Integrated Studio (2019) is an interdisciplinary undergraduate studio project that took place in semester one of 2019. It involved a group of third year AUT students from various design disciplines—spatial design, product design and communication design. Integrated Studio worked collaboratively with AUT’s Good Health Design and Waitematā DHB’s Institute for Innovation and Improvement (i3) to rethink what the future of a new healthcare facility on the North Shore Hospital campus could be.
“I feel that this [project] has been the most valuable to me over the last 3 years at AUT as it has guided my ability to apply my skills [and] problem solve with a human-centred approach for a subject I may not be well-versed in, while also providing a real-world experience of the industry.”
This was an opportunity for us to challenge and reimagine the future of care. By working collaboratively with patients and staff we had an opportunity to use creative processes to better understand the needs of users and to challenge thinking around what a healthcare facility might look and feel like, challenge current conventions and use design to advocate for those who are most vulnerable.
“I had a lot of fun with this project and I’m so glad I had the opportunity to do it. I learnt a lot and gained so many valuable insights into a more human-centred approach to design.”
Much like a healthcare journey, the process we went on was a rollercoaster of uncertainty and unknowns. But through it all we learned a lot about the challenges of healthcare and opportunities it has to offer. As designers we were able to challenge how the healthcare journey might be different and provide a better experience for both patients and staff.
As part of our research we visited the Institute of Innovation and Improvement (i3) at North Shore Hospital, where they gave us an opportunity to role play being a patient in one of their wards, gain empathy through disability simulations, and undertake a range of co-design activities with patients, their families and staff.
“It’s been super exciting not only to work on a real life project but to design something truly valuable that benefits patient’s lives at the hospital, I think that’s what design is all about.”
The project bought together students from different design disciplines. This was an opportunity to experience how those from other areas might think differently and use different creative approaches. The project ran with students as one studio team, but as the research process developed, smaller project teams were formed around specific opportunities. The project focused on building a strong collaborative culture. Consequently throughout the process all members of the team contributed to all projects, through ideation, critique, sharing of ideas and presenting final outcomes.
“I’m very excited by what comes after this project, because I think as a person and a designer, I have matured a lot, and the development would not have been the same if I had done the Studio V project in Industrial design."
"We were really impressed with the quality of what the students came up with, and the creativity they brought to their projects. I think when we’re working in health we get very task focused, and we don’t often get the space to be creative or have people that have that creative energy like the students did. I think the staff absolutely loved that. It just brings a completely fresh set of eyes, which helps us to challenge the status quo."
Acknowledging and welcoming patient and family experiences as fundamental to the way the hospital works, starting from the initial welcome through to helping them building confidence to be empowered throughout their healing journey.
“I achieved what I wanted through this experience and more. I was able to make mistakes, learn, explore, and use my creativity to its fullest potential. This enabled me to reach our goals as a team and inspire people’s thoughts on healthcare.”
While in hospital, patients can feel lonely and disconnected from the outside world. A lack of freedom to go about their daily lives can have a huge impact on their general wellbeing. The atrium, located at the heart of the new hospital, has immense potential improve the healthcare experience for patients during their stay and healing journey. Our solution, called ‘The Vertical Sky’ is an interactive installation bringing natural elements inside.
The space encourages patients to engage with their surroundings and connect with people through shared experiences. The interactive installation is constructed of a series of hanging light capsules suspended between the two buildings. Inspired by the rhythm of nature, these lights represent starts that twinkle and change in response to the environment and the movement and activity of the hospital. The stars will move more during the day when the hospital is active, and be still as the hospital sleeps during the night.
The design of the walkway and balcony takes inspiration from natural curves of waves, again bringing in those elements of nature. The three-tiered balcony offers various spaces for patients and their family to relax and enjoy to sun, sky and installation. The installation can also be viewed from within the ward room, from the walkway situated directly underneath the installation itself.
The Vertical Sky reimagines what this un-utilised space could be and how it can contribute to better a healthcare experience for patients during their recovery in hospital.
The integrated studio paper has taught me a lot of essential key skills in problem solving, collaborating with others, and to trust the design process. I loved observing the different parts of the hospital and investing time into identifying the problem we could solve later on."
“By constantly trusting the process, we’ve seen a project [come] together through collaboration.”
Bathrooms make up some of the most unsafe and uninviting spaces in hospital. Bathrooms are where most falls occur. Patients, who are at their most vulnerable, often feel overwhelmed by their bathroom experience. Furthermore due to the fear of being a burden and challenges around loss of dignity, they fail to ask for help when they most need it. This presented an opportunity to create a patient centred bathroom- that was both welcoming, safe and supported patients to feel empowered and dignified.
Accessibility
Handrails wrap the room to ensure that as soon as a patients enters there are supported to be independent. This includes in the shower door, storage doors and basin front and sides. Toilet rails have been designed to rotate safely to a 90-degree angle at a push of a button. Lastly, a three height railing system installed between the toilet to the shower to create a system that is comfortable for a range of heights in an area that most falls occur.
Cognitive
A clearly designed cognitive system differentiates staff and patient facing emergency buttons. Two patients buttons consist of a classic circle form, with illustrations and writing. The first is a “Call nurse” button for a simple assistance. The second is patient “Emergency” button- for when a patients falls, has hurt themselves or feels unsafe. Staff have two buttons that are easily accessible encase of an emergency. The yellow “Staff” buttons allow staff to call for extra assistance. The “Code Blue” is an international standard for medical emergency. Both staff buttons are a triangle shape with no illustration.
