Designing healthy health facilities

A slide from the presentation showing a cafe area with large glass windows looking out to a garden.Hospital design is evolving. We have moved from the Florence Nightingale era focused on regimes and hygiene to one of patient healing. And not just in a medical sense. Knowing that building design impacts our sense of wellbeing, we have entered the era of designing healthy health facilities. This was the topic of Michael Walker’s presentation at UD2021 Conference. 

Michael’s presentation took a biophilic approach to designing health facilities. Biophilia is about increasing connection to the natural environment. This is achieved through the choice of building materials and/or direct connection to nature. He gave several examples of the design features that matter: 

“Natural shapes and forms – the use of botanical and animal motifs, natural forms such as shells and spirals, egg, oval and tubular forms and shapes that generally resist straight lines and right angles.

Light and space – the use of natural, filtered or diffused light, the incorporation of shadows, warm light, spatial variability, spaciousness and the connection of inside and outside spaces.”

Other factors to consider in hospital design are:

      • Wayfinding: Most people can be easily overwhelmed when trying to find their way in unfamiliar surroundings.
      • Entrances: Arriving at a healthcare facility can be challenging for people and their carers. If arriving by car, there will be concerns about safety and wayfinding.
      • Reception: Areas should be clearly identified and provide people the opportunity to identify that they may need help in navigating the engagement process. 

The presentation slides have more information on this aspect of designing healthy health facilities. Michael’s presentation is titled, Design Matters to Make Well Spaces, and  linked closely with Stefano Scalzo’s keynote address on universal design. 

Mapping how something gets built

Virginia Richardson ran a workshop at the UD 2021 on mapping how something gets built. Although local government is not the designer, it has many responsibilities for the project from start to finish. The question for the workshop was, how can we embed universal design in the process? 

Virginia began with a graphic showing an example of the number of stakeholders involved in house building. A line of complex manufacturing machinery used to show the complex process and number of stakeholders involved in mass market housing.

This concept was developed further in the workshop. It showed how many people get involved in a building project from a local government perspective. 

A linear machine picture has lots of coloured post it notes on it depicting all the people involved in building a park project.
Slide from the workshop

Virginia’s slides include the Draft Universal Design Policy and associated documents for the Mornington Peninsular Shire Council. 

There are more presentation slides and published papers on the UD2021 Universal Design Conference page . 



Construction code changes and home modifications

Front of a new house with 12 steps to the front door showing why construction code changes are needed..
New home with 12 unfinished steps abutting the boundary.

The ATSA Independent Living Expo was held alongside the UD2021 Conference in Melbourne. I used this opportunity to discuss the upcoming construction code changes and home modifications. My presentation explained the history behind the changes and what it means for the future.

State and territory Building Ministers agreed in April 2021 to amend the National Construction Code to include basic access features in new homes. This is meaningful social change for Australia, and time to re-think regular practice.

Major housing industry associations fought these amendments, but industry stands to gain longer term. With more suitable designs on the market, older people will be encouraged to move to a new home. Families with a disabled family member will likely be in the market as well.  

The supply of home care packages will increase and established homes will need modifications. Currently the government subsidises home modifications for this group, but modifications are not the same as renovations. 

Modifications vs Renovations

Occupational therapists assess clients and decide on functional modifications as part of a home care package. They are often done in haste and have little aesthetic value due to funding constraints. Clients often refuse these modifications because of poor aesthetics and concern about devaluing their home. On the other hand, renovations usually have a designer involved. Recent research by Monash University commissioned by the Human Rights Commission, indicates that design-led modifications will gradually increase.

With basic access features already in place, modifications and renovations will become easier. Homeowners will be more willing to have modifications because it will minimise major works, and concern over the value of the home will be reduced. The NCC changes provide an opportunity for smaller builders to capitalise on this market. The Building Designers Association Australia is already on board, and has training courses to bring designers up to speed. 

If you want to check out the specifications for changes to the code, see the Livable Housing Design Guidelines Silver level.

Jane Bringolf, Editor

The picture above shows a very poorly sited home where the distance from the front porch to the property boundary was not quite sufficient to put 12 or more steps. 


