Alexandra Hospital, formerly the British Military Hospital, built in 1930s,
Empathy + Design Thinking in Healthcare Architecture
Contributors: Lynette Liew | Nicholas Tan | Khai Toh
Delivering successful healthcare environment entails a firm knowledge of the overall operations of the healthcare orga- nization, its culture, and among others, the emotional needs of its occupants – patients, caregivers, administrative staff, C-suites and including operational and maintenance staff members. The effort is often a delicate balance of science, art, business acumen and a huge dose of patience and empathy to arrive at a holistic whole.
At Arch’lab, we had the opportunity to immerse ourselves into this ideology through the lens of Design thinking for the “Ward of the Future” project at Alexandra Hospital – an ini- tiative stemmed from the Ministry of Health Transformation (MOHT) Singapore.
Architect and user groups engagement at design thinking sessions
Design Thinking is a holistic empathetic approach to arrive at innovative solutions. It entails empathizing to draw out the in- herent issues at hand that defines the problem statements. Following which a range of ideas are generated, prototyped (a series of mock ups in the case of healthcare environment) and tested prior to its final launch. The result is a symbiosis of human needs, possible technological integration, and the requirements for business successes.
In the case of Alexandra Hospital Ward of the Future project, the design brief sets the ground for a collaboration between the design thinker, architect, medical planners and the health- care operator, to develop 2 hospital ward designs where the models of healthcare delivery could be tested and be scalable in time to come. These are “future ready” wards that are tech- nologically enhanced with modular units; integrated services highways (that afford rapid addition and reconfiguration of mechanical and electrical systems); information technology; robotics and other forms of care innovation. Through this en- deavor, the hospital seeks to learn from its many discoveries through its various pilots to inform future campus develop- ments.
In its process, surveys, workshops and visioning sessions were conducted to understand the qualitative and quantitative as- pects of the organization that also included the delivery of care model. They were then translated into a program brief and designed into the ward spaces in collaboration with the stakeholders. The design and decision-making process subse- quently benefited from the clarity sought from the initial De- sign Thinking methodology. It afforded the operator and the design consultants to share and align ideas toward a more tar- geted outcome.
The Design Thinking process challenged conventional norms and perceptions through engaging dialogue across the spec- trum of its user groups. The ideas of biophilia and indoor plants in healthcare environment were contested. The process drew out the favoring and opposing views, desires and con- cerns of various parties. In the end, what was then perceived and considered undesirable, may now be possible due to new- er technologies and innovative materials.
Another exercise was to re-envision the patient experience of C-class ward with a classical barracks style organization of beds marching along the length of walls – devoid of dignity and privacy due to its openness. Several iterations of bed orienta- tions were tested against needs of patient observation; safety; emergency scenarios (simulated to find the optimum path); visual connection to the tranquil landscape outside (unique to Alexandra Hospital) to promote healing; privacy of patients at rest during the day and night time; visitors’ experiences and functional clearances around beds, among many other consid- erations. The optimum design solution resulted has the patient bed oriented to allow patients a view to the exterior landscape as a form of positive distraction. The orientation also caters for comfortable turning of the beds as they are rolled into place from a common corridor by porters. Lighting strategies to mimic natural daylight patterns were proposed and integrated into each cubicle to benefit patients’ experience and recovery. Physical walls between beds were designed to reduce sound transmission between patient beds and options to control vi- sual connectivity. This allows for better rest throughout the day and night by patients and gives them control over privacy
User sketches and thoughts from design thinking sessions
needs, in addition to privacy during routine medical examina- tions in bed. The dividing walls are also designed to permit caregivers visual surveillance across a few patients at a time and allow natural light to penetrate deeper into the interiors of the wards. The Class C ward continued to be naturally venti- lated, aided with systems to maintain the environmental tem- perature at a comfortable level to enhance healing in patients amid our tropical climate.
Since Healthcare is ultimately about healing of both the emo- tional and physical state of being aided by technologies and expertise, it then becomes even more imperative that the rai- son d’etre of the healthcare organization, its people, its cul- ture be drawn out as early as possible in the early stage of the project. It was done through Design Thinking process in this case. Afterall, the numeric areas we accorded to each room we called “spaces” in our Schedule of Accommodation (SOA) will continue to be “spaces” until they are given life to become “Places”. “Places” have meaning and usefulness that creates memories that gives essence to our lives.
We are glad for the Design Thinking methodology initiated by Ministry of Health Holdings (MOHH), Singapore, and Ministry of Health Transformation (MOHT). Very importantly too, is Al- exandra Hospital Management Team for engaging us with this process and in believing in the value of apportioning addition- al time needed ahead of a typical project schedule for Design Thinking to happen.