Hospital design for healing

A hospital waiting area with just three people.Hospital design is incorporating features that reflect the concept of healing rather than sickness. Older people make up a significant proportion of patients, and that means we need more age-friendly approaches to care. Physical environments are getting slip resistant floors, indirect lighting and large print wall clocks and calendars. Some hospitals are replacing harsh florescent lighting with systems similar to day – night cycles. An article on the AARP website discusses this and how hospital design is about healing.

Other ideas are a piano at registration, walking paths and gardens – making the place feel more hospitable rather than hospital. It’s about customer convenience and comfort. And this must help when people are in pain and feeling stressed. Many visitors feel stressed and anxious in hospitals and they aren’t even sick.

As for coffee bars in waiting areas – the sound of grinding beans in coffee bars adds to noise levels and the smell can be nauseating. Small things can make a difference to comfort and reducing stress levels.

Other changes involve telehealth services which can be delivered to patients at home. For more on this see the AARP article.

Older adults lead universal design processes

Three soda cans showing the ring pull opener. Older adults lead universal design.
Ring pulls need more space for fingers

If you design for the extremes of the population, you include the middle. That’s one way, among many, of describing the universal design process. So asking people at the older end of the age spectrum to engage in design process could bring good outcomes for all. A recent study tested this idea to see if older adults could take a lead in universal design processes. They found that they could.

“Lead users” are people who have the potential to identify needs that could be present in the general population. The concept is based on the premise that what is good for lead users is good for many others. A group of researchers decided to test this idea with older adults. In the process they found additional things they weren’t expecting. 

The researchers discovered that many everyday products do not comply with universal design principles. This leads to older adults ignoring tasks due to design complexity. For example, wearing slippers to avoid shoes that demand bending for socks or laces. 

The researchers found no real difference between the needs of the older population and the general population. They also found that products redesigned for older adults were preferred by others, on average, 89% of the time. One of the redesigns was the ring pull tab on soda cans. A deeper dent under the tab makes more space for all fingers.

The title of the paper is, A Lead User Approach to Universal Design – Involving Older Adults in the Design Process. It is open access. The paper provides the method and results in detail. 

From the Abstract

Previous work has shown promising results on involving users with physical challenges as lead users – users who have the potential to identify needs that could be latent among the general population. It has also been shown that older adults can act as such lead users. They can help design universal product ideas that satisfy both older adults and the general population.

In this paper we build on this and examine if involving older adults in the design phase can result in universal products, products preferred by both older adults and the general population over a current option.

Products were redesigned and prototyped based on the needs of older adults and tested among both populations. Although the needs differed between the populations, on average 89% of the general population participants preferred products designed based on design needs expressed by older adults over the current option.

This provides further evidence supporting the use of older adults in designing products for all.

Guide for body shape and size

A page from the Guide for body shape and size.How much do our body shapes and sizes differ? A lot. But if you only know a few different shapes and sizes, how will you know if your design is inclusive? A guide for body shape and size is a useful reference.

The Centre for Excellence in Universal Design in Ireland has a set of information sheets on body shape and size. They guide designers in how to apply these factors in their work to achieve more universally designed products and services.

The overview of the guideline project explains the importance of considering body shape and size in designs. For governments and other institutions it helps with the selection and procurement of everyday products such as street furniture. Designing for the extremes of body shape and size affords extra convenience for all users. It also helps avoid user discomfort, embarrassment and even harm. There are five fact sheets

A related academic paper from 2014 takes body size and shape further and applies it to mobility devices. The guide to the circulation requirements for various wheeled mobility devices is from Denmark. It includes research on the spatial needs for parking as well as toilets and building entries as well as accessible paths of travel.

Charts with dimensions of the various mobility types is included and includes tables for children and the bariatric population. The guide also discusses the need to think to the future of mobility devices and not assume that the size and styles will remain the same. 

Person-environment fit using the ICF 

Making the environment fit for all regardless of capacity is an important goal for public health efforts. But valid methods for measuring accessibility are currently lacking. This study aims to address this lack. Using the ICF as a conceptual framework, a typology of person-environment fit was developed along three dimensions: 1) accessibility problem range and severity; 2) aspects of functioning; 3) environmental context.

