OpenIDEO is an open innovation platform. Join our global community to solve big challenges for social good. Sign up, Login or Learn more

mind, body, space.

A new type of hospital space that doesn't look to replicate the home but better transitions the individual and family for change.

Photo of Emily
25 22

Written by

Who is your idea designed for and how does it reimagine the end-of-life experience?

The idea is that the new hospital room will not only borrow elements from brainstorm/innovation space that encourage people to think differently and analyse all the information available but yoga rooms that create a sense of relaxation and reflexivity, a hospital to legitimise the expertise within the room whilst also a hostel where its a place to meet knew people and share in experiences. Its not a daunting space, but one full of life.

As an interior designer, I am very passionate about the impact an environment has in our sense making process. A space can generate implicit conversations that develop our insights in which we understand, interpret and respond to our present situations.

With this in mind, I propose that its not about trying to replicate a homely environment in our hospitals, or trying to replicate the idealism of dying in our sleep, but strengthening our mindfulness through our environments. We need to create environments that correctly convey what is happening and what could be.

I suppose with death we all feel a lack of control over our lives, but if our environments strengthen our ability to respond better instead of striving for a sense of anaesthetic, we can make our own decisions of what is and what could be. Which would generate a sense of empowerment and will both of the patient and their family to continue in whichever way they like. To be comfortable with the future and prepared for change.

We must consider, the whole user experience.. a further involvement where possible in the treatment plans rather than being given unknown medications, better lighting to create a sense of privacy and intimacy, unique elements that create a sense of place within a room; a small kitchen to allow the ability to participate in cooking or smelling dinner being cooked, a communal dinning to encourage conversation of people in similar situations, large windows to create a connection with the world around.

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

I am currently assisting on a project dedicated to providing a resort for brain and spinal rehabilitation, although not at all end of life, we are discussing with focus groups the key drivers within hospitals that remind people of their injuries and create a mental barrier to a sense of normal and considering the change in mentality of all users.

What skills, input or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

Architects & Interior Designers
Doctors & Nurses
Patients of all kinds: long term, short term, regular

Tell us about your work experience:

Designer

This idea emerged from

  • An Individual

25 comments

Join the conversation:

Comment
Photo of OpenIDEO
Team

Welcome to the refinement phase Emily! Here are some key questions and milestones we encourage from all ideas in the Refinement:

1. How might this idea address the unique needs of the target audience you're designing for?
2. Clearly summarize the value offering of your idea in 1-2 sentences
3. Communicate your idea in a visual way with user experience maps http://ideo.pn/UX_Map
4. Identify assumptions that need to be answered in order to validate your value offering: http://bit.ly/1Oi8ZHu
5. Collect feedback from potential partners and users to answer the assumptions you’ve identified.

Lastly, here's a useful tip: When you update the content of your post, it'd be helpful to indicate this in your idea title by adding an extension. For example, you can add the extension " - Update: Experience Maps 07/12" to you idea title. This will be a good way to keep people informed about how your idea is progressing!

Photo of Madeline Duhon
Team

Hi Emily, 

This seems like a really great idea. I imagine that the environment is so important, both for the patient in the hospital space as well as family members spending lots of time visiting their family member. From my family's own experience, I know that it is particularly difficult to spend lots of time at the hospital visiting and caring for a loved one. I imagine any creative solutions that aim to make the hospital visit experience more enjoyable and pleasant, or simple and practical solutions to ease the burden and lend convenience would be very helpful. For example, I love the idea of an open kitchen, where patients in the hospital can have freshly-prepared meals or even just enjoy the smell of cooking food, or where family members could keep snacks and meals around to get them through a long visit. 

I used to volunteer occasionally at a hospital center caring for terminally ill children. There was a playroom where there were stated rules to help the kids be kids, help them to leave their illness at the door when they entered to play with tonka trucks, video games, or color in coloring books. Could there be specific zones or rooms for the patients as well, where in that room or space, the patients are able to leave their conditions at the door and simply be themselves?

Another idea borrowed from children's hospitals would be to have art from the patients lining the hallways. Maybe there could be a space stocked with materials that patients could use to create artwork and have it displayed throughout the hospital, to help lend a more personal and homey feel to the space.

Overall, I love the concept and I am looking forward to seeing the idea grow!

Photo of Chris Lee
Team

Hi Emily,

I like the idea of using space to help create a more pleasant experience. I see this a lot in office and retail space but haven't seen it carried into hospital roolms. I just spent some time in the hospital and it was a very unnatural, out of control, isolating time. I can see where facing that every day until I died would not put me or my family at peace.
I can also see why the hospital is set up this way: to facilitate the medical process I was a part of.
Do you know what regulations or practicalities are keeping things are they are in the hospital setting? It would be interesting to know how much is regulation is and how much is convenience for the hospital.

