The healing power of good design – an ER case study
Hospital staff, architects, and patients can contribute to designing hospital spaces that promote better communication and patient care.
Inspired by the work of architect Kieran Timberlake, ER physician Dr Bon Ku is advocating the power of good design for quality patient care.
In 2013, architect Kieran Timberlake was researching the impact of urban park design on behaviour, which inspired Dr Bon Ku, Assistant Dean for Health & Design at Thomas Jefferson University, to explore the impact of hospital design on patient care and staff communication.
In 2016-2017, Timberlake and Dr Ku worked together on a research project that would evaluate hospital design and quality of care at the Thomas Jefferson University Hospital’s ER department. The team employed occupant mapping, environmental monitoring, and surveys to evaluate the ways in which staff interacted with each other, their environment, and their patients.
Timberlake designed a spatial analytics app for medical students to use on iPads as they shadowed nurses through the course of their day, logging movements, interactions, and behaviour. The nursing staff worked in two different ER departments within the hospital – one with a centralised nursing station that was thought to encourage interaction with doctors and one with decentralised stations so that nurses were closer to patients. Whilst individual staff members had their subjective preferences, the research project provided quantitative and qualitative evidence of patterns and possibilities for good hospital design. From a detached perspective, the team could analyse exactly how the space was being used and whether it was functioning effectively by optimising patient care or if the design needed to be improved.
After analysing the spatial analytics and satisfaction surveys, the data yielded some unexpected results. Despite being positioned further apart, the decentralised stations saw greater doctor-nurse interaction with much of the communication taking place at patient’s bedsides, allowing patients to be more involved in their own care.
The results intrigued Dr Ku, who is also the Director of the Health Design Lab. He is passionate about raising awareness of good hospital design and plans on developing an app so that doctors can contribute information about hospital design and quality care. At the Health Design Lab, Dr Ku is training young physicians to integrate medicine and design – he believes it is time to remove the stereotype that creative types don’t belong in medicine.
Dr Ku believes that creative design is exactly what’s needed to resolve issues of poor efficiency in healthcare settings. From time-consuming computer systems to poorly designed medical equipment, the neglect of good design in hospitals puts unnecessary strain on staff and impacts patient care.
The form of evidence-based design (EBD) used by Timberlake and Dr Ku is not new to healthcare. Although, Merhdad Yazdani, the design director of CannonDesign’s Yazdani Studio, admits that balancing the technical and practical needs of hospital staff with patient experience and good design is a challenging task.
Yazdani designed sculptural storage walls to conceal medical equipment in patient’s rooms at the Jacobs Medical Centre in California. It was found that patients were sometimes alarmed by all the medical equipment and Yazdani’s design helped to remove it from sight but still made it accessible to staff.
Healthcare professionals and designers are taking a holistic look at patient care and have found that patient experience can impact stress levels and recovery time. Selecting natural materials; having access to natural light, open spaces, and greenery; and ensuring medical spaces are welcoming are all key to good design in healthcare. Research going back to 1984 shows how surgical patients recovered more quickly when placed in rooms with views of natural environments compared to those recovering in rooms with urban views.
It is clear that integrating design and function can improve patient experience and support quality interactions between staff. Good design really does have the power to heal.
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