Storage
To create a welcoming and practical space for patients requires accessible areas for their belongings. This includes a shelf in the shower for soaps etc, a shelf on top of the sink for toiletries. A bench provides a place to sit while getting dressed or to put important items. Clothes hooks are positioned above this bench. Well designed staff storage is critical to avoid the clutter currently associated with hospital bathrooms. Through our research, we were able to identify essential staff equipment, stored out of patients view in a staff only closet. Inside there is ample storage space for all the necessary items, including shower/toilet chair, bedpans, gloves, sprays etc.
This bathroom is patient facing, with warmth and comfort through the use of natural materials to help patients experience the care they deserve, while empowering staff with all the tools to be most effective in their work.
“I believe that my design process has developed a lot. I’ve seen myself as a designer grow and feel most confident in design areas in which I feel challenged.”
“I have learn[t] that designing for health care is important because it empowers patients and improves their healing journey in a vulnerable space.”
Patients often feel undervalued, unwelcome and out of place during their hospital stay. This makes them feel like they have little control over their healing journey. Technology offers potential for patients to regain control over aspects of their journey.
There is an opportunity to imagine how a patient app can enhance the patient experience. Hospitals are often busy and understaffed, meaning they have to watch over many patients. This patient app empowers patients to see who is caring for them, and track their pain and wellbeing in real-time which can be used to alert staff when there is a problem, or when a patient needs more attention and care. The healing journey in hospital can involve a lot of unknowns and uncertainty, especially considering that most patients are first-time users of the healthcare system. The patient app has features to inform patients where they are in their health journey, so this is more transparent and open. Lastly, the patient experience can be improved by giving patients control over their in-bed experiences and entertainment, from being able to control their bed position to ordering their meals.
Using technology in this way will raise patient health literacy and provide a better patient healing journey. We intend to make the digital environment simple and easy to use for all patients.
“I really appreciate that you gave me this opportunity to work with i3 people and hospital staff.”
Public hospitals are often unpleasant spaces. Hospital environments fail to support and comfort patients and whānau at their most vulnerable. Patients often feel like outsiders in unfamiliar environments during their time in hospital and don’t know how to make their experiences better. A public healthcare focus is to get patients home as soon as possible. This emphasis can negatively impact patient experiences.
From our research and analysis, we developed a framework to holistically drive the project – using the different hospital environments to transition patients through their healing journey. Patients begin their journey in the ward room and progress through the two lounges. These spaces support increasing levels of energy and interaction as patients heal.
This framework led us to design for three different experiences encapsulated by the respective spaces and connected by progressive patient recovery. We focused on holistic wellbeing and themes of increasing socialisation and personalisation. Our spaces facilitate different levels of interaction between people. We focused on how we might give patients agency to take control of their experiences, to help improve the mental wellbeing of those at their most vulnerable.
Working with a public hospital meant inclusivity and accessibility were at the forefront, informing our design decisions. Our solution needed to advocate for those with physical or mental impairment. ‘Primum non nocere – First, do no harm’. It was also critical that any new solutions or interventions did not impact the operation of the hospital or hospital staff.
Our design solution presents an opportunity to reframe the hospital environment for a holistic patient and whānau experience, rather than viewing it as a collection of different areas. This helps ensure that patients and whānau feel they belong to a healing community through shared experiences, not just a building.
“Overall, integrated studio was a wonderful experience because despite the sleepless nights and extreme stress, we all managed to surpass our expectations. [It] inspired me to be more considerate, patient and cooperative and it’s been great learning more about healthcare through design.”
“Beyond presenting our own ideas, we had also challenged their (hospital staff) thinking and [led] them to think differently about patient care.”
“This project made me more aware of users wants and needs, at the same time helped me challenge the current conventions of the space by designing to advocate for those who are most vulnerable. As a result I feel I have been open to having a more human-centred approach towards my designs over the look and feel of the space.”
The aim of this explorative project was to consider the balance of power within a hospital environment and how we might allow patients to feel more like people and provide more moments of human connection. It also sought to expand the definition of care to provide a better healing experience for patients.
Artefacts were created as a literal communication of four ideas to be used as prompts for discussion around an idea, or rather more powerfully, a question. By curating an exhibition of these artefacts in the hospital space, staff, patients and the general public can interact with the artefacts, presenting an opportunity to more effectively facilitate conversations about peoples’ experiences of the hospital environment.
Idea 1. Photo Frame
This is Who I Am — How might we help patients feel more like people?
Idea 2. Tin Can Telephone
Care for Me — How might we encourage patients to ask for care when they need it?
Idea 3. Books
Idea Exchange — How might we create a space for the exchange of ideas and stories?
Idea 4. Cleaning Sign
Cleaning With Sound — What if the cleaning carts played sounds from nature?
“It is a unique opportunity to learn different skills and contribute solutions to real world problems.”
"When you come out of the classroom environment and into somewhere that’s real, you can actually come in and make a difference. You can come up with all these different ideas and actually put that into practice. And it might take a few years, but actually when you think "that was my idea, I did that" and it’s actually working and its made life better for patients and staff. It's just a fantastic opportunity."
Serene Aun, Communication Design
Benny Butcher, Spatial Design
Angel Chen, Spatial Design
Madeline Dumagan, Spatial Design
Samantha How, Product Design
Jim Huang, Spatial Design
Becca McLean, Product Design
Sharon Ng, Product Design
Juvanka Rebello, Spatial Design
Sara Song, Product Design
Alyssa Tang, Product Design
Steve Reay (Lecturer)
Cassie Khoo
Ivana Nakarada-Kordic
Michael Grobelny
Jarrard O'Brien
Gill Fisher
Lara Cavit, Patient Experience Team
Sam Dalwood, Disability Services
Betsy Scherer, ESC Charge Nurse Manager