Photo of Emily
Team

Thanks for sharing your experience Chris. For me this idea was only really generated by being a visitor to family members in hospitals and reflecting on my different experiences. In one instance, it was the lack of regular nurse visits, the quietness of the room and the emptiness of the space that kind of mentally informed me that this was the end for my Grandmas. In a complete opposite example, another relative who is regularly in the ICU, has often told me how he prefers to be in ICU enjoying the continual interaction of the nurses and action of those around him. An interesting perspective given, you should really not want to be in ICU.

Its interesting how you mention regulations, obviously integral in hospital design and whilst I haven't ever worked on a hospital interior, it would be great to questions the necessity of all them. For example in the project mentioned above, although it has many hospital like elements because of its resort building classification we remove many regulations and design for user rather than code. 

Photo of Bettina Fliegel
Team

Hi.
Emily - It is very interesting to note that your relative liked being in ICU due to the constant companionship of staff and action all around.  Is that relative isolated in his regular life?  This insight might be really helpful to him personally if hospital staff knew about it, as they might be able to link him to services in the community that connect him to others for socializing.  Also it is a great insight that might be used when thinking about designing hospital spaces.  On a regular ward one does not need to be monitored so closely so nurses will be in the room much less.  Also years ago there were hospital wards with multiple beds.  We have moved away from that to private and semi private rooms.  Perhaps for some they would prefer to be in larger shared spaces where there are opportunities to speak with other patients and their visitors, rather than being isolated.
Also what about day rooms?  Are they available and do patients know about them?  Are they inviting spaces?

Photo of Emily
Team

Hi Bettina,

Interestingly, not at all. He is not particularly isolated when he is in the hospital he would have his whole family visit ever day and family events every few weekends.. It just makes him feel easy about his situation he knows that if something goes wrong during his sleep.. a nurse will know about it and similarly for us too! He's not just something they have to routinely check like a "chore" on but closely monitor. 

Funny you mention the group room situation, he is often in a group room on the ward and will bump into people he sees in hospital every now and then or placed with people who have identical illnesses and really enjoys that. However, this is not typically the case and I think theres an interesting stigma hospitals that you must let people rest and be quite etc.. How much joy a small noisey child often brings in these places?

Photo of Bettina Fliegel
Team

Hi Emily.
Interesting observations!  Yes small children can bring joy, but I think there is some truth in that for some that are ill they do need to rest.  In my experience some, not all, older people are less patient with children that are not family members.  In situations where elderly might gather like a nursing home, or adult day care/ community center I think it might be great to think about a  nursery school that can be co-located in the building as children do bring joy.  In this case the people might be elderly but in good health, and perhaps happy to have noisy kids nearby to interact with.  It can also be great for small children to get the love and attention from elders.  This can be a design idea for these facilities.
 I remember visiting my grandmother as a family with my nephew when he was old enough to walk. She had a cane and he would grab it and walk alongside.  They both held one end of the cane.  It was really cute as he pranced through the halls.  I guess she did not need the cane consistently as she was fine.  They were quite the duo in those moments.   She lived in an assisted living facility.  For her that meant there were staff on the premises, there were meals served in a dining room and there were people to socialize with if one wanted to, at various activities in a common room.  She lived there until she die at the age of 103.  Most folk there seemed to enjoy the company of children when they came for visits.

Photo of Chris Lee
Team

Hi Bettina,

Your observation that the "joy" of children depends significantly on the condition of the person experiencing it triggers another thought in my mind about a talk by Malcolm Gladwell on Spaghetti Sauce and happiness (https://www.ted.com/talks/malcolm_gladwell_on_spaghetti_sauce?language=en).
The short of it being that there is no single thing that makes everyone happy.
But we build and act as if there is - probably because it costs more to build the variety required to allow for choice. Choice is messy. Choice can't be as easily proceduralized and cost reduced.
What can be done to design for choice?
Office spaces might be starting on this trend: Reconfigurable personal workspaces, movable desks, multi-purpose rooms (quiet work areas, private meeting rooms, open work areas, social areas, etc).
How would this apply to a hospital or end of life care setting?

