01.02.15
‘A beautiful yet functional space for patients and clinicians’
Source: National Health Executive Nov/Dec 2014
NHE talks to Dr Clarissa Murdoch, who took a lead role in designing her trust’s new Ambulatory Care Centre, with extensive input from staff and patients.
The Whittington Hospital NHS Trust in north London opened its new Ambulatory Care Centre in 2014, after a remarkably inclusive approach to its design and construction, involving staff and patients at all stages.
The trust had previously worked with the Design Council to improve the outpatients’ pharmacy department, and carried through the same principles of ‘collaborative design’ to its new centre.
Dr Clarissa Murdoch, lead consultant for ambulatory care, told NHE: “The other places that do ambulatory care, they either look like a ward, or like an outpatient department. We didn’t want either of those two things, because we knew that wouldn’t meet our needs.”
The architects said it “should be a new kind of space; a chance to create a world-class unit that didn’t feel like a hospital”.
Instead, the patient experience was put at the heart of the new design, which focused on staff’s day-to-day experiences of how things actually work in this kind of healthcare setting, ultimately creating a clinically-directed layout, the best use of space, air and natural light, clear signage, coherent and helpful branding, and a design that incorporates aspects like infection prevention and security.
During the opening ceremony last year, health and care minister Norman Lamb MP called it “the future of healthcare in the UK”. He said: “This new centre is a fantastic experience for the patients, fusing together the skills in the community with this exceptional centre of excellence. I have seen a wide range of patients on my visit, with various healthcare needs and conditions, who are all getting the right support and treatment in a wonderful setting.”
The trust worked with design firms and architects including Studio TILT and Levitt Bernstein, as well as commissioning London illustrator Alex Green to produce murals to give a unique feel to clinical areas with calming, large-scale graphics.
Levitt Bernstein say these have created a “social, café-style environment”, with “clear, colour-coded way-finding systems”. The overall feel is a radical departure from conventional hospital waiting and treatment areas.
Early involvement
Asked why the trust decided to go down the ‘collaborative design’ route for such an important facility, Dr Murdoch told us: “We’d had a really positive experience of involving patients and staff in co-design of our pharmacy, and there were lots of key people within the organisation who thought that was a good way to go and would give us a good result. With ambulatory care, we were designing a unit when people don’t really understand the model yet, because it’s novel.”
Co-design workshops included more than 70 people across the trust: managers, clinicians, administrators, infection prevention staff and patients. There followed the creation of models and then full-scale mock-ups, including every element: treatment rooms, sluices, scanners, ultrasound and phlebotomy, as well as support and outreach resources for teleconferencing, seminars and integrated community services spaces.
Dr Murdoch said: “It’s much more inclusive. We designed our unit with the most vulnerable people in mind – for patients with dementia, or bariatric patients, for paediatric services and so on. It’s a much more ambitious ambulatory care unit than anywhere else.”
Oliver Marlow, design director at Studio TILT, added: “Transforming public services has to begin with people. Using a collaborative approach to design ensures the purpose of the space is understood from all perspectives and enables the culture of the space to form the design. Putting people at the heart of design has proven to enhance patient and staff satisfaction, transform processes and training, improve risk management and make dramatic efficiency savings.”
He explained that the design switched corridor and treatment rooms, so it is the rooms receiving the most natural light and ventilation. This is not just a ‘nice to have’ – many studies show the benefits of such factors on staff wellbeing and even productivity.
Allowing more light to penetrate the space in this way represents a “stepping away from institutional aesthetic conventions”, according to the architects and designers.
Dr Murdoch explained: “The collaborative effort has produced a beautiful yet functional space where the patient experience is excellent, there is lots of interaction and the clinicians can function efficiently.”
Comfortable and relaxing
Feedback from patients has been excellent in its first months since opening. One patient was quoted as saying: “It’s very comfortable and relaxing. I can chill out while I’m waiting.
“It’s fresh-looking, bright and cheerful. The staff are very nice too. They couldn’t do enough to help and were very quick to see to everything.”
The unit has “unobtrusive but specialised provision for CCTV, access control and a panic alarm for the new unit”, while infection control was prioritised in both the materials used and the design.
Dr Murdoch said: “We needed a space that would be future-proofed, but also day-to-day proofed. We couldn’t have ‘difficult’ areas that would need repeat cleaning. We talked to staff about how they would use the space – if they were likely to be carrying waste or bodily fluid for example, we don’t want them walking past the reception area.
“It’s key, thinking about how to provide a nice, clean space that works clinically. Designing a clinical space that doesn’t have infection control as an absolute key consideration would mean you’re not running an effective clinical space. Overall, it’s been fantastically successful, and we want to spread the model.”
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