Including mobility scooters in planning

A woman in a powered wheelchair and a man in a mobility scooter enjoy the pathway.Powered mobility devices, such as mobility scooters, are forms of transportation, but are they considered in city planning? Little is known about these devices and their users so the likely answer is, no. Climate change is another issue. Transportation systems are turning to renewable power and there is a risk these devices will be left out due to a lack of understanding how they are used. As more electrified devices take their place in our streets, we must be sure we are including mobility scooters in planning as well.

Theresa Harada’s presentation at UD2021 Conference highlighted some of the issues scooter and powered wheelchair users face. Using some of the quotes from participants, the lessons became clear in the slides. On the one hand, mobility scooters allowed a greater freedom to get out and about. But on the other, there were times when it became difficult, such as waiting for a lift along with many others.

The presentation also showed how others perceive disability. When one participant went from a scooter to a wheelchair, she found attitudes towards her changed dramatically. 

picture of a woman on a mobility scooter trying to get under a barrier constructed to prevent vehicles and bicycles from entering the pathMass transportation is for the masses – that means it’s for everyone. With more understanding of “vulnerable” groups we need an inclusive focus within infrastructure planning. The frameworks that govern mobility have barriers to inclusion which good design will overcome. This research gave voice to those who use mobility scooters. Their voices are loud and clear in Theresa’s published paper. 



The potential of accessible tourism in Australia

Header slide on accessible tourism showing a woman in a wheelchair bending down to feed a wallaby.
Photo courtesy Travability Images.

There’s a lot of potential for accessible tourism in Australia, and everyone stands to win, both operators and travellers. The business case has been well researched over many years and in different countries.  However, the data are not convincing many tourism operators to re-think their business model. 

Nicole Healy’s presentation at UD2021 Conference covered the facts and figures. Tourism Research Australia commissioned a research project which involved Victorian and Queensland governments. Nicole listed the research objectives which included: 

      • The size of the market and drivers and barriers
      • Needs of travellers with disability and their companions
      • The best communication channels 
      • The best ways to support businesses and explore opportunities
The results

The results show the potential of accessible tourism to be in the billions of dollars representing 10% of the total domestic spend. And that’s only for those who are willing to travel. Many others say it is all too hard. 

Travellers with and without disability choose trips for the same reasons. Eating out and visiting family or friends are top of the list for both groups. Sightseeing, pubs, clubs, and shopping are all popular. Going to the beach was not high on the list for people with disability. 

Lack of awareness of what’s on offer and not knowing what to expect were barriers to travel. Attitudes of tourism operators and staff was not encouraging either. Higher costs for people with disability were an issue as well as not enough accessible rooms.

Travellers with disability want to see better staff training and more practical information. Better access to toilets, public transport and airports were also important. More detail is available in Nicole’s presentation slides and the data report. You can download the executive summary of the Victorian and Queensland report.

Victoria has a kit to help businesses, and Queensland has their own guide to inclusive tourism

A separate website, Accessible Victoria has specific information and more links. And one specifically for Melbourne also has brief information and more links. 

There is more about inclusive tourism in the travel and tourism section of this website.

Local Government and Accessible Housing

Exterior of a modern single level home.Local government rarely gets pro-active about accessible housing or Specialist Disability Accommodation (SDA). But the City of Whittlesea bucked the trend. This local government area is one of the fastest growing communities in Victoria. It also has a significant population of residents with a disability, most of whom are ineligible for SDA housing. Consequently, action was needed for mainstream accessible housing.

The Disability Housing Project was established as part of Council’s commitment to inclusion. The project identified the level of demand for both accessible and SDA housing. This information was then used to inform policy and strategic action. 

The slide shows the five elements of the project.
Slide showing five elements of the housing project

Rosie Beaumont and Linda Martin-Chew tell their story of venturing into the emerging disability housing market in their presentation at the UD2021 Conference. Council wanted to explore opportunities to progress commitment to accessible and affordable housing. They involved disability advocates, housing developers, strategic and social planners and residents with disability in the project. Developers keen to get into the SDA market were not going to solve the need for accessible housing overall. This was especially the case in the rental sector. 