Photo of Bettina Fliegel
Team

Chris Lee and Emily -
Great insights and questions Chris.  There is a hospice in the Bronx, NY that I heard was wonderful.  When I checked their website I saw that they have a cafe space that services patients and visitors.  I thought this was great and unusual as in most hospitals I have been in patients do not access the same areas for shopping (gift shops) or eating (cafes) that visitors do.  Why not create places where they can pick up things for themselves or perhaps they want to pick something up for their loved ones?  That is one idea I like. 
Another observation I had was that in hospitals in other countries there are common eating spaces for patients.  If they are well enough to leave their room they can sit together in a dining area to eat.  I think this is great for socialization.  Not sure if there are regulations around this in the US.
 Speaking to users to get their ideas on what they would want would be the best place to start I think.  I think this would include patients, visitors and staff.  I would also include conversations with ancillary staff - kitchen staff that bring up meals, housekeepers, patient escorts, phlebotomists etc. - they are around all the time and therefore could be great sources of information and observations on the needs of patients throughout the day/night cycle.  
A simple thing I have noticed about medical facilities and I think this is ironic - they often have the name of the disease state on the building - ex) The name of the donor who contributed to pay for the facility and then the disease - ……Center for Excellence in Breast Cancer.  To me this is a breach of privacy.  As someone who appears ill walks in it becomes obvious what their illness is.  We have so many rules around privacy in medicine, HIPAA, but these signs stand out and announce what the issue is.  I always wonder about that.  How can design contribute to maintaining privacy and dignity?  Does everything need to be labelled on the outside?

Photo of Emily
Team

The ABW of hospital design... I like it. 

I think maybe the key point of both Bettina and my comments regarding children is not specific to children but the unexpected interaction, the ability to observe life and not be stuck in a box.

Photo of Aaron Wong
Team

Chris and Emily,

I haven't worked on a hospital project either, but if you compare it to standard interior design projects, it's about the programming - specifically, where the money comes from. When it comes to hospitals, I believe they would prioritize operating rooms and less so on recovering or waiting areas. The majority of what hospitals would probably spend their money on is equipment and cleanliness/sterility. This is represented by the amount of detail that is paid on choosing the right materials, and technology in a space. 

A good way of thinking about it are through these diagrams:
https://www.wbdg.org/images/hospital_2.gif
https://www.wbdg.org/images/hospital_3.gif
As you can see from these diagrams, everything is centered around "Diagnostics and Treatment", which it should be. Seeing these diagrams, I think the challenge is not necessarily a new room for a new function, but instead, might be to tie all the rooms together through an overarching new function that would seep into the design of all spaces.

To give you a better idea of how Hospitals are currently designed, it is very straight forward and "logical"- an example is the VA's guideline: https://www.wbdg.org/ccb/VA/VADEMAN/dmidhonh.pdf
These guidelines are based on ease of access, cleanliness, affordability, etc. There hasn't been nearly as much publication, research, or money spent on dissecting successful hospitals as there is towards workplace environments. Perhaps if people understood that a hospital with better mind/body space can save money, hospitals would more readily adopt new ideas.

In my opinion, hospital design specialists still haven't "cracked the code" yet. When we think of the new workplace, we think of places like google and facebook, but from reading this challenges discussion, there is no benchmark or new standard for hospitals yet. When reading Anne-Laure Fayard 's link to https://hbr.org/2015/10/better-healing-from-better-hospital-design, its points are shockingly similar to productive workplace environments and healthy living conditions - i.e. indoor ecology.

Photo of Chris Lee
Team

Hi Aaron.

Those are interesting diagrams. My experience with doctors and hospitals has been that they are very much about "fixing" a pathology as a business problem. Business asks for efficiency. It seems like the best model of efficiency we have is a factory. Unfortunately, a factory invites the things flowing through it to be treated as interchangeable things. Emphasis on THINGS.
People and sickness, especially as we face a terminal situation that can't be "fixed," upends this focus on efficiency and pathology. It becomes about a person's expectations and ability to reconcile the actuality of what they are going through with their stories of what they are going through. Kind of like the Placebo effect writ large: how do you create an environment where the process is about "treating" the expectation instead of the (unfixable) condition (end of life)?

Photo of Chiara Pineschi
Team

Hello Emily! This is a great input. I was very impressed by this topic, and I had posted an Inspiration for the challenge in: Can architecture help create a better way to die?  If you want to read it. I loved your sentence "it's not a daunting space, but one full of life.", I truly believe much can be done in terms of interior design for renovating hospitals. Thanks for sharing!

Photo of Emily
Team

Hi Chiara,
I really like this talk shared. Its a really important point, fundamentally hospitals should be a positive environment as they are full of people & equipment there to help you but yet we have such a negative connotation to them. WHY?
 Sure, because normally it means we or someone we love is unwell/ harmed and we face a trying situation.... but fundamentally its better we are in a supportive environment than not, so why doesn't it feel like that? Why don't we walk in to a hospital with relief and think "everything will be okay"? Can we achieve that?

Photo of Yury
Team

Great Job Emily. Very impressed by your idea. 

Photo of Emily
Team

Thanks Yury.
Do you have any ideas of the kind of environment or feeling you would like to have at end-of-life?

