Field trip: a US community hospital
How Sibley Memorial Hospital implements design and innovation, and what the NHS can learn from it.
In April 2017 it was a strange time to be visiting a US hospital. Whilst I was seeing the best of what the US healthcare system has to offer, the GOP down the street were continuing their attempts to remove people’s access to it.
I was in D.C. for the week as a visiting fellow at the Sibley Innovation Hub, the hospital’s in-house design and innovation team. Sibley is a 300 bed hospital with 930+ staff. It’s a community hospital which provides general and specialist care including Oncology, Maternity and Emergency medicine.
Sibley’s recently opened a new 7 floor hospital wing and a brand new Emergency Department. So it makes a great example of what the cutting edge of American hospital looks like.
The first clue that you’re in a US hospital might be how you arrive. Sibley is served by a few bus lines, but patients predominantly arrive by car. To that end, you can use the hospital’s valet parking if you like.
The main lobby of the hospital is in the new building and flooded with light. The waiting area which is large, spacious and felt unusually quiet for a large hospital. The self playing Steinway captures the most attention. I’ve never seen a piano in a hospital before, but it certainly helped create a pleasent atmosphere.
Device charging stations are in abundance around Sibley, both in public and patient areas. There’s also free wifi and tablet’s available for patient’s to use for both entertainment (Netflix etc) and to request concierge services like toiletries and other amenities.
Sibley just opened a new building which houses 200 patient rooms. Each suite is equipped with a large TV, a pull out sofa-bed for family and an en-suite bathroom. Whilst the rooms seemed luxurious to me, there are some neat features which are low-cost.
The ‘about me’ sign in each room came directly from an innovation hub project and after some initial prototypes were tested, they’re now a permanent feature of the new rooms.
The patient food menus in each room are extensive and include detailed guidance for specific dietary choices.
In the corridor of each floor you’ll see a sign highlighting the time since the last patient had a fall. It’s a refreshingly honest and open idea.
I got to tour the new Emergency Department which had opened the previous year. The Sibley ED has around 37,000 attendees every year. In comparison, St Mary’s hospital in London might see 280,000, and the Leicester Royal Infirmary 220,000.
The first thing that struck me was low ambiant noise in the department. At first I wasn’t even sure there were any patients admitted. It was remarkably quiet and calm.
One of the specialist departments at Sibley is Pediatric Radiation Oncology. The department’s facilities for children include a dedicated waiting area, and specialist Pediatrics Nurse Practitioner (PNP) who manages all young patients.
On the wall of the waiting area is a tree where past patients are invited to post an image which represents themselves. It’s a great touch.
One of the main roles for the PNP is to prepare children for treatment procedures. This teaching is undertaken on dedicated ‘play dates’ at the hospital.
A week before treatment is due to start, the child and their parents are invited to the unit. Children are introduced to the machines used for the therapy in a fun and playful way. It’s important that these sessions are in advance of the treatment days so they can get comfortable in the environment beforehand.
Sometimes when radiation therapy is needed on the jaw, implants are placed in the mouth. This can be difficult for children as they can have an unpleasant taste and smell.
To help this, the staff thought of using food flavourings used in candy production.
Once the child chooses their favourite flavour, the unfamiliar medical device is turned into a suckable lolli-pop.
Once the course of treatment is complete, children (and adults) are invited to ring this symbolic bell.
The Sibley Innovation Hub is home to Sibley’s dedicated design and innovation team. Made up of experience designers, technologists and strategists, the team work closely with staff members from across the hospital.
The team’s day-to-day role is to guide the doctors, nurses and other staff from across the hospital through the design process. So far they’ve completed some fascinating projects such as designing a patient centred hospital room, improving the cafeterias recycling programme and Centre Sibley.
Centre Sibley is a new space located in the main foyer of the hospital. It hosts seating for working and relaxing, tablets, books and most unusually, a concierge service.
The concierge offers patients and their families help navigating the hospital, access wifi and providing essentials like toiletries which may have been forgotten. It’s a great idea, and I saw the space being well used by both patients and their families catching up on work. One patient was on a group Skype call with her team in a booth, whilst still wearing an identity bracelet around her arm.
Sibley is impressive in all respects. Architecturally it’s beautiful, and the attention given to patient experience could be a case study in itself. I’d never visited a hospital which felt as relaxing and pleasant before.
On reflection, one feeling that’s stuck with me is how the NHS and similar healthcare systems could borrow ideas from Sibley.
The project which stayed with me the most was the ‘about me’ boards in patient rooms. I couldn’t recall seeing anything more than a standard name board in my NHS experiences so far.
After some searching, I did see this initiative by University Hospitals of Morecambe Bay NHS Foundation Trust.
This board offers more information about the patient, including options for butterfly and maple leaf icons to represent dementia or end of life care respectively.
This looks like a step towards a better solution. Improvements which appear small, like adding some items to a whiteboard, can make big improvements to patient experience.
So would boards like Sibley’s work in a NHS hospital? Probably not if you just copied-and-pasted them. It might seem simple, but transferring a design solution from one healthcare system into another isn’t guaranteed to end in success. For instance, who’s going to be in charge of writing the board, do they have time and where is the pen going to live?
Good design is rooted in patient needs and an understanding of the context we’re designing in. And Sibley’s context (a wealthy, cutting edge American hospital) is very different to an NHS hospital in the UK.
What we can learn though, is what a team of designers can accomplish when given some resources, and space in a hospital. The boards are just one of many projects to come out of the Sibley Hub, and it’s easy to see how similar design solutions could emerge in a UK context.
And indeed, it’s already starting. The Helix Centre in London is a team of designers working in St Mary’s hospital. NHS Digital is beginning to make a design led impact in the world of public sector IT services. The new NHS Digital Academy has UCD as one of it’s core learning modules. And some Academic Health Sciences Network units have strong UX and design teams.
Is it enough though? Design’s place in the NHS is haphazard at best. And when it does appear, such as when identity guidelines are reviewed, it’s met with derision.
Design needs a home in the NHS. And I mean in the NHS.
The Helix Centre is a great start. But the model of the Sibley Hub, and it’s success, isn’t unique. There are plenty of examples around the USA, in both normal, and in safety net hospitals. And in Canada. And New Zealand. And the Netherlands.
Having design and innovation teams ‘in-house’ could have huge impacts in the NHS, and the wider health and social care environments.
I’m a freelance researcher and designer who focuses in the healthcare sector. You might like the first post in the Field Trip series where I visited a Dutch hospital.