The end result was better industry engagement to promote housing that benefits the whole community. It is an example of joining the dots between the niche of specialist housing and mainstream housing. 

There is more detail in the published extended abstract, “From Niche to Mainstream: Local government and the specialist disability housing sector”. 

Editor’s Note: Rosie and Linda were clearly passionate about the topic in their presentation. Whittlesea was one of only four councils that joined the campaign for mandated access features in all new housing.


Inclusive Towns Project

Page of website for Inclusive Towns Project.
Inclusive Towns webpage for employment

The Inclusive Towns Project was a collaborative affair between Bendigo City and Lodden Shire Councils. It focused on local businesses to show how being inclusive makes economic sense. The aim was to show that improving the accessibility increased their customer base. 

Nikki Williams’ presentation at UD2021 Conference had some interesting statistics. One third of complaints to the Victorian Human Rights Commission were about disability. One third of these were about employment, and another third about goods and services. Consequently, the aim of the project was to tackle equal access to goods and services and employment. 

A project officer, admin support, and six casual staff with disability were appointed to run the project. It was the role of the casual staff to visit businesses and collect information about their accessibility. They followed up with an action plan and then a review. 

One of the key barriers to overcome was previous poor experience with Council. They also had to overcome lack of understanding of disability in terms of employment and customers. Many businesses thought it would be expensive to make changes. 

Feedback showed that solutions were easier to to implement than first thought. Businesses saw good outcomes from small changes and enjoyed positive feedback from customers. 

The end result of the project is a website with information for businesses and the value of being inclusive. It also has a lot of resources.

The project also saw change both in the community and within Council. The need to build capacity with staff to understand disability better was key. 

Nikki Williams’ explains the project well in her presentation along with her conference abstract. 


Speaking fluent universal design

Head and shoulders of Stefano Scalzo.
Stefano Scalzo Executive General Manager Planning and Development

Stefano Scalzo was speaking fluent universal design at the UD2021 Conference. In his keynote address he showcased what the Victorian Government is doing to progress universal design in state projects. Stefano gave practical examples of how UD has been applied in real life, to real buildings for real people. 

Stefano Scalzo is the Executive General Manager, Planning and Development with the Victorian Government. Their UD approach is based on their Universal Design Charter, which is: 

      • Equity
      • Respect
      • Participation
      • Sustainability
      • Responsibility
      • Awareness
      • Collaboration

This is not a building code compliance approach: it’s a human rights perspective and putting people first. 

Universal Design Charter slide with 7 elements
The 7 elements of the Universal Design Charter

It’s part of the tender process

The Government’s commitment is not just a policy – it is action. Their procurement process asks prospective tenderers to tell them how they will achieve universal design. And they are promoting a culture of inclusion where UD is integrated at the beginning of every project. 

Stefano explained more about the tender process and then showed us several examples of buildings that met their charter. He added that we are really just beginning and there is so much more to learn. And he challenged us to keep the conversation going. Specifically he asked delegates to commit to the conversation by:

      • Taking this back to your Director
      • Presenting to your team
      • Forming an advisory group
      • Redrafting the design
      • Listening – really listening – to someone with lived experience
      • Adopting a charter
      • Adjusting your process
      • Thinking beyond accessibility – to participation, safety, welcome
      • Going beyond compliance 
      • Delivering more than a minimum standard. 

It was wonderful to hear a government representative speaking fluent universal design. This is the kind of leadership we all need in Australia if we are to become truly inclusive. 

Slide says How will you keep this conversation going?Stefano shared his slides and his speech notes which have a lot more detail about the work they are doing in Victoria.

Michael Walker’s presentation expanded on aspects of this presentation. Victoria is clearly committed to inclusion and universal design.

Universal Design and Local Government

Three children, each a wheelchair user, are enjoying the spinner in the playground: a universal design.
Children enjoying the spinner in the playground

Adam Johnson used Bunbury in Western Australia as a case study for his presentation at the UD2021 Australian Universal Design Conference. Bunbury set itself an aim, and a challenge, to be the “Most Accessible Regional City in Australia”. Adam explained how he used participatory action research (PAR) methods to meet Bunbury’s challenge. Universal design in local government means involving the people who are the subject of the research. In this case, people with disability and older people. 

