The Center for Health Design Blog

Someone Went And Did It

Working in conjunction with the UK’s National Physical Laboratory (NPL), Imperial College London (ICL) has created a virtual hospital in the 3D virtual world of Second Life and a series of ‘machinima’ documentary films that describe what healthcare of the future could look like.

This is an experimental, innovative and efficient means of communicating complex healthcare messages as well as illustrating what healthcare of the future could look like. The design of the virtual hospital in Second Health is based on the principles and recommendations outlined in the recently published National Health Care Service London Framework for Action report which details how Professor Sir Ara Darzi believes London’s healthcare needs to change over the next ten years. Professor Ara Darzi, who is now Parliamentary Under Secretary for Health in the UK and a member of the House of Lords is now leading the reform of the National Health Service in Britain.

ICL and NPL are testing the effectiveness of Second Life as a medium for conveying complex healthcare delivery messages and essential healthcare information to care givers, doctors and the public. “In the future we expect to provide healthcare services in the metaverse.”

Learn more

More On Signage

There was a great slideshow in the NY Times the other day about work being done to update highway signs. The accompanying article is a terrific window into an evidence-based design process.

The project is the culmination of a nearly ten year effort by a team including an environmental designer and a type designer. Their goals? Improve readability for all drivers at a distance and at speed. A timely thing for highway officials to realize. Though only 12.4 percent of the U.S. population was over 65 in 2000, that number will increase to 20 percent by 2030.

Some people would think this a simple task, but for those of us who know full well the impact one particular design choice can have over another, and how many people these choices will affect, the project is a daunting undertaking. Ten years seems an appropriate time frame within which to solve the problem.

The current road sign design has effectively been in place since the 1950’s. The team’s intention was to build on the effectiveness and familiarity of the original sign system, while also addressing its deficiencies.

They considered generational differences in the audience and how (or how well) those audiences can see. They also factored other variables - inclement weather, fog, night, dusk, dawn, differing road speeds, oncoming headlights, and screaming kids in the back seat, to name a few. Needless to say, the designers had a lot to think about.

This story highlights how graphic design can be deployed to solve serious real world challenges, and help people get where they need to go.

That same idea holds true in healthcare settings. Below is a picture that we like to show as a great example of bad signage that hinders people’s abilities to get where they need to be. Just as a road sign that can’t be deciphered could make the difference between life and death, not being able to find an emergency room, for example, could create a catastrophe. At the least, being faced with confusing signage can induce feelings of panic, discomfort, frustration and other negative consequences. And that’s not conducive to a healing environment.

The Center’s New Office Space

Here’s a sampling of our new colorful office space, replete with beautiful artwork donated by Henry Domke.

Debra Levin met Henry, a practicing physician and fine artist a few years back at the HEALTHCAREDESIGN Conference.

When The Center opened its Concord office he generously offered some artwork for the new space and offered again when The Center recently expanded.

Henry’s wonderful eye and his stunning work soothe and inspire all of the busy staff who work here.

To see more of his work, or to learn about Henry’s passion for art in healthcare visit Henry’s web site or his blog.

Jain Malkin’s New Book

I have the privilege of working with Jain Malkin to produce the eagerly anticipated new book she’s written for The Center, A Visual Reference for Evidence-Based Design. It promises to be a must-read for anybody in our field. The Center staff have had a sneak preview and are really excited about how great it’s going to be because no such book has previously existed.

Jain’s an industry legend. I’m also discovering that she writes at an amazing and prolific pace WITHOUT the use of a computer. This entire book was handwritten by her, which for someone like me, who relies heavily on a computer for my writing, is quite a feat in and of itself.

Her book was originally planned to be an annotated visual guide with some text, but it’s blossomed into a much larger and significant work. Not only is it chock full of photographs and practical information about the application of evidence-based design theory, it’s also up to the minute and full of studies from a wide number of sources (some of which will surprise readers.) Jain has told me that she’d often get an email from the AIA or another organization about a burning new issue and it would already be in the chapter she was writing at the time.

The book is coming out later this year and I’m sure it’ll sell like hot cakes. Between now and then, there’s still lots of work to do, including making sure we print enough copies for everyone who is going to want this on their bookshelf.

File This Under Things That Don’t Make Sense

Clare Cooper Marcus, Professor Emerita of Architecture and Landscape Architecture at UC Berkeley and co-author of the book Healing Gardens came to The Center today to talk to us about the healing power of gardens in medical settings.

If you haven’t had the pleasure of experiencing Clare speak, you’ve missed out. She’s extremely smart, yet very approachable and easy to understand. Plus, she has some great stories to tell.

I was interested to learn from her research that staff are statistically the heaviest users of outside gardens in hospitals - most patients are in and out too quickly and those that aren’t are often too sick to get outside. For hospital staff the gardens are a breath of fresh air (literally) and a welcome relief from the intensity of their jobs. One staffer told Clare that without the garden at her place of work she might go “insane.”

Amazingly, Clare’s found that many hospitals she’s visited have outdoor garden spaces that are not sign posted well, so they are difficult to find. Some are even locked so that they can’t be used. For some reason, the hospitals don’t seem to want people to be using them. She doesn’t know why this is but has some possible theories - perhaps the hospital wishes to minimize maintenance costs or keep homeless people away.

