Editor’s Note: A version of this article first appeared in UED/Urban Environment Design.
At a recent healthcare salon in Shanghai, hosted by the design firm I work for, NBBJ, we heard from physicians, policy-makers and urban planners about the challenges and opportunities China faces in securing a healthy future for its citizens. Several trends became apparent: an aging population, an increase in chronic conditions like obesity and diabetes, patient dissatisfaction, the need for clinical efficiency, a boom in new hospital construction, and more.
A range of solutions — political, economic, social — must address these challenges, but design plays a key role in bringing them all together. Specifically, design can transform both the performance of healthcare — by improving patient outcomes, or making the delivery of care more efficient — as well as the experience of healthcare — by putting patients and family at ease, enabling clinicians to perform at their best, and connecting everyone to the natural world.
Here are just a few ways design can make a difference in healthcare in China:
1. Personalized Health Journeys
China’s citizens are growing increasingly aware of the value of good health; more and more they are playing an active role in their own wellbeing, both in and out of the hospital. Where choices are available, many patients will pay for higher-quality care that is state-of-the-art not only in terms of technology and clinical practice, but also in terms of experience. As a result, a great opportunity exists for those healthcare providers who are willing to change their approach to a patient-centered experience.
2. Hospital Scale
Traditional public hospitals in China can be huge, with potentially thousands of inpatient beds. These facilities can easily overwhelm patients, which contributes to stress and makes it more difficult for them to concentrate on healing. But we can design smaller, more decentralized hospitals. We can break down the mass to be more human-scale, providing access to daylight, gardens and courtyards, and more intimate scale waiting areas. Careful wayfinding design — integrating graphics, signage, lighting, materials and architecture to help shape the patient journey — also helps patients and families negotiate larger facilities.
3. Obstetrics and Maternity Care
With the cancellation of the one-child policy in October 2015, we’ll see a shifting focus on maternity and pediatrics. In maternity spaces, which will become utilized more frequently, care isn’t just for the parents and the child, it’s also for grandparents, extended family and additional caregivers like nannies. This will require adequately sized spaces with comfortable furniture, natural light, privacy and — through using color, texture, lighting and sound quality — a sense that the patients’ time with the physician is dedicated to their new family.
4. Patient-Physician Relationships
This raises an issue that we heard repeatedly in our salon: the strained relationship between patients and caregivers. Many patients don’t trust their physicians to provide adequate care, and many physicians face daunting caseloads. Design can help in two ways: first by facilitating better relationships between the patent and caregiver, and secondly by creating calming, stress-free environments. For instance, we designed an outpatient pediatric surgery clinic in which parents can accompany their child until the last minute before surgery. With greater interaction with caregivers, trust increases.
5. Clinical Workplace
Healthcare environments are more than places where patients go to get well — they are workplaces for the clinicians who spend their days there. From working with the world’s top technology companies — Tencent, Alipay, Samsung and others — we’ve learned the importance of collaboration, flexibility and mobile work; these priorities are also necessary in designing clinical workplaces that will keep pace with changes in healthcare delivery, which is becoming more and more multidisciplinary and team-based. Collaborative workplaces not only allow clinicians to provide more integrated care for their patients, but also provide a sense of mutual support in a potentially stressful environment.
The environment matters a great deal in terms of how well and how quickly a patient can heal. We have found that, when patients have access to nature and natural light, they use less pain medication and their length-of-stay decreases. It is easy to create courtyards and roof gardens — and even adapt them to the traditions of Chinese horticulture and landscape design — in order to create pleasant environments that help patients heal faster and make staff happier and more productive at work.
There is also a tremendous opportunity to create less energy-intensive healthcare buildings. In China the public sector can mobilize resources and solve problems with great speed and efficiency. Pollution and energy consumption are widely recognized as challenges, but adhering to international green building standards — or creating China-specific standards — for new healthcare construction would send an important message to the rest of the world about the importance of sustainable design.
7. Integration into the City
True wellness is only possible when people are equipped to live healthy lives outside of the hospital: in their homes, workplaces, schools and in the streets of the city. Many hospitals are located in urban environments, where they can function both as places of clinical care as well as symbols of wellness that are incorporated into the daily life of the communities they serve. Healthcare facilities can be designed with space to host farmers’ markets, exercise programs, classes and seminars or other public events.
8. Integration of Health into Everyday Life
At their best, the experience of healthcare and the performance of healthcare reinforce each other. Better experiences — for the patient, for the patient’s family and for the physicians — lead to better outcomes, and vice versa. Great healthcare experiences can’t be implemented with a factory approach, however. It requires designers and clinicians who can understand and meet the needs of the people they are caring for.
Finally, when we think of health, all too often we think of disease treatment; in actuality, health is a network of factors — among them social connections, nutrition, economic security and the built environment — which have historically been strong in Chinese culture. If China can take advantage of these cultural traditions, blending them with state-of-the-art technology and clinical practices, it has the potential even to leapfrog Western medicine.
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