Photo of Anne-Laure Fayard
Team

Emily, there's clearly a lot that environment can do to lower anxiety, create a sense of control, etc. 
You might want to check the Maggie Centers. I remember a designer telling me about this specific one in London: http://www.rsh-p.com/projects/maggies-london/

Check also this paper: https://hbr.org/2015/10/better-healing-from-better-hospital-design

I think that while there has been some work and experiment, there's still a lot to be explored as the standards have not changed much so far. Good luck!

Photo of Emily
Team

Thanks for sharing this great example and the HBR article.
It is really tricking to move these concept past regulations, even worse is that standards/ building code varies country to country.  I know in here in Australia for example our standards are typically higher than most.. perhaps not the most user centric though!

Photo of Bettina Fliegel
Team

Hi Emily and A- L.

A-L,  Thanks for posting the link to Maggie's Center!  What a great example of how space can help to create community.  The community there then becomes supportive for it's members.
 I love what Maggie had to say about her motivation for this project - "Maggie Keswick Jencks lived with advanced cancer for two years. During that time she used her knowledge and experience to create a blueprint for a new type of care. Maggie’s Centres are built around her belief that people should not “lose the joy of living in the fear of dying”.  
 The last bit - "people should not lose the joy of living in the fear of dying"  -  this is the goal.

I know there is some emphasis on technology in this challenge, and in our society in general, but for me I would choose a local Maggie's Place for support for anyone in my life, rather than something virtual, or something that required connecting online.  I wonder about our fascination with technology sometimes.  Can we use it as a tool to bring people together on the real world, particularly during end of life when experiences that involve all senses are so important?

Looking forward to checking out the article you linked as well.

Photo of Anne-Laure Fayard
Team

Thanks Bettina. I was very inspired when I heard for the first time of the Maggie Center a few years back. I'm not sure why I did not think of sharing this during the research phase. Yet reading Emily's post, it came back to me! 

Regarding your second point, I agree on the importance of face-to-face. During the research phase,  a few posts highlighted the importance of the senses. For example: https://challenges.openideo.com/challenge/end-of-life/research/goodbye-oma
and https://challenges.openideo.com/challenge/end-of-life/research/i-want-my-dad-s-soup 
and others highlighted the importance of relationship and communities. You are right to highlight the importance of community for the Maggie Centers. I think this is at the core of their success. 
I hope that some ideas will look at these aspects too. If you can come to our ideation session for  the NYC OpenIDEO chapter that would be an opportunity to brainstorm along these lines. 

Photo of Anne-Laure Fayard
Team

Emily,
I'm glad you found these useful.
 I did not realize you were in Australia.
I can see how there might be some regulations but I also think that there are things quite simple that can make a space more friendly that would not clash with regulations. It can be colors, types of furnitures, windows, ... maybe outdoor space. 

Photo of Aaron Wong
Team

Great links Anne-Laure! And I'm happy to see you thinking about space, Emily!
My background is in interior design as well, and I can fully appreciate thoughtful design of space -specifically in the design program and processes around space. There is so much opportunity to innovate when we embody abstract ideas into physical space! From my experience, creating new spaces and materializing new ideas require a lot of change management and building new cultures using space and design - in fact, I believe interior design can be the main driving point in changing how we live and behave on an everyday basis. I love interior design cause it can be so personal and engaging.

Also, check out what Brad Wolfe 's Death Cafes  about creating space to talk about death, Anne's own post, @Baba Yaga's House about merging community into healing spaces, and @Chiara Pineschi 's @Can architecture help create a better way to die?  to beautify hospital space. These people and posts are great resources for more ideas!

Photo of Bettina Fliegel
Team

Hi Emily.
I agree that environment is important in healing, and in treatment.  I believe design has a huge role to play in patient care and safety.   As a physician I have worked in many different environments, some good, some pretty bad in terms of what they bring to care, and also for the experiences of staff working in these environments.
Can you elaborate a bit more on the project you mention which is "dedicated to a resort for brain and spinal rehabilitation"?  What do you mean by resort?  I have a close friend who is a physician specializing in spinal cord injury rehabilitation.  Perhaps she might have some thoughts around your project?  

Photo of Emily
Team

Hi Bettina,

You're right, its really important in facilitating a new mentality in staff also.
This is something we also discussed on project mentioned. Whilst I am just assisting in the project at my organisation from a design perspective, there is an amazing team of people behind the concept and the community in funding to try and ensure a new type of 'resort' is available for individuals to have a break from full time hospital care and reconnect not only with themselves but others. It would great if she has seen or knows of any outstanding solutions in this area... http://www.sargood.org.au

Photo of Bettina Fliegel
Team

Thanks for the link. I will check it out and share!