Wednesday, May 13, 2020
Learning from COVID-19: 4 Ways to Start Designing the Future of Healthcare Now
In response to the COVID-19 pandemic, our team will be interviewing experts from across the ecosystem to bring the HLTH community timely facts and updates.
We’ve now seen how coronavirus and its disease, COVID-19, revealed a most dire learning: how ill-prepared many environments are to control the spread of infection. The struggle to accommodate a highly infected populace has forced decisions about who gets what, and where, and how – a debate we shouldn’t and hopefully will never have again. I’ve found myself thinking about what can be learned and how people like me – designers – can take action to help safeguard against future health crises.
Reimagine the physicality of healthcare facilities
Right now, we’re grappling with the physicality of our healthcare facilities. Hospitals have not been designed for situations in which there are more patients to treat than medical staff can attend to. Moving forward, we’re going to challenge ourselves to think more efficiently about proximity in future hospital builds, from the moment one enters the lobby – patient, staff and visitors alike – to the waiting areas, to treatment rooms, to hospital beds and beyond. We’ve already gotten a head start on this one.
Recently, ICRAVE led design strategy for the interior and public spaces of Memorial Sloan Kettering’s new David H. Koch Center for Cancer Care in Manhattan. This 750K sq. ft. facility is a microcosm of what all public spaces are experiences in this COVID era: it houses patients who are very susceptible to infection as well as caregivers and doctors who are not. When we began planning in 2014, we examined the standard process of checking into a hospital and how a person is required to navigate the facility to reach their final destination; there were roughly 18 checkpoints to move from the lobby entrance to a doctor’s care. This revealed countless exposure points for patients and a number of spaces built for very narrow uses. Our goal became to eliminate unnecessary touch points not just to make the overall experience more positive, but also for the hospital to become part of a person’s care instead of yet another stressor.
Achieving this wasn’t about moving walls; we had to lean into tech to design more flexible spaces. “Waiting areas” needed to adapt to a patient’s day to day needs as their treatment progressed. At this facility, that meant creating three new typologies of waiting areas called Activation, Restoration and Recreation, each of which held a unique set of choices and experiences for the patient. In order to make treatment efficient, the facility assigns each patient with RTLS technology so that they can be located and alerted when needed. Meaning, patients could roam more freely between floors and typologies depending on their needs, instead of being captive on one floor or neighboring other ill patients in an overcrowded waiting area.
In the future, the physicality of hospitals can become more nimble and change from use to use – spaces can become treatment areas, clinics, or ORs if needed, instead of being fixed office space or waiting areas.
Use a tipping point to create behavioral change
From grabbing the same door handles as countless others, to fishing out sugar packets out of shared tins at the coffee shop, to merely sharing an elevator, we’ve witnessed how everyday habits unwittingly put us at risk. So, it should also remain true that changing these habits, in small, incremental ways, can actually be an important part of keeping our healthcare environments clean as the day unfolds.
Getting people to change behaviors that can have a huge impact on the cleanliness of a shared space – like a hospital lobby or waiting area – is very challenging, but key. For example, changing behavior around handwashing to make it a central task could occur by putting a handwashing station right at the front entrance of a facility, or by installing a soft audio cue or blinking light that prompts people to use that station, and makes it obvious when they have not. At most hospitals, clinicians and caregivers are already aware of the importance of handwashing and do so instinctively, but visitors and outsiders need retraining. This is the Koch Center’s own tipping point: just as the world is doing now with self-quarantine, self-isolation and social distancing measures, people are acutely aware that they’re not protecting themselves; rather, they’re protecting the most vulnerable people from harm.
Another example is motivating people to better care for their surroundings. Families that spend all day in a waiting area as their loved one is in surgery may throw their shoes up on a couch or allow food wrappers to accumulate throughout the day – two common actions that allow germs to build. How can we dissuade this behavior? Some hospitals solve for this by keeping areas pretty bare, but we’ve done the opposite at a few of our healthcare projects, by designing spaces that are more homey. The thinking is that if people feel truly at home somewhere – as if they are waiting in someone’s living room – they will treat it better and keep it cleaner.
Leverage technology to its full potential
A decade ago, my team first introduced food ordering via iPads at JFK Airport; it was revolutionary in that it allowed travelers to enjoy pre-boarding meals anywhere in the terminal, which meant people were less likely to stay in gate hold areas and more evenly disperse throughout the airport, a crucial shift in reducing crowd density and the spread of germs. Now, I wonder: why aren’t we just ordering directly from our own phones, instead of on devices that thousands of people touch in a day’s time? And why, especially in a clinic or hospital, isn’t this true?
Technology might be the simplest yet most-overlooked solution to creating safer, cleaner spaces. For decades we’ve understood its promise to be life-changing, but we haven’t yet meaningfully integrated technology into the everyday healthcare spaces, and how we interact with objects, surfaces, and each other there. Tech is breaking ground in how we diagnose and treat patients, but it has not been integrated into the built healthcare environment with any urgency or sophistication.
Build new environments through strategic design
A future hospital can be designed with all contagion areas in mind: unclean air, droplets living on bed frames and medical equipment.
Solutions could involve air filtration systems above every bed area; beds themselves could be made from copper, an antimicrobial surface; monitors and other medical machines could be housed within waterproof, self-cleaning surfaces. In the future, your doctor won’t be able to “disable” a patient’s room’s red light check to green until they’ve washed their hands for 20+ seconds.
Further, the need for spaces like the Javits Center in New York, and Central Park itself, to be turned into makeshift hospitals signals an obvious demand for more buildings to be structurally designed with flexibility in mind. How much time could be saved if we could easily transform any of the near-or-fully empty office buildings in our cities, into makeshift hospitals, simply through a re-shift of their interior walls and rotating floors?
Solutions like these require airtight partnerships between teams like mine – experience strategy and design – as well as hospital administrators, facilities, operations, IT and medical. But, they are very much within reach and show how good design can keep us safer and healthier.
About Lionel Ohayon:
Lionel Ohayon, is the founder and CEO of ICRAVE, a leading design firm based in New York City that solves business challenges through strategy and design. Since launching ICRAVE in 2002, Ohayon has grown the studio into an internationally renowned practice that drives clients' bottom line by designing spaces as experiences that capture people’s attention. Ohayon works with Fortune 500 companies, top developers and other retail innovators to create award-winning work spanning healthcare, airports and air travel, hospitality and entertainment, and mixed-use residential.
Ohayon is passionate about fostering creativity in the world around him. Outside of the office, Ohayon donates his time and resources to Performance Space 122, a not-for-profit arts organization and one of the longest standing venues dedicated to contemporary performance art in New York City. He lives in Manhattan with his wife and three children. Ohayon graduated from the University of Waterloo School of Architecture.
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