work together on idea generation and service innovation. Indeed, this research reminds health practitioners that physical technology alone does not warrant service quality; rather, it is the confluence of physical and social factors that leads to successful new-to-the-market services, new delivery processes, service improvements, cost reductions, and so forth, in healthcare and perhaps all service settings.

The fifth article from Philipp Klaus again focuses on healthcare settings, albeit in a luxury cosmetic surgery setting. Klaus notes that in contrast with the voluntary nature of cosmetic surgery, healthcare is viewed as a human necessity that is linked in some manner to mortality. Thus, Klaus suggests that cosmetic surgery is a type of ‘wealthcare’ rather than healthcare. The physical and social servicescape of cosmetic surgery, such as in the world of Botox and injectables, can best be managed as one would manage a luxury hotel or boutique. That is, the relationship between a patient seeking non-invasive cosmetic enhancements and his or her provider represents a personal bond that seems more like a commercial friend than a relationship a patient has with a traditional healthcare provider. Furthermore, the spa-like facilities that typically adorn this world are more like a hotel and less like a medical healthcare center. The music, aromatherapy, and overall ambience of a medical spa are more characteristic of Saks Fifth Avenue than an urban hospital. Thus, Klaus’s contention that wealthcare is a type of healthcare may be correct; however, its physical, social, and natural servicescapes are more characteristic of hospitality and high-end retail than traditional medical care.

Research from Steven Rayburn, Sidney Anderson, and Linda Nasr continues the focus on service design by exploring how a healthcare servicescape may promote consumer engagement and collaborative patient–provider relationships. The authors encourage health practitioners, as well as those involved in healthcare design, to consider a patient’s journey throughout a medical service and to employ designs such as examination rooms, lighting, and furniture in a way that enhances patient and healthcare provider relationships and collaboration. In particular, they encourage healthcare organizations to consider how they can use technology, at each touchpoint, to give patients the opportunity to participate in their service delivery rather than simply being service recipients.

Last, research from Dahlia El-Manstrly and Mark Rosenbaum reveals how gender plays a role in the way cancer patients respond to a cancer resource center’s physical, social, and cyber servicescapes. They show that cancer patients may be able to lower their mortality rate by patronizing and participating in cancer resource center services. Despite the health benefits cancer resource centers offer, these centers tend to be disproportionally patronized by women, even though the disease affects both men and women equally. The authors suggest that cancer resource centers consider hosting social programs for men with cancer in non-home-like environments or alternative spaces that they perceive as having masculine esthetics. For example, rather than encouraging men to participate in emotional support groups, cancer resource centers should provide men with socialization opportunities to engage in play-like activities, without demanding that they discuss their emotions in forums. Overall, the research reveals that gender influences the manner in which patients respond to design elements in healthcare settings.

We thank the authors, reviewers, editor, and editorial staff for their efforts in compiling a though-provoking issue that blends together service design theories in an effort to transform human health and well-being. We also encourage researchers investigate how under-researched consumers, such as consumers with disabilities, vulnerabilities, and the elderly, or consumers in developing and least developed nations, respond to environmental cues in service settings, as doing so would expand our understanding of the seminal servicescape framework at a substantive level.

Disclosure statement

No potential conflict of interest was reported by the author.