Given how staff satisfaction and stress relief is just as important as patient outcomes when it comes to the bottom line for hospitals, the cost of good signage, upkeep or security patrol for an existing garden space seems very minor compared to the immeasurable benefit it could provide.

To all you facility planners out there I ask this: why not make sure your gardens are open, easily accessible and locatable? It’s a small and simple thing that you can do that will pay the hospital back in spades.

Purchase Clare’s book

The Democratization Of Expert Knowledge

I was listening to a podcast recently of a debate that originally aired on NPR about whether social media undermines the quality of the information that we find on the internet.

Before the advent of web 2.0. it was argued, we had mainstream media and cultural institutions inhabited by “experts” who made sure to filter our information for us. Now, all bets are off and readily available but potentially substandard content is in danger of destroying whole industries, particularly our culture industries. It was posited that the so-called wisdom of crowds is itself an “extraordinary popular delusion” and the best work can only come from the individual, professional mind.

How do you define expert? To me, an expert is someone who has demonstrated know-how backed up by solid credentials. Usually an older professional who has paid their dues and learned a lot along the way. How much of that expertize is making its way into web 2.0? Not as much as you’d think. Because web 2.0 is still fairly immature, older professionals are typically less plugged into it - they don’t feel like they understand or can control it - which means that younger, “digital natives” are producing the majority of the content.

Fortunately, more and more academics are embracing sites like wikipedia and the newly launched citizendium. Some time ago, we wrote an entry in wikipedia defining evidence-based design. We think we know what we’re talking about when it comes to this subject, (we’ve certainly paid our dues) but the wikipedia moderators apparently didn’t agree and have made a notation that the introduction to the article provides insufficient context for those unfamiliar with the subject matter.

So, to all of you experts out there in the CHD community, please give us a hand. Collaborate with us and other experts on the web to create meaningful, relevant and, most importantly, accurate information that can be accessed by many people. Log into wikipedia and help us improve this definition.

If you don’t, who will?

Caring for boomers in the community

Interesting blog post from architect Greg Olsen about reinvesting in communities to provide long-term, at home care for boomers as they age.

Top Ten Virtual Medical Sites in SecondLife

I’ve been keeping an interested eye on what is going on in the world of SecondLife as it relates to health care.

One of the benefits of using SL is that everyone can download the software and run it on their own machines which seems like a great way to reach many people. But, that being said, I’m still on the fence as to whether I would recommend using it for a health care project. Beyond the investment in a technology that may go away in a few years, there are some barriers to entry for the average user:

• The learning curve in SecondLife is steep - just moving around in the environment with some control is difficult initially, even for a sophisticated user. A lot of people get frustrated with the GUI and give up

• The software requires a newer computer with plenty of horsepower to render the graphics effectively

• If the Linde servers are down for some reason, your SL project is also down, which means you lose touch with your visitors and constituents in SL

All that being said, many health care organizations are jumping into the virtual space and using SL as a medium for demonstration, experiment design, collaborative meeting spaces, training and even actual experiments, to name but a few.

This top-ten list of virtual health care spaces, while not exhaustive (number 9 is a little strange) provides an interesting glimpse into some of the SecondLife projects under development by those in our industry.

Green Healthcare News

Maybe healthcare is catching the green design bug. And it’s about time. According to a recent study, nearly two thirds of healthcare administrators believe that sustainability will change the way healthcare buildings are designed and constructed.

Becoming good stewards of the environment just makes good sense for healthcare organizations. Not only does this affect how buildings are designed and constructed, but also operational things like reducing waste, promoting recycling, conserving energy, etc. An even bigger leverage point is purchasing power. If healthcare organizations lead by example, the benefits to the community — and the earth — are potentially enormous.

The study, “The Health Care Green Bulding SmartMarket Report,” was conducted by McGraw Hill and sponsored by Turner Construction company, Johns Manville, and the U.S. Green Buildings Council. For more detailed information on the study, including where to purchase it, see this article on Buildings magazine’s website.

Also, check out The Center’s papers on environmental responsibility.

Thanks to Kirk Hamilton for forwarding this along.

Cross pollination

Carolyn Quist and I had dinner recently with a good friend of mine, Christen Soares, a LEED certified architect, who works for the reputable architecture firm Field Paoli, in San Francisco. While Field Paoli’s practice focuses on commercial and residential spaces, our after dinner conversation turned to the work that The Center does and a broader discussion of how evidence-based design could be used to inform all design projects.

Christen was excited by the idea of Field Paoli introducing more rigor into their design process and being able to make a strong business case for using certain design principles in their retail and commercial projects.

This was music to our ears.

Our practice at CHD focuses on healthcare and long-term care, yet we are very much aware that how the built environments affects us is not limited to the places we go when we are in need of care. We’re affected when we shop, eat out, work and hang out at home too.

As CHD staff members we don’t leave our work at the office at the end of the day or the week - we’re passionate and thinking about this everywhere we go, even on a Saturday evening over good food and wine.