Breaking barriers in healthcare design

Changing patient needs, technological advancements and updated models of healthcare delivery mean that it’s time to embrace a fundamental shift in health infrastructure, moving the focus from systems to people.

Hospitals and health precincts must be designed based on empathetic insight into what people feel and respond to, and how they need to be cared for; not on perceptions of a broken system. The time to pivot to people-centric care driven by human impact and behaviour is here.

These days, hospitalisation demonstrably exacerbates patients’ emotions and increases feelings of depression and anxiety, impacting their ability to cope and adjust. This stress is also felt by families and carers, who report higher levels of anxiety, social isolation and fatigue. Bullying, discrimination and burnout are rampant for health professionals, and deeply detrimental to mental health, decision-making and staff retention.

The impact is even more damaging for First Nations people. The percentage of Aboriginal and Torres Strait Islander people who report being treated with respect and dignity at the hospital is significantly lower than non-Indigenous patients, while more than half of First Nations healthcare trainees experience or witness bullying. Indigenous people are also less likely to present to or stay in hospital, risking the need for more elevated care later and indicating a worrying lack of cultural safety in our health system.

These are not individual issues but symptoms of a system-level concern that affects our ability to deliver quality health care. They are experiences that reinforce the urgency of our need to rethink what ‘inclusive’ health care means in practice and fuel for us to change the conditions that prevent equality across the healthcare system.

Design and behaviour

Design influences behaviour. While change requires industry input, a designer’s role is to prioritise people-centric care through the creation of spaces that deeply consider their influence on each user’s personal health and wellbeing.

These changes to do not necessarily mean higher costs, they simply indicate a reorganisation of priority that considers user experience first as a way of informing outcomes. Emphasis on the individual, customisation and comfort sets people-centric care apart as the next step in healthcare design, impacting behaviour for the better.

The specific experiences of First Nations people must be met with respect, deep empathy and great behavioural change. Cultural safety is for everyone, and design’s impact can be felt via the creation of spaces that focus on the comfort everyone deserves. It’s these shared needs — for shelter, nature, safety, sensory input and community — that should influence the kinds of spaces our hospitals will become. To serve our diverse, multicultural community well, this approach of recognising and responding to our human commonalities rather than our differences results in a space that feels intuitive and welcoming for all.

People-centric precincts

Healthcare spaces developed around people-centric care improve lives by dissolving barriers between people, disciplines, facilities, spaces and cities to create people-centric precincts that foster social and psychological wellbeing alongside physical recovery. A project that embodies this goal is Adelaide’s New Women’s and Children’s Hospital (New WCH), which will be purpose-built for the health and wellbeing of babies, children, young people, women and their families.

Responding to feedback from patients, staff and clinicians, the New WCH features a dedicated helipad, an ICU for women, extra beds and critical care services all on the one floor. These practical additions allow people to arrive, rest and recover in spaces that have been designed to promote wellbeing by being as seamless and gentle as possible. Ultimately, the design allows for age-appropriate paediatric, women’s maternity, neonatal and gynaecological care for our most vulnerable in purpose-built spaces that feel safe.

Located near the Royal Adelaide Hospital and Adelaide BioMed City, the New WCH maximises the existing precinct’s potential by strengthening connections between buildings that provide clinical outcomes — like proton therapy treatment. This cross-locational care means medical needs can be met with the appropriate level of technology regardless of where a patient checks in. As a result, patients and their carers can move around the precinct to access specialist care and research, while staff benefit from closer connection to tertiary and quaternary services.

Designed to be keenly interconnected with Adelaide itself, New WCH is in the city’s north-west corner. Sitting at the intersection of Karrawirra Parri (River Torrens), the city and the parklands, the new hospital forms connections at a pedestrian level by linking with the CBD’s grid, integrating with public transport and improving access to the nearby Park Lands. This connection to nature pays respect to Aboriginal connection to Country and improves the experience for all by extending the site through physical links and views to Tulya Wardli (Bonython Park) and Karrawirra Parri. A new playground creates more green space for patients, families and workers to rest, wait and recover.

Health precincts are multidisciplinary. Part workplace, research facility, accommodation, sanctuary, cafe, school and playground, these spaces facilitate a vast spectrum of experience. Taking a people-centric design approach means reframing health care as an ecosystem in which patients, professionals, students, families and the community work together in harmony.

Communities of care

The built environment is a key character within this ecosystem. When place is understood to impact outcomes as much as people do, emotions and behaviour improve. Connection to nature, daylight, art and symbolic or spiritual objects alongside considered lighting, wayfinding, access and environmental control alleviate the higher levels of anxiety and fatigue felt by all users. Although small, these changes the understanding that hospitals must be gentle and encouraging places fit to deal with the unavoidable strains of the hospital experience in ways that put people first.

By appreciating a place’s cultural heritage, demographics, landscape and culture, a health precinct surpasses the role of landmark. Instead, they can leverage their site and surrounds to become deeply embedded into their communities as places of sanctuary, growth, inclusion and opportunity.

*Edwina has over 20 years’ experience in Australia and overseas in the design, delivery and management of a broad range of building typologies. She has delivered projects across a range of sectors including health and life sciences, education, defence, commercial, hospitality, commercial fitouts and large-scale residential developments. She is currently the Regional Management Stream Leader for Woods Bagot, Australia and New Zealand.

Image credit: At Adelaide’s New Women’s and Children’s Hospital (New WCH), connection to nature is strengthened via the inclusion of a playground that creates a lively environment suited to help all users cope with stress and anxiety. Here, doctors can relax, families can play and patients can recover among greenery and fresh air. Artist's impression. Image: Supplied.