Front cover of the ICF. Red with white text.

Abstract background

Making the built environment accessible for all regardless of functional capacity is an important goal for public health efforts. Considerable impediments to achieving this goal suggest the need for valid measurements of accessibility and for greater attention to the complexity of person-environment fit issues.

 

To address these needs, this study aimed to provide a methodological platform, useful for further research and instrument development within accessibility research. This was accomplished by the construction of a typology of problematic person-environment fit constellations, utilizing an existing methodology developed to assess and analyze accessibility problems in the built environment.”

Download Typology of person-environment fit constellations: a platform addressing accessibility problems in the built environment for people with functional limitations.

Article by Björn Slaug, Oliver Schilling, Susanne Iwarsson, and Gunilla Carlsson

6 Steps for effective wayfinding

A street signpost with multiples signs going in several directions. They need 6 septs to effective wayfinding.
Image by Kim Broomhall from Pixabay

Wayfinding is more than just putting up a sign, but where signs are needed it’s time to call an experiential graphic designer. They have expertise in understanding human behaviour and perception. Knowledge of access codes is also part of their skill-set. The key point is to involve them at the beginning of a project for best effect. A SEDG blog post has 6 steps for effective wayfinding. 

6 Steps for Effective Wayfinding

Think about wayfinding long before the development site and architecture have taken shape. Experiential graphic designers are the go-to people at this point. The following steps are edited from the SEDG blog post. They outline the process for working with designers to integrate wayfinding into new or existing space. 

1. Kick off. A good designer will listen to the problems and challenges that a wayfinding systems needs to solve.

2. Strategize and plan. Designers think about how people move around and interact, anticipate needs and identify obstacles. They should also consider any regulations and restrictions to ensure designs are approved. 

3. Concept and design. A good designer will have skills in type, colour, form, materials, lighting and more and present a variety of designs. They consider sightlines, obstructions, language and culture, physical disabilities and visual impairments.  

4. Review and approve. This is the most important part of the process. A good designer packages the designs for approval and negotiates where necessary. 

5. Bid for pricing. Allow up to three weeks for this step so mistakes aren’t made leading to bigger issues. Proposals should include samples, colours, materials, shop drawings and permits.

6. Fabricate and install. Fabrication and installation takes eight to twelve weeks. A good designer will work with fabricators and installers to ensure design intent is followed, down to the last sign type and location.

Community Wayfinding

Jon Sanford’s chapter, Design fFront cover of the book Community Wayfinding: Pathways to Understanding.or All Users explains that despite its potential, universal design has not been widely adopted as a strategy in promoting community wayfinding. The book, Community Wayfinding: Pathways to Understanding is published by Springer Link and individual chapters can be purchased. Or go to the ResearchGate site and request free access to the full chapter. 

You can download the table of contents to see what else might be of interest.

From the abstract

In this chapter, the author describes not only what universal design is, but also what it is not: specialized designs to compensate for functional limitations.

Universal design, as articulated by a set of performance guidelines, describes how to promote usability and inclusivity—including community wayfinding—for everyone. The chapter addresses directions in research, policy, and practice necessary to promote universal design implementation.

 Award winning wayfinding design

Birds eye view of a wide pedestrian crossing with lots of people on itThere are three wayfinding design articles in this post. First, is public transport systems where good wayfinding is essential for reducing travel stress. Community wayfinding is essential for orientation, and hospitals are another situation where people experience wayfinding stress. And wayfinding is so much more than signage. 

Deborah Abidakun, won an RSA Student Design Award for her wayfinding system design. Being just below average height she found herself on tiptoe trying to understand 3D graphics. At night the lack of lighting made reading even more difficult. So Deborah started to wonder how others found these signs. This led her to carry out research around the existing pedestrian wayfinding system.

Deborah’s winning design was based on enhancing the Transport for London system. Find out more by going to the article – the illustration below has two more screens that help with the explanation. The title of the article is, Enabled by design: A way finding system that considers the disabled.

a prototype accessible wayfinding post and panel design. Award winning wayfinding design.