PAR has three principles: 

    • The people most affected by the research problem should participate in ways that allow them to share control over the research process
    • The research should lead to some tangible action within the immediate context
    • The process should demonstrate rigour and integrity. 

Adam recruited 11 co-researchers to work with him: 6 people with disability, 3 family carers, and 2 support workers.

The research team with the Mayor (standing).
The research team with the Mayor (standing)

Local government is where the ‘rubber hits the road’. Local government is best placed to work with residents and understand the context of where they live, and it means they can be innovative with solutions tailored to local needs. 

The research project had a positive impact:

– Greater alignment between policies and practices at the City of Bunbury with universal design.
– Co design panel created informing many current infrastructure projects.
– Universal design standards adopted.
– Staff and contractors trained in Universal Design.
– $100,000 per annum allocated for auditing and retrofitting

The project was undertaken with a three year industry engagement scholarship with Edith Cowan University. The title of Adam’s presentation is, Universal design in local government: Participatory action research findings. 


What is Easy Read and who needs it?

page from Access Easy English on COVID. Writing for readers.
  Example of Easy English

Easy Read is a good example of how less is more. But conveying messages in fewer words is more difficult than writing more words. Easy Read is for people with low levels of literacy. It’s mostly used for essential information such as health alerts and legal terms and conditions. Writing with minimal words is a skillset of its own. It’s not easy. But it does make you think about what you really need or want to say.

Proficient readers can use Easy Read versions to get the take-home message quickly and easily. That’s also why it’s universal design – it’s for everyone. However, Easy Read is not the same as Easy English – the example in the image. It has even fewer words and focuses on actions not just information. Cathy Basterfield says that Easy Read is not simple enough for some people and explains this in a simple poster analysing the difference

Easy Read not the same as plain English or plain language. Complex documents such as research reports are beginning to include a plain language summary. However, these require an average level of literacy. They are usually presented as a paragraph or a list of sentences in dot points. Easy English drills down further to the key words and concepts. The techniques include:

      • a lot of white space
      • directly relevant illustrations (not photos) to convey the meaning of the text
      • short words and sentences
      • minimal punctuation
      • positive phrasing
      • bullets to separate items in a list. 

Editors can learn from Easy English

The Chartered Institute of Editing and Proofreading blog has a more detailed article. It summarises Cathy Basterfield’s presentation at their annual conference. She shows how editorial professionals can learn from Easy English. 

Blog writer, Anna Baildon, said she learned a lot from the session and had her assumptions challenged. She said she could see “the links to plain English but it goes further”. The headlines she remembers are:

      • It’s hard to write in Easy English
      • Access to written information should not be a reading test. It should be enabling
      • Unpacking the language so the meaning becomes accessible.
      • Access to information is a right. ‘Access’ means that a person reads, understands and knows what they can do.

The Chartered Institute of Editing and Proofreading has a guide to Editing in Plain English

Many people need it

More than 40% of the population has low literacy skills. In some remote parts of Australia and in institutions it is higher than this. There are several reasons why so many Australians need information in easy to understand formats:

– acquired disabilities
– lifelong disabilities
– poor educational outcomes
– psychiatric or mental illness
– dyslexia
– early school leavers
– older people
– different cultural backgrounds
– hearing impaired and/or people from the Deaf community

Accessibility and universal design needs to be considered at the outset of any project, not as an afterthought. Information formats such as brochures and websites are no exception. Some important government documents include an Easy Read version, but this is still rare. 

Cathy Basterfield has pioneered much of the work on Easy English in Australia. People with high level literacy skills can grasp the key points with little effort. And there are times when people with good literacy skills need help. For example, the stress of a court hearing can temporarily affect one’s reading skills and level of understanding. 

Cathy Basterfield presented a paper on this topic at the Australian Universal Design Conference, UD2021. There is a related post on choice of typeface or font for easy reading. Cathy has an Easy English blogsite that explains more. She did a lot of work for COVID-19 too. 

There is an Easy Read version of the UN Convention on the Rights of Persons with Disabilities.  The Bumpy Road website is a good example of Cathy’s work for interacting with the justice system. 

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