Tuesday, February 27, 2018

Demographic Design

Kim Struthers is the Project Executive for SA/NT/WA Interite Healthcare Interiors.explores how to put people back in the picture when considering practice design.
In an era of ATM’s, self-checkouts and faceless foreign call centres, in a time where it is often easier to communicate across the globe than across the street via new and ever-improving technology, fewer and fewer of us can even recall the quiet comfort of an attendant pumping our petrol or a concierge assisting our harried selves through a department store doorway.

A recent survey conducted by Lifeline Australia identified that over 60% of respondents reported ‘often feeling lonely’, making it clear that our modern society is facing a crisis of disconnection, despite being more technologically equipped than ever before. Furthermore a 2017 Lonergan research effort citing that Australians spend a cumulative average of between 9.4-11.4 hours in front of a screen on a daily basis identifies the fact that there is still room for a more tactile approach and the need for design strategies which facilitate authentic and mindful human interactions.

The concept of Human Centred Design is not a new one. HCD has, been accepted as a design practice in some form or another for the last 20 to 30 years, with the Australian Commission on Safety and Quality in Healthcare (ACSQHC) in 2010 defining patientcentred care as “health care that is respectful of, and responsive to, the preferences, needs and values of patients and consumers”.

However, in the light of exponential technological advancements, and facing an increasingly competitive marketplace, progressive healthcare practitioners are focussing on HCD anew as a holistic and overarching premise under which to futureproof the ongoing success of their internal operations, whilst also optimising essential outcomes for their demographic; specifically incoming patients.

Whether renovating, relocating or building from scratch, by welcoming a human centred perspective into the design phase, healthcare practitioners are able to go beyond simply integrating user ‘feedback’ and are instead able to prioritise the vital aspect of user interaction through spatial and functional considerations. The impact of this kind of consideration goes far beyond presenting an aesthetically pleasing and architecturally savvy built result, with Human Centred Design aiming to resonate far more deeply with users across all interfaces. Patients are increasingly willing to make tremendous compensations in order to align themselves with healthcare facilities which deliver a Human Centred, holistic experience.

The truth of this fact was highlighted by a recent conversation with a family member who admitted they had made a 3-hour round trip to visit a dentist 25km away for a simple check-up. When quizzed on the reasoning for this choice, especially since there was a dental clinic at the end of the street, I was provided with a detailed comparative account of numerous poor experiences at the local clinic, versus the fantastic customer experience which had led this savvy relative to make what others might call an inconvenient attachment
– at least from a logistical perspective
– across the city.
But apparently the drive was worth it, for I was told that clear wayfinding and direct access made for a feeling of ease from the moment of arrival, with parking an important, and commonly overlooked factor as many practitioners set up shop in residential areas or share tenancies with limited access to parking. Furthermore, the practice was advocated to consistently project a happy and welcoming atmosphere generated through bright and engaging staff who proved their genuine care for each patient by greeting each one by name.

Complimenting the socially welcoming atmosphere, my relative painted an enviable picture of a spacious and relaxed waiting area set about with large comfortable lounges (as opposed to Long bench seating), and clinical rooms which felt anything but; the addition of large windows offering just the right dose of natural light. If an outlook of calming greenery wasn’t up to the task of comforting the obligatory dentist ‘jitters,’ the more indulgent widescreen television funnelling Days of Our Lives was on hand to provide any added relief needed whilst the practitioner provided a commentary understandable in layman’s terms throughout the procedure.

The complexity of building a positive experience for the target demographic becomes readily apparent upon hearing this kind of commentary, with many similar scenarios being carried out on a daily basis as end-users focus on accessing a positive experience and are therefore becoming more informed, consumer conscious and diligent in protecting their most precious asset; their health.


When confronted with design decisions it can be difficult to attain adequate distance from the more visible fiscal concerns. When cornflower yellow paint is dearer per tin than its alternatives, understanding the benefits to be gained from the aesthetic and functional inclusions aligned with a HCD ideology allows us to balance any projected fiscal limitations with anticipated returns through more subtle avenues, such as increased referrals, improved staff retention rates and businesses equipped to grow with demand.

To further encourage more than a cursory nod to the HCD ideology, practitioners can enjoy a wide range of options to enhance their practice, thereby being equipped to achieve predetermined goals through the use of new and powerful design tools. From something as simple as improved internet connectivity in waiting areas, to whole rooms intended to house family and loved ones for extended periods of time, the options are really limited only by one’s willingness to entertain them. Clear wayfinding, has already been mentioned, but what about easily identifiable, transcultural signage which caters to a multi-cultural audience? Empowering users by accommodating their own individual preferences can also be catered to through ergonomic lighting, audio, entertainment and communication controls located within easy reach of each patient, and defining caregiver, patient and family zones through the use of varying textiles, scaled furniture and colour, as well as the separation of public routes into service and private traffic zones provides clarity and comfort for all.

Beyond just physical design, the human centred approach should seek to value each interaction in the client lifecycle, from the physiological to the psychological. Designing engaging environments which promote empathy throughout the entirety of the patient experience has been proven not only to benefit both the immediate and long-term care results of the patient, but in a classic ‘reap what you sow’ scenario, healthcare providers also extract significant value along with their patient.

Research is building which shows that practices adopting design thinking in light of user perspectives to actively improve patient experiences are also benefitting through an increase in initial traffic, faster patient turnaround, shorter postoperative stays and dispersal of fewer analgesics than those facilities featuring only quality clinic services, all of which works out better for the bottom-line. In addition, many of the so called ‘horror’ aspects of healthcare have been shown to be reduced or avoided altogether, including emergency department return visits, medication errors, infection and mortality rates, poorly rated all over clinical care, and even decreased mortality rates. Consumer-oriented patients are increasingly exercising their rights to choose.

Complimenting this data is a study which examined data for inpatient units at two similar hospitals in the US over five years, with one introducing an extensive program of patient-centred practices and the other continuing their usual practices. The study found that the patient-centred unit consistently demonstrated a shorter average length of stay; a statistically significantly lower cost per case; a shift in emphasis from the use of higher cost staff to lower cost staff; and higher than average overall patient satisfaction scores.

All of this is reason enough for healthcare facilities to continue to court the newer generation, with post baby-boomers much more computer savvy and willing to self-research their potential healthcare providers, relying more heavily on the patient experience reported by others. Millennials (those born after 1982) are even less likely to choose their care site by physician recommendation, with a high percentage conditioned to respond to healthcare options in the same way as to the rest of the consumer market, i.e. by associating most strongly with the branding and quality of amenities provided.


In the same way that Human Centred Design is a collective ideology, so too the benefits of integrating HCD into a healthcare facilities range dependant on the individual facility, their specific demographic, and the overall Vision predetermining the implementation of this user-centric approach.

With new research rapidly uncovering both the depth of our societal need, and the escalating benefits of Human Centred Design, healthcare providers are welcoming this new way of working and partnering with designers to optimise their practice spaces for both their business, and their patients. While the final resolution of HCD may not yet be at hand, I have at least come to one conclusion: I think I might have found myself a new dentist.

Kim Struthers
is the Project Executive for SA/NT/WA Interite Healthcare Interiors.

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