Hospital wayfinding

A boy sits on a chair and in front of him is a giant heart shaped apple sculpture with red hearts and other bright colours on it.Healthcare environments are under the design microscope with a growing body of evidence to show how design is linked to well-being. The design project manager for the Seattle Children’s Hospital is Integrating Art and Wayfinding. 

This short article outlines how the art planning team decided on the style of art. Patients, families, clinical and administrative staff. “Finding the right visual voice for patients whose ages range from infants to young adults, along with families and visitors is key” 

 

Inclusive design: more than a checklist

A desk with a large sheet of paper and pink post it notes. A person stands with their hand resting on the table. Inclusive design is more than a checklist.Design is powerful. It connects us to the world around us and shapes our lives. Inclusive design shapes products and services in ways that are useable by everyone. It requires a shared understanding of population diversity. Whether it’s a building a webpage, a policy framework or a town park, it ensures we “leave no-one behind“. Inclusive design is more than a checklist.

A blog page from Automattic says, “Truly inclusive designs are never really finished, and becoming fluent in inclusive design takes more than a checklist. We all need a map when we start exploring any new world”. This is the introduction to a “guidance map” aimed at leading individuals and teams through the processes of creating inclusive thinking and practice.

Although focused on technology, some of the principles and processes can be applied in other design situations. For example, “Learn about your audiences; their motivations, needs, behaviors, challenges, pain points and goals”. The key headings in this article on Design.blog are: 

      • Broadening perspectives and building empathy; 
      • Bringing diversity into teams and processes; and 
      • Building inclusion into designs.  

The article explains each of the three steps in more detail. Some concepts such as colour contrast are well-known to designers. Less considered factors are providing cost-accessible options of designs, and designing for low bandwidth. Designs should be adaptable for longer life and empower clients to continue without more designer input. These ideas really show that client needs are at the centre of the design. Designing out “pain points” is essential for all users. 

Design is a powerful tool and inclusive design has the “potential to unite heterogeneous cultures in shared understanding. To make products and experiences globally accessible.” Good design is inclusive design. 

 

Occupational Therapy meets Industrial Design

Four people are standing leaning over a large table with pens and paper and looking at a laptop. They appear to be discussing something.Co-design has gained attention as a good way to increase accessibility and useability.  However, there is another way to tackle the issues – interprofessional learning and teaching. When occupational therapy meets industrial design in the classroom the end result is a great learning experience for all.

Bringing designers to a better understanding of disability and accessibility remains a vexed issue. Many and varied attempts at teaching and learning have made some improvements. Some interdisciplinary work has also shown promise and perhaps it is worth building on this model. So this is what they tried at Thomas Jefferson University.

A group of occupational therapy doctoral students were embedded in a masters industrial design course. The doctoral students delivered lectures and learning activities for the masters students. Over the eight months there was time for students to share knowledge more informally. Occupational therapy students were also able to provide insights for student design projects.

The knowledge and insights gained by the masters students was nuanced and best measured qualitatively using mixed methods. They had originally hoped to quantify the knowledge gained. But perhaps this kind of learning is best measured by the accessibility of future designs. 

The purpose, methods and outcomes are reported in an article published in the ‘Journal of Accessibility and Design for All’. The article is titled, Insights from an inaugural eight-month interprofessional collaborative co-design educational experience between occupational therapy and industrial design. The discussion and conclusion section is worth a read.

Abstract

The design of the built environment greatly impacts how all types of individuals and populations actively participate in their daily lives. Lack of access in the built environment for disabled populations remains a daily reality, negatively impacting engagement and life satisfaction, leading to isolation, loneliness, and depression. A university in the Northeastern United States sought to expand current constructs of the end-user and environment within a universal design (UD) perspective. On an eight-month inaugural interprofessional collaborative co-design experience, third-year occupational therapy doctoral (OTD) students were embedded in a first-year masters of industrial design (MSID) curriculum, which ran the course of the academic calendar (two consecutive semesters: Fall and Spring).

