Design & Health International Academy Awards 2009: International Research Project
Sponsored by: MAAP Architects
Lead judge
Dr Paul Barach, senior research fellow, University of Utrecht, Netherlands
Panel
Dr Eve A. Edelstein, MArch, PhD (neuroscience), Assoc AIA., F-AAA, Visiting Scholar, University of California, San Diego, NewSchool of Architecture & Design, San Diego Academy of Neuroscience for Architecture
Mungo Smith, director, MAAP Architects
Criteria
Awarded for a completed, independently assessed, piece of research focused on a particular aspect of the design, function, construction, financing or maintenance of a healthcare facility or addressing a relevant topic concerning public health in the context of the working environment.
Winner
Inpatient Unit Flexibility: Design Characteristics of a Successful Flexible Unit, Dr Debajyoh Pati BArch, MASA, PhD, FAIA; HKS, US; Tom Harvey MArch, MPH, AIA, FACHA, LEED AP; HKS
The judges said: “Awarded for overall scientific rigour, innovativeness, impact on field, clarity of writing and ability to raise the tenor of the discourse around this key topic. In patient flexibility is key topic in Europe and Australasia and to certain extent in the US.”
(Insert pic of Dr Pati)
Abstract: Flexibility in healthcare design is typically addressed from an architectural perspective without a systematic understanding of its meaning from the end-user viewpoint. Moreover, the architectural perspectives have been generally focused on expandability and convertibility. This study explored flexibility needs in adult medical-surgical inpatient care with the objective to understand its meaning from an end-user perspective and identify characteristics of the physical environment that promote or impede stakeholders’ requirements. We used a qualitative design and conducted semi-structured interviews with 48 stakeholders in nursing and nursing-support services at 6 hospitals across the United States. Data was collected during September-November 2006. Findings suggest that adaptability influences more aspects of unit operations than convertibility or expandability. Further, physical design characteristics impact nine critical operational issues where flexibility is required, spanning nursing, environmental services, materials management, dietary services, pharmacy, and respiratory therapy.
For full paper, visit
Highly Commended
Determining an Environmental Audit tool for Dementia Specific Research
Ian Forbes, Director Health, DesignInc Architects and Adjunct Professor, Faculty of Design Architecture and Building, University of Technology, Sydney.
Richard Fleming, Director, Dementia Services Development Centre, HammondCare and Clinical Associate Professor, Faculty of Health and Behavioral Sciences University of Wollongong
The judges said: ”This paper which evaluates the validity of a new survey method by comparing it to an existing accepted survey method is unique among the submissions this year, this paper demonstrates how the scientific analytic method can be used to explore design related questions.”
Abstract
Typically successful treatments for people living with dementia have used a mix of pharmacological treatments (for anxiety, depression, cognitive ability, etc) and non-pharmacological treatments (communications, behaviour, activation, etc). Of the non-pharmacological treatments two approaches stand out. The first is an appropriate and responsive communication approach intended to mediate the effects of the brain losses and support retained memories. The second treatment is the use of evidence-based environmental treatments. Evidence from trials indicate that specific characteristics of the physical environment help with reducing symptoms allowing the environmental design characteristics to provide natural mapping and memory cues (Zeisal et al).
Methodology
The project involves 30 facilities assessed according to a Dementia Specific Evaluation Tool developed by researchers. A baseline assessment identifies the level of compliance with 10 key aspects of spaces and an understanding of the impact this will have on behaviour of dementia residents. The dementia specific units are assigned randomly to three streams in which impacts of the alterations made to the units are evaluated. These are: one stream undertaking PCC, one with alterations but no PCC and one with no intervention.
Benefits derived from the research
• Demonstration of the relationship between physical environments, care models and the health outcomes for dementia
• Validation of the design requirements described for physical facility requirements under the Australian Commonwealth Government Accreditation of Aged Care Facilities, 2008
• Development of planning and policy guidelines concerning what should be provided in aged care design
• Development of information and training packages for staff and developers of facilities to improve the quality of built space and better understanding of the use of those spaces by staff and families
• Generally to create an improvement in the physical support for the staff and the consequent reduction of stress for both staff and residents
• Show the potential for reduced costs of care through less staff, the variance in mix of staff and reduced absenteeism
The finalists
Critical Care Design, The Winners and Future Trends, an Investigative Study, Charles D Cadenhead, FAIA, FACHA, Senior Principal, WHR Architects, USA
The Intersection of Evidence-based Design and Sustainability, Bill Rostenberg, FAIA, FACHA, Principal and Director of Research, Anshen+Allen, USA
Cultivating a Sense of Place / Bloorview Kids Rehab Case Study, Terry Montgomery, OAA, FRAIC, Principal, Montgomery Sisam Architects, Canada
Intangibles: Design Quality Standards that Bring Hospitals to Life, Tye Farrow, Senior Partner, Farrow Partnership Architects
Pathfinder Project P(05)07 funded by the Estates and Facilities Division of the Department of Health. Building on the Evidence: Qualitative Research on the Impact of Arts in Mental Healthcare, Norma Daykin, Ellie Byrne, Tony Soteriou, Susan O’Connor, Jane Willis. With Nola Davis & Mark Palmer
Determining an Environmental Audit tool for Dementia Specific Research, Ian Forbes, Director Health, DesignInc Architects and Adjunct Professor, Faculty of Design Architecture and Building, University of Technology, Sydney.
Richard Fleming, Director, Dementia Services Development Centre, Hammond Care and Clinical Associate Professor, Faculty of Health and Behavioral Sciences University of Wollongong
Inpatient Unit Flexibility: Design Characteristics of a Successful Flexible Unit, Dr Debajyoh Pati BArch, MASA, PhD, FAIA; HKS, US; Tom Harvey MArch, MPH, AIA, FACHA, LEED AP; HKS
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