First Impressions

First Impressions

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6 minutes
6 minutes

First Impressions Assessment

First impressions matter.  This is certainly true for patients encountering a health or community service for the first time. If they start out with a clear understanding of what to expect, where they need to be and how to get there, they are more likely to have a positive outcome from their appointment and a positive impression of the service.

A consumers’ first impressions of a service are influenced by a range of factors. These factors can help or hinder consumers making their way to and around a service and engaging in their clinical interactions. For example:

  • the way staff speak with consumers and carers,
  • the buildings where the care is delivered – are the design and layout accessible and appropriate for all users,
  • signage and maps – does the size, colour, format and location meet the needs of all users,
  • forms – are they plain English and easy to use, are they available in other languages,
  • the service’s website – how user friendly and informative it is,
  • internal policies and processes – do they consider the impact on consumers, and
  • the information provided – is it clear and easy for consumers to understand.

These are all elements of the health literacy environment.

The First Impressions Project

The First Impressions project aims to decrease the complexity of the health system and the demands made on the consumer to find and access services, resulting in better health outcomes. It is one strategy to improve the health literacy environment of health services in the ACT.

The First Impressions Project is delivered by the Health Care Consumers Association (HCCA) in partnership with healthcare consumers, the ACT Health Directorate and individual health services.

The project involves consumers assessing the “first impressions” that a service makes. The assessment reviews four key features:

  • physical aspects of the service, particularly how easy it is to get to and around the service,
  • the impression provided by staff at the service,
  • the services website – ease of use and quality of information, and
  • telephone communication with customer service staff.

The assessment is based on a phone call, a website search and a short walking tour of the site. HCCA then compiles the assessment data and provides written and verbal feedback to the service about the consumers’ first impressions, including their suggestions for improving the experience.

This consumer feedback is provided in a constructive manner and can form part of the useful overall feedback collected by a health service. A review from the First Impressions Project also demonstrates that the service is attempting to meet Standard 2 of the National Safety and Quality Health Service Standards – Partnering with consumers.

The assessment includes regular follow up at 2, 6 and 12 months to monitor progress and identify changes implemented as a result of the review.

The sites for First Impressions assessments are chosen based on both consumer feedback and health service request. The HCCA Accessibility and Design Consumer Reference Group provide valuable information on suitable First Impression sites. This reference group meets to discuss design and access issues at existing health service sites in the ACT and identify when a First Impressions assessment will help in the design of new health service buildings, renovations or processes.

First Impressions Project background

The First Impressions project activities were developed by Dr Rima E Rudd [i] , a health literacy lecturer at Harvard University, as part of The Health Literacy Environment Activity Packet. HCCA has further modified the tools used using the Planetree Person-Centred Care Environmental Audit Tool and feedback from local consumers


First Impressions Review Activities

Activity 1: The finding of phone numbers and making a call to find information required to get to the facility by car or bus. Notes are recorded by a consumer on an activity sheet.

Activity 2:  Finding information about getting to the facility via the facilities’ website. Notes are recorded by a consumer on an activity sheet.

Activity 3:  Walking review – impressions of the accessibility and wayfinding systems of a health facility including:

  • the main entrance (for all facilities) including such things as signage, ease of transport to site, car parking, distance and time taken between bus/car and area sought,
  • the reception of an area in the facility chosen according to previous feedback from the HCCA Accessibility and Design Consumer Reference Group,
  • the identification of environmental access issues such as signage, physical environment including lighting, waiting areas and design of patient / client areas, and
  • the evaluation of staff helpfulness, responsiveness, tone of voice and body language – such as eye contact or smiles.

Please contact HCCA on 6230 7800 or by email to discuss how First Impressions could assist your service.



[i] Rudd, R.E. The Health Literacy Environment Activity Packet: First Impressions & Walking Interview. On-line tools. Health Literacy Studies.

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Last Updated on 27 March, 2024.