Primary aims wanted to determine, via an interrupted timeseries quantitative design, if embedding OTD students within the industrial design curriculum influenced the MSID students’ prior assumptions, understanding of disability and enhanced their willingness to create more inclusive final products. Quantitative findings indicated that it was difficult to capture the meaningful change that occurred in the doctoral capstone program experience with the existing psychometric tools available.

Anecdotal mixed-method findings indicated that informal interprofessional learning experiences in the classroom, such as lectures and learning activities created and facilitated by the OTD students and delivered in real-time, broadened and enhanced the MSID students’ knowledge surrounding disability and accessibility in a more nuanced way than the chosen quantitative survey tools were constructed to capture. A detailed literature review and description of the program have been provided, along with suggestions to capture meaningful outcomes for longer-term interdisciplinary collaborations.

 

European universal design standard

Front cover of the Design for All standard.Universal design is a design thinking process so a universal design standard is a contradiction in terms. Standards are fixed where universal design is a continuous improvement process. However, where designers cannot grasp the concept of an inclusive thinking process, a set of design directions is needed. Hence a new European universal design standard for products, goods and services.

The standard sets out requirements and recommendations for extending the customer base for products and services. It’s for organisations that design and manufacture products and/or provide services. The aim is to ensure products and services are available to the widest range of users possible.

Diverse user needs, characteristics, capabilities and preferences area all covered. It is based on processes of user involvement and building on accessibility knowledge. The standard can also be used for complying with legislation and to advance corporate social responsibility. 

The standard was developed by Ireland’s National Disability Authority that houses the Centre for Excellence in Universal Design. The document has the title “design for all” which is a recognised European term, but notes that universal design, barrier-free-design and transgenerational design are the same thing. 

Design for All – Accessibility following a Design for All approach in products, goods and services – Extending the range of users can be purchased from the standards authority

There is a media release explaining a little more. 

Handbook for accessible graphic design

Front cover of the handbook for accessible graphic design. Bright yellow with black text.Graphic design covers all kinds of creative design and visual communications. The accessibility of graphic design should always be considered in the production of websites, brochures or Word documents. Fortunately there is a great handbook for accessible graphic design to help.

Graphic design covers creative design, visual communications, applied design and technology sectors. The text covers typography, digital media, web accessibility, Office documents, accessible PDFs, print design, environmental graphic design, colour selection and more. It’s relatively easy to read and has a logical structure. At the end is a list of publications, links to websites and tools to help. 

There are so many little things that graphic designers can do to make their creations more accessible. The guide shows how to make graphic creations accessible with little, if any, extra effort. The title of the guide is, AccessAbility 2: A Practical Handbook on Accessible Graphic Design, and comes from Ontario, Canada.  

Beginning with some questions… 

How do we plan a graphic design project to ensure it is as accessible as possible for the intended audience? What considerations do we need to make for accessibility across various media? And how does our desire to communicate effectively with people of varying abilities translate into specific design decisions?

This book is for a broad group of individuals, including professional graphic designers, clients, educators, students and many others.

Architects and empathy: the key to inclusive design

A man wearing simulation gloves and glasses tries to open a sticky note padLoughborough University has a good track record for inclusive design research. The latest article reports on a study to find out if “empathetic modelling” could influence architects’ design thinking. Impaired vision and manual dexterity are the most common losses as people age. So these factors were used in the study to improve architects’ empathy and understanding of users.

The method involved using glasses and gloves that simulate loss of vision and loss of hand dexterity. Participants were given reading, writing and dexterity tasks while wearing the gloves and glasses.

The results show that the tasks challenged their traditional view of disability. Participants began to see it more as a continuum and effecting a wider population. The key themes are summarised below.

