The Center For Health Design
Why does this study matter?
One of the best ways to understand the patient experience is to use participatory research methods. Research that engages patients in the design decision-making process gives them a chance to share their point of view, and, if used in a real project, increases the likelihood that the final design will actually meet their needs. While this method is becoming more common in research on healthcare environments for adults, we do not see a lot of examples where children are given chance to share what they want in pediatric spaces. And in general, the design research in pediatric healthcare settings is limited. One of the many challenges in doing research with children, is finding an appropriate method to gain their perspective.
How was the study done?
In an effort to bring the young patient’s voice into the healthcare design process for a hospital, researchers used “Lego Serious Play” methodology with a group of nine hospital patients, ages six to 11 years old. This method uses Lego building bricks to give children the means to show and express their ideas. The activity was led by a nurse who had previous experience using this method, with assistance from a physician. They began by talking with the children about some of the challenges they face in the hospital. Then they asked the children a series of questions about what they would include in their ideal hospital, and using the Legos, the children constructed examples of these spaces and features and described their designs to the facilitators.
So what do we learn from the study?
Children in this study shared their desire for the same things we all want in a healing environment, starting with designs that support safety and comfort. They included elements like a nightlight “that doesn’t bother you, so you don’t get scared,” and emphasized the importance of elements that provide optimal rest for both patients and their families. Participants also created designs that reflect a commonly cited need for positive distractions, such as access to nature and good views, and access to opportunities for leisure such as TV and a swimming pool. What may set these findings apart from typical studies with adult patients is the inclusion of whimsical elements like “a flower that has a button to be able to play music,” and “transparent walls and bell on the ceilings to let the light in.”
Can we say the results are definitive?
This was a quick informal study with a small sample size and not a high level of rigor. The authors acknowledge that findings are only representative of these nine patients, and cannot be generalized to other children. However, given the scarcity of research in pediatric healthcare design, this study is a worthwhile contribution to the knowledge base and a good starting point.
What’s the takeaway?
This study shows a creative way to gain the insight of children through a design decision making process. There is a great need for research in this area, and future studies would benefit from building on this method. While a more rigorous approach would be beneficial for better generalizability, the general framework is there: ask the children what isn’t working, give them a chance to show you what they want and need, and what design ideas they have to get there.
While we generally discourage design researchers from asking users to be designers, this method shows how it can be done appropriately. The goal of having the children design solutions is not necessarily to implement the actual designs, but rather, to find out what is most important to children when they have to be in the hospital.
Rubio, N., Macías, F., & Gómez, E. (2021). The Children’s Council as a mean of participation in a hospital. American Journal of Nursing Studies, Issue 2, Volume 2, Pages 1014.
As a part of The Center's research team, Melissa focuses her efforts on grant-funded research initiatives, as well as supporting ongoing work of The Center, such as the Affiliate+ program, the Knowledge Repository, and the Evidence Based Design Accreditation and Certification (EDAC) program. She examines the impact of the built environment on health through the development of conceptual models that link design and outcomes and by evaluating the effects of evidence-based design innovations and by disseminating research findings through tools, presentations, and publications.
Melissa was previously a senior design researcher for Davis Partnership Architects and prior to that she served as a researcher with the OMNI Institute and the Center for Children, Youth & Environments at the University of Colorado. With a background in both architecture and social science, Melissa describes her research style as “boots on the ground with a knack for rigor.”
Melissa graduated from Cornell University with a Masters of Science, Applied Research in Environmental Psychology and received her Bachelors of Environmental Design, Emphasis in Architecture from University of Colorado, Boulder.