Design and Health World Health Design


Ceramicist Eva Zeisel touched thousands of lives with her playful, curvaceous tableware designs. But she also lived a remarkable life of her own – one where beauty and health could not be separated. Her son John Zeisel pays tribute.

Eva Zeisel, my mother, died on 30 December 2011, a few weeks after her 105th birthday. Her long life was one of overcoming adversity, being creative, empowering students and family, giving and receiving love, and living to 105.
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Dialogue: The shift left

The financial crisis could quicken the movement of services from acute to community settings, and design has a critical role to play, John Cole tells Marc Sansom.

John Cole, chief estates officer of Northern Ireland’s Department of Health, Social Services and Public Safety and chair of the European Healthcare Property Network gives his views on procurement, design quality and the contribution research can make to improving healthcare environments.
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Inquiry: Sustainable strategies

The global economic recession has highlighted the challenge of the ever-rising costs associated with healthcare delivery around the world.

Our four experts discuss the role of design in containing costs and supporting preventative approaches to care.
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Standpoint: The broader view

Designers need to take a more proactive role in helping the health world understand the real impact of design on health, urges Jacques Mizan.

Faced with the volatile mixture of ageing communities, cutbacks in public funding, reduced access to capital and an ever-increasing demand for the latest and best healthcare provision, there is a frantic need to find something to stem the tide – and prevention is it.
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Inquiry: A dose of dialogue

With the vibrant Singapore cityscape as its backdrop, old colleagues reconnected and new friendships forged at the 6th Design & Health World Congress & Exhibition.

Here, three participants reflect on the knowledge they gained, and look forward to the themes that may emerge at the 7th World Congress in Boston in 2011.
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Standpoint: Shaping the future

It’s not just better design; it’s the chance to shape a nation’s health, writes Dr Ray Pentecost. Economic turmoil and rising healthcare costs are creating new opportunities for healthcare planners and architects.

Healthcare planning and design communities worldwide are experiencing unprecedented opportunity to expand their influence beyond the confines of the built environment and into the policy realm where national priorities, agendas and strategies are shaped.
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Inquiry: Lost in time

Patient safety is not a new issue. So why are we yet to learn the lessons given to us by Florence Nightingale and Sir Rupert Vaughan Hudson 150 and 50 years ago respectively?

And how important is the role of design in minimising the risk to patients in healthcare environments? Four experts give their views.
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Dialogue: Panoramic Perspectives

The world would not only be a less progressive place if it were not for men like Professor Arthur Lim, it would also be a far less interesting one. Marc Sansom interviews the famous Asian eye surgeon who sees no mirrors, only windows.

Arguably Asia's most celebrated and finest eye surgeon, Prof Lim is acknowledged by his peers as the father of this specialist field of medicine in Southeast Asia, and a mentor and icon to eye surgeons all over the world.
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Standpoint: Designs on shared ground

Sunand Prasad says that building interdisciplinary relationships is key to the delivery of good design.

The emergence of patient-focused medicine in the 1980s, followed soon after by patient-focused design of health facilities, were part of a change in the way the relationship between consumers and producers was viewed in our working culture. We realised then what now seems so obvious – though is still neglected – that focusing on the needs of the ‘customer’ greatly increases the value that services and products release.
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Health Record: The Great Shell Game

The hospital industry is in the throes of the largest building boom in its history. The funding, however, of global health capital investment is in great peril, writes Dr Paul Barach.

An estimated $200 billion is planned to be spent on new hospital construction in the US in the next decade. The global economic crash, however, has the potential to derail this plan and create barriers to the design of better quality healthcare environments, leading to years of postponement or cancellation of new hospital design and construction.
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Inquiry: Crunch time
As the global economic crisis deepens, three leading experts assess the impact on investment in health and public infrastructures around the world in 2009.

The deepening economic crisis will not necessarily create barriers to the delivery of effective healthcare design and associated research in 2009, but I would predict a distinct refocusing of priorities. The overarching emphasis will not change dramatically – it has always been an imperative of healthcare design to do more with less, to deliver tangible performance improvements within tight budgets, particularly on public projects.
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Standpoint: Buy now, pay later

Stephen Harris asks if the global economic downturn will put paid to the internationalisation of public private partnerships (PPP)?

There are now around forty countries in the world with their own PPP units and another fifty looking seriously at PPP as a preferred funding model. That’s nearly half the nations of the world. Many of these countries are fast tracking PPP healthcare schemes – Greece, Egypt and, most recently Sweden, all have PPP hospital tenders out to market.
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Dialogue: Standards bearer
Carlo Ramponi talks to Prof Per Gunnar Svensson about the role that architecture and design can play in improving the safety and quality of international healthcare provision.

Primum non nocere. Never before has patient safety been so high on the agenda, fulfilling one of the principal precepts taught to all medical students, that the first consideration of a medical intervention must be ‘First, not to harm’.
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Standpoint: Learning the lesson

Successful capital projects in Europe require much more than good architectural solutions, healing design and environmental sustainability, claims Bernd Rechel.

