Healthcare design is often used to refer to the design of building facilities in healthcare, including interiors, architecture, and landscape architecture; this is an industry supported by its own trade magazines, academic journals, and conferences. However, the term can also be used to describe how the healthcare industries engage with design to rethink the patient experience, and the delivery of services. User-centered and codesign approaches are becoming more common as the world’s demographic changes and the population ages, putting financial and capacity pressure on existing systems. Two core goals underpin healthcare design: design for people through patient-centered and staff-supportive design; and cost savings through efficiency in practice and “lean” systems.
Informed by the Six Sigma approach to manufacturing, lean hospitals are designed to improve quality of treatment, patient safety, and employee engagement through optimization of “flow” and value to the patient (customer). An extreme example of lean process design in the UK can be found at the Great Ormond Street Hospital, which invited Formula One pit-stop teams from McLaren to advice on the handover of young patients from theater to Intensive Care. The result was a new codesigned protocol which rationalized staff roles, reduced noise, and streamlined the changeover between teams at what is a critical moment for the patient; technical and information-based errors reduced dramatically within a year.
Healthcare environments vary widely, and include Accident & Emergency, theater, pediatric wards, private homes for owners living with disabilities, living spaces, and care for people with special needs, as well as respite care and hospice care. The design and layout of these spaces can impact on patient and staff safety and well-being, the smooth operation of the facility, and ultimately, clinical outcomes. Building guidance includes Health Building Notes (HBNs) and Health Technical Memoranda (HTMs), which outline criteria on such details as robustness and ligature points, although these are often seen as starting points rather than regulatory. The successful management of privacy, quality of light, noise levels, location of supplies, and adequate space for staff to work have been shown to have a significant impact on the holistic quality of patient care. Maggie’s Centres in the UK present an interesting case study, in that they are noninstitutional spaces that sit within the grounds of NHS cancer hospitals. They offer unconditional emotional support to anyone affected by cancer, in spaces designed by celebrated architects. With an emphasis on joy, the Maggie’s environment is designed to act as a refuge or sanctuary, and is held to be an example of best practice in holistic people-centered support.
User-centered approaches to healthcare design champion the voice of the patient alongside other stakeholders in the development and improvement of experiences, services, and products. Patient experiences can be communicated through user-centered design (UCD) and service design methods such as user journeys, and “touchpoints” redesigned to improve primary, secondary, and tertiary care. However, an emphasis on evidence-based practice can mean that qualitative research has little impact on policy makers, and it can be difficult for designers to engage with healthcare while it remains fragmented and changeable; there remains a need for a service design approach to mapping the landscape of care provision.
Health Environments Research and Design Journal.
(accessed January 14, 2015).
Lab4Living. About Design4Health.
(accessed January 15, 2015).