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Healthcare Design From The Patient Perspective
By Christine Guzzo Vickery, CID

Two years ago, a co-worker and I decided that to provide the most effective design strategies for our healthcare provider clients, we needed to better understand the needs of their clients - the patients who are the actual users of the facilities.

My colleague, Steve Christoff, AIA, and I knew that positive patient feelings and attitudes contributed to better health and faster recovery rates. We also knew from previous experience and research that, in both acute and ambulatory care environments, patients rank a building's "conduciveness to well-being" as a top priority, second only to "access to caregivers."

But, exactly what design elements are most conducive to better health? What values do patients most closely associate with feeling well? What places most strongly trigger positive thoughts of health and well-being?

If we could answer those kinds of questions, Steve and I believed that we and others at our firm, Hammel, Green and Abrahamson (HGA), Inc., could more strongly evoke those values and places in our designs. We would be able to create built environments that would contribute to improved patient outcomes and enhanced perceptions of care.

Discovering How Patients Perceive Well-Being

Our goal was to quantify and translate patients' perceptions of their well-being into successful healing spaces. We wanted to understand how design affects patients in healthcare environments ranging from hospitals and ambulatory care centers to clinics and facilities for the aged. We wanted to know not only what made them heal, but also what made them feel well.

Applying an analytical approach to a highly subjective topic, we developed the Discovery Design Process^TM. This "visual survey" helps to answer questions like: "What makes you feel well?" and "How do your physical surroundings have an impact on the way you feel?"

During the past two years, more than 600 people representing a diverse demographic sample have participated in the Discovery Design Process^TM. Gathering in small groups ranging from first graders to senior citizens, participants were asked a number of questions and instructed to use wooden blocks and colored shapes to illustrate their feelings and thoughts regarding wellness and healthcare facilities. Then, they were encouraged to explain their creations.

Although it has come to be called the "Blocks Game," the true value of the Discovery Design Process^TM is in the opinions and insights the blocks help to reveal. How participants arranged the blocks was not nearly as interesting or informative as their stories and explanations.

We heard senior citizens reminisce about old family farms. We listened while a young woman described whale watching as a child with her family. We even learned that the number one value for senior living facilities was "Fun!" - which was not necessarily something we had expected to be a priority.

One participant named John deliberately gestured as he erected a long, tall metal barrier. Using colored blocks of different sizes and shapes, he composed a rhythmic interplay of positive and negative spaces representing a city. On the other side of the barrier, two simple branches were used to support a translucent, circle-shaped piece of Plexiglas. He called this structure his forest. John explained to us that his well-being depended on the balance between the competition and challenge of urban life and the rejuvenation of privacy and peacefulness of the woods.

Top 10 Values and Places

Now, two years later, we continue to use the Discovery Design Process^TM. Yet, the responses have already begun to form a consistent pattern. Besides "fun," some of the Top 10 Values associated with wellness include "peace," "beauty," and "friendship and human contact." Some of the Top 10 Places are "nature," "home" and "bodies of water."

These insights have made it possible for us to translate consistent emotional responses into materials and design guidelines. Although the design and construction of a wellness concept is not as literal as recalling the images we have mentioned, the appropriate implementation can provide a greater opportunity for an enriched experience.

For example, we translated a tranquil, natural setting into elements of design. Gardens, creeks and open space became natural woodwork, water features and daylight. We recreate the quiet comfort of family experiences using color, subtle patterns and interesting artwork.

Every healthcare system has a unique mix of patients, community and mission. Listening and responding to administrators' and patients' concerns helps us to express its meaning in new ways. Values can be translated into powerful places that are intrinsic to the nature of an existing healthcare system and represent places for well-being.

Chris Guzzo Vickery, CID, is an Interior Designer with HGA, Inc., a Minneapolis-based firm specializing in healthcare facilities design and engineering. For more information about the findings of HGA's healthcare design study, please contact Chris at 612.758.4337.