Each year, many billions of euros are spent on capital investment projects in the health sector across Europe, and this amount is likely to increase in the coming years, as many countries face a backlog of maintenance and refurbishment.
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Dialogue: Cultural challenges

Phil Nedin and John Cooper go head to head on the role that research and evidence-based design can play in improving the quality and performance of the global health estate.

Used by architects, interior designers, engineers, and estates and facilities managers in the planning, design and construction of healthcare buildings, evidence based design (EBD) is one of the more popular tools available within a rich tapestry of research methodologies.
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Inquiry: Does one size fit all?

Increasingly recognised as an industry standard in the US, in other areas of the world the jury is still out on the 100% single patient room model of care. Our four experts consider when, where and for whom single patient rooms are appropriate.

Before this design guideline becomes the industry standard, we must consider the issue from both a medical and a design perspective. Are private rooms beneficial for all patient populations? Will this design concept alter important psychological and social aspects which accompany the process of illness and healing? How will this change the experience of hospitalisation?
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Health Record: Invest to save

Gunnar Ohlen says a whole life costing approach to capital investment in the global healthcare estate will reap long-term rewards.

The world is full of appropriately planned and well-intended healthcare buildings. But, all too often, as a result of financial compromises agreed towards the end of the planning process, the final outcome results in a suboptimal building that fails both patients and the healthcare staff that work there.
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Standpoint: Towards 2020 - An action plan for a healthy planet
Only bold, innovative thinking can head-off a global healthcare crisis, according to Texas A&M University’s George J Mann.

The future belongs to those who prepare for it. By 2050, our planet will support an extra three billion people, placing an incredible strain on healthcare systems and necessitating new and innovative ways to tackle healthcare delivery.
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Dialogue: Think globally, act locally

More must be done to help hospital managers understand the economic and clinical value of good design within their local cultural context, new International Hospital Federation director-general, Eric De Roodenbeke tells Prof Per Gunnar Svensson.

In ‘pure’ economic terms, healthcare is no different from any other industry or business, in respect that it is a scarce resource, subject to the laws and fluctuations of supply and demand. Many health economists also theorize that healthcare is derived from the wider demand for health, such that individuals will allocate their resources in order to both consume and produce health, with the ultimate aim of improving their ‘health stock’.
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Inquiry: Partnership on the precipice
Using private money to finance public healthcare buildings is nothing new in the UK, but as the concept is rolled out around the world, is it a sustainable model for achieving design quality and does it provide value for money? Here, four experts speculate on the future of Public Private Partnerships.

Learning from 10 years’ experience should result in lower costs through more effective processes, as well as innovative solutions, bringing the patient experience to the forefront. Such learning needs to be abstracted and transferred to other countries in which PPP models are being adopted.
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Health Record: In praise of appraisal
The best way to see how a new building is performing is to evaluate it, says Paul Willetts. So why do so many healthcare providers choose not to bother?

As German philosopher Friedrich Hegel said, “The only thing we learn from history is that we learn nothing from history.” Is this the reason that the number of Post Project Evaluations (PPEs) carried out on healthcare buildings in the UK is so woefully low? It’s no different in other countries, where despite significant investment in healthcare, there’s still insufficient evaluation.
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Standpoint: Financial folly
The international sub prime crisis lays bare PPP’s popular delusions, writes John Cooper.

Things fall into place in the strangest ways. Last November I gave a friend a book of Don McCullin’s photographs for her birthday. It’s a record of England in the 60s and 70s. Full page black-and-white plates illustrate a country of terraced houses, bleak urban landscapes and pinched-faced people, a land which was much closer to the nineteenth century than today – not only in its architecture but the economic model which these images represent.
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Dialogue: Advance warning system
Nigel Crisp and Chris Liddle go head to head and agree that global human health requires a research-based approach to design that supports the concept of ‘early health, not late disease’.

Leadership is many things but most of all, in the words of management theorist John Adair, it is the manifestation of practical wisdom, consisting of a powerful blend of intelligence, experience and goodness.
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Inquiry: The methods of our madness
Evidence-based design (EBD) is the new buzz-word in the field of design and health. Jacqueline Vischer asks five leading experts to give their reflections on the merits of EBD relative to research-based design.

The idea that immediate, in situ identification of space-use research problems pertinent to an ongoing design process can lead to basing design decisions on empirical research outcomes is immensely appealing, because the one thing no design project has today is time.
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Health Record: Theatre of care

The work within a surgical department is often demanding for nursing staff, who have limited control over the design, quality and performance of their environment, reflects Irini Antoniadou.

A crude, but useful, way of understanding the working environment is to consider it within a physical and psychological context. Both are significant in relation to their impact on the performance and the well-being of the operating room nurse.
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Canada: What's out there?
Increasing emphasis placed by healthcare organisations on the implementation of evidence-based design principles in their capital projects supports architects’ long-standing efforts to deliver integrated ‘indoor-outdoor’ designs.

Most Prime Consultant RFPs (Requests for Proposal) for significant healthcare developments now allude to these principles, and require a commitment to patient-centered design respectful of the theories of Dr Roger Ulrich and similar studies. While often difficult to quantify, as the number of variables abound in the healthcare setting, ample anecdotal evidence suggests a relationship between a serene, empowering daylight-filled therapeutic setting and the speed or efficacy of the healing process.
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