Hospitals: Design for a Healing State of Mind!
Had an interesting conversation with a healthcare executive recently. She is working hard to build a new hospital. The design team is arguing about seemingly small things like how to decorate the lobby. Should we make it look like a library, should there be a piano, large fish tank, silent waterfall and so on? All of this cost money and in a time of great concern over the cost of healthcare does it even make sense?
This is a good question to ask especially as health systems around the US are trying to build facilities that are more like five-star hotels or luxury malls than traditional hospitals.
We did some design thinking to explore the issue. Specifically I asked questions about the four levels of functional impact every artifact, including a new hospital, has including:
1. Utility or core functionality (engineering)
2. Usability or how easy the artifact is to use (human factors)
3. Look-and-feel or how the artifact impacts the five senses (sensorial design)
4. Think-and-Feel or how the artifact impacts the thoughts, emotions and frame of mind (cognitive design).
A shortened and somewhat fictionalized synopsis of the conversation follows. It holds a couple of lessons for any complex design project.
Q: What is the core functionality or basic utility of the new hospital?
A: To make patients well, treat their families and loved ones with respect and be a wonderful place for our clinicians and staff to work.
Q: How easy is to use the new facility? Or more precisely, how are you designing the facility to make it accessible, convenient and “low cognitive load” for patients and their family members?
A: We have an advanced and carefully engineered way-finding system, they can do a lot with us over the web, we have greeters like Walmart and concierges like a five-star hotel. There is a personal information system in each room and patients get an itinerary so they know what to expect and when for their entire stay. We have used industrial engineers to make sure waits are minimal and that people are comfortable when they must wait. We even have a control room that monitors the progress of the patient as they flow through the hospital and can send alerts to the right people when they spot problems.
Q: How is the new facility designed to delight or stimulate the senses – sight, sound, touch, taste and smell?
A: We make sure every room, even in the ICUs has plenty of natural light. We are investing a lot in minimizing the amount of noise patients must put up with. Housekeeping is very focused on preventing and eliminating unpleasant odors. We are doing this mainly for clinical reasons and frankly are unsure how to approach the aesthetic issues.
Q: How are you designing the facility to make patients and their family members think and feel? What thoughts (ideas, memories, mental models) and emotions do you want them to experience in the new facility?
A: Well we have not given that a lot of consideration but I am sure we want them to feel safe, comfortable, well looked after. We want them to have thoughts like this is being at home or at church where things are good.
We spent some time talking about how all four levels of functional impact need to work together and reinforce each other for maximum effect. The look and feel you create (sensorial design) should be geared towards generating the thoughts and feelings you want (cognitive design). The think and Feel you create should support the core functionality and so on.
I told her the trouble figuring out how to decorate the lobby and likely other parts of the hospital was linked to the fact that they are unclear on the target cognitive design (thoughts and emotions) for the customer. So the question is who is the lobby designed for and how do you want them to think and Feel?
I further suggested that if is is designed primarily for patients and family members you will want to put them in a “healing state of mind”. With luck there is literature to help you figure out what that means – hope, comfort, authentic empathy and so on. Being in a healing state of mind might even make the clinical interventions more effective and therefore support the core functionality.
This means the design pattern for making decisions at the sensorial level (look-and-feel) of the decor is mainly determined by what would support the psychology of hope and comfort.
So how do you invoke a state of hope and comfort in your customer’s mind as they enter and use the lobby? Would a piano do that, would giant tank filled with exotic fish do that? Likely not. I suggested she spend some time with patients and family members and perhaps even consider using the Zaltman Metaphor Elicitation technique to build up a profile on the psychology of comfort and hope for patient. I challenged her to dig beneath the surface and be sure to discover those images, colors, textures, sounds, symbols, metaphors, stories and shapes that would invoke a feeling of safety, comfort and hope for the people she servers.