Key themes

      • Inadequacy of the current building standard, Access to and Use of Buildings. It only recommends minimum access standards.
      • There is no incentive for developers to go beyond minimum compliance.
      • Developers often commission design briefs so the end user is often unknown.
      • In the absence of knowing their end user, they tend to design for themselves.
      • They feel there is a stigma associated with accessible designs and this reinforces the disability-centric concept of able bodied versus disability designs.
      • It challenged their traditional view on disability and capability loss and the current polarised view within design, between ‘able-bodied’ and ‘disabled-users’.
      • A lack of inclusive design training within their undergraduate and post graduate training and a desire to include more in their continuing professional development.
      • Participants felt strongly that commercial, accessible design decisions, mainly addressed physical impairments.
      • All participants reported an increased awareness of the psychological effects of the simulated capability loss, reporting frustration and fatigue.

The title of the article is, How ‘Empathetic modelling’ positively influences Architects’ empathy, informing their Inclusive Design-Thinking.  Arthritis is rarely recorded as a disability but it affects one in seven Australians. Opening packages, lifting the kettle and turning door knobs can be difficult and painful. 

Abstract

Empathy is described in the literature as being the first stage in the Design-Thinking cycle. Architects and Design professionals should ‘Empathise’ with their users to understand their needs and gain insight into the exclusion barriers that many users face within the Built Environment.

This paper presents the results of a study conducted with a cohort of Architects, investigating whether an ‘Empathetic Modelling’ intervention could influence their intrapersonal state empathy levels and inform their inclusive Design-Thinking.

A validated empathy scale was used to measure Architects empathy levels, pre and post intervention. Visual acuity and hand dexterity were the two capability losses simulated, with participants performing common Activities of Daily Living (ADL) and two design tasks.

Results showed that all participants empathy scores increased, when comparing pre and post-test measures. This was supported with qualitative data, with results suggesting that all participants gained unique and useful insights into how they can incorporate more accessibility, adaptability and inclusivity into future designs, to reduce user exclusion within the built environment.

This increased awareness of incorporating an inclusive design philosophy, has positive implications for design professionals understanding the diverse needs of the wider user population and especially for the increasing ageing population, who want to maintain their independence and enjoy barrier-free access to the built environment.

The video below shows the gloves and glasses in action.

Major re-think of office design

A drawing depicting the Library design. Major rethink of office design is needed.
Image of Library design courtesy Clive Wilkinson Architects.

The open office design is dead. That’s according to the designers of offices for big corporates such as Google and Microsoft. The COVID pandemic has caused a major re-think of office design and how people best function in office settings. 

Many workers have found open offices less than ideal workplaces. According to an article in FastCompany, apart from being noisy they reinforce sexist behaviour and make people leave their jobs. 

The three design typologies in the article indicate good circulation spaces, but there is little in these designs that indicate inclusive design principles.  For some people, working from home is still the optimum if office design and office culture do not make them welcome. However, these designs offer space to move around and interact with fellow workers rather than being tucked away in a nook.

The Library is an open floor plan with large working tables, individual nooks and comfortable chairs. Rather like an airport business lounge. 

The Plaza is a kitchen and lunchroom space and encourages social activity. This is the part that people miss by working from home. It might encourage people back to the office.

The Avenue is, as the name suggests, a place for chance interaction with tables and stools and little nooks.

The title of the article is, These architects popularized the open office. Now they say ‘the open office is dead’

Open plan offices: what’s the verdict?

Looking down into a large open plan office with desks and partitionsThe debate about whether open plan offices make good places to work continues. A team of Harvard researchers found that they weren’t. But it seems they were looking at the extreme of open plan offices, and poorly designed at that.

In defense of open plan design, architect Ashley L Dunn argues that the Harvard study chose offices where there were no partitions and no separate meeting rooms or places for private conversations. These are elements that make open plan effective. You can read more from Dunn in the FastCompany article. By chance, most open plan designs end up being more accessible for people using wheeled mobility devices. Toilets and staff rooms might be another matter though.

What about accessibility?

It would be good to see an article such as this also tackle issues of inclusion and accessibility in office design, particularly for people who for example, are deaf or hard of hearing, have back pain, or have low vision. Some solutions are simple such as moving clutter from walkways. The video below from the Rick Hansen Foundation shows how simple things make a big difference – it doesn’t have to be perfect.