Prototyping of a hospital triage space
We worked with the Arcispedale Santa Maria Nuova (Reggio Emilia) emergency to design a space that ‘will reduce overcrowding, reduce waiting times, and help relieve stress for patients and staff.
In hospital environments space, processes and human interactions are profoundly intertwined. Each tool and area is functional to the onboarding and distribution of patients to the various departments. Empathic human connections need to happen in a timely manner, to ensure that diagnosis are correct and patients are not distressed in an already often traumatic situation.
The co-design of the space allowed doctors and staff members to own the space and learn from the get-go how to leverage that to offer the best care possible, and iterate as they learn emerging patients and future hospital needs.
What we did
> User Research
> Organizational Research
> Experience and Live Prototyping
> Service and Spatial Pilot
Work Model
Our research took place over a period of 4 months with the aim of understanding the ‘human’ needs of patients and hospital staff:
- 70+ hours of direct observation
- 14+ interviews with internal stakeholders
- 5 patients interviews
- Extensive comparative analysis of similar cases
- On-site Organizational Research
Shadowing doctors in their shifts and talking to patients both during their visit at the hospital and after, gave us insights on the holistic experience of patients. We understood what cases, besides clear emergencies, trigger them to go to ER, and how the relationship with doctors and the hospital continues after their visit to receive additional treatments.
“As doctors, sometimes we don’t even know who else was on shift with you.”
“Sometimes there is this pressing by older nurses even when it’s not necessary”
We arrived at 4 key insights:
- Because of time pressure, doctors loose awareness of what happens around them: who are the other members of staff they can collaborate with and what are the other ongoing processes they need to coordinate with.
- The lack of awareness results in lack of collaboration with other doctors.
- Nurses struggle with maintaining concentration due to the high number of low-acuity patients.
- Patients don’t feel taken care of due to lack of staff, which cause anxiety and distress and make the treatments harder and less effective.
Temporary Work Environment
We expanded these insights in a next phase where we developed a series of collaborative low-fi prototype, with the staff and waiting patients. The resulting ideas envisioned an open and flexible space, that took away the concept of the waiting room and gave patients a faster, more personal treatment.
Using role play, customer journeys and spatial representations of the prototypes, we gained a better understanding of the patient and staff experience in relation to the new spaces and ideas, and clarified each new interactions that emerged to be designed.
The new space included 3 main innovations:
- An area for low complexity patients with staff and waiting patients in the same space.
- A Family room dedicated to family members while patients are treated
- A new role of Process Nurses that looks over the entire ED and manages internal flow
We co-designed and activated a functional real-scale new room in a portion of the hospital to understand the impact of the spatial changes on the ways of working of doctors and staff. To do so we involved staff, patients and management engineers to understand the human and organizational impacts of the prototype.
In this experimental environment we tested a variety of tools and processes, for example laptop carts for doctors to visit the patients at their seats, without being assigned to a specific room.
This temporary environment also opened up the opportunity for staff to design their own tools. An example of that is a nurse that glues down binder spirals in a container to better hold clipboards for passing through information. The temporary work environment allowed observable emergent behaviors. Without a fixed room structure doctors become more engaged and direct with their feedback.
Scaling Pattern
The final concept is an open space ambulatory that places waiting patients and doctors together in a more flexible and dynamic care-oriented environment, paired with more private spaces (boxes) into the final blueprint of the space, potentially saving thousands of dollars in restructuring costs.
Finally, we transferred the learnings from this pilot to onboard staff members that were not part of the project, using video prototypes to explain the concept of the new room and how it would change their working conditions and collect feedback.
