Architects are temporarily crippling themselves to understand hospital users’ needs. We joined them in a painful exercise in empathy
I am struggling to make it to the end of the corridor. My feet ache with every step, I have to fight to open doors and I can’t see properly.
I am a perfectly healthy 27-year-old man, but a short walk around a hospital has become a real effort and I feel cocooned.
My knees are stiff, I can’t lift my arm properly to pull on the door handle, and I am having trouble gripping anything.
I am struggling because I am wearing a movement-restricting suit developed to improve the design of new hospitals. The suit - an assemblage of Velcro grips, straps, splints, obscured goggles and gloves attached to a boiler suit - simulates what it is like to have a number of debilitating disorders, such as cataracts, arthritis and back problems.
The suit’s designer, Skanska design manager Howard Jeffrey, is touting it as the latest way to ensure designers don’t fritter away the billions being pumped into new hospitals. It has been used on the £333 million redevelopment of Derby City General Hospital by Capita Symonds, due for completion in 2008, and may also help designers to meet Disability Discrimination Act requirements in other, nonhealthcare buildings. It is an invention to make Heath Robinson proud and could change your perspective on the importance of user-friendly design for good.
After I am trussed up like a turkey in the series of corsets, restraining splints and goggles with scratched lenses, I take a walk around an existing ward at Derby, following in the painful footsteps of a pair of architects who used the suit to inform the design of the new hospital.
The effects of the suit are not revolutionary. Rather they are the sort of insights that seem obvious, but would not have occurred to you had you not worn the suit.
Thanks to the buttons sewn into the suit’s socks that make walking more than 10m excruciating, you realise that a patient with arthritis of the feet will not want to walk very far because of the discomfort.
One of the architects at Capita Symonds, Gordon Knowles, wore the suit, and realised that many en-suite wards are too large for people with impaired mobility.
He is using the experience to design a new en-suite bed for the NHS that uses less space.
This has major cost implications on tightly budgeted PFI hospitals. “We are trying to get the quality of the space without just adding area. Obviously, with PFI you need value for money, and this approach can deliver that. From wearing the suit we are finding that it is the quality of the space that is important. Not the quantity.”
Knowles also found that the suit enabled the team to fine tune the design within the tight timescales of PFI projects. “The suit can deliver value for money because a small change on a 1,000-bed hospital has a huge effect on the overall job,” he says.
I'm trussed up like a turkey in corsets, restraining splints and goggles with scratched lenses
As a result of the suit, Capita Symonds made lots of simple but significant changes to the design of the hospital that will make a huge difference to the patient experience; simple changes such as the height of tissue dispensers and the positioning of wash basins. It has also reinforced the architect’s argument for bolder colours as they make navigation easier for patients with impaired vision. Knowles says: “Sometimes getting colours into a scheme can be fraught, but the suit reinforced why we needed to use the colours.”
He also believes that the suit helps to “soften the relationship between the client and the architect”, because the client can understand why changes need to be made, and that they were based on quantifiable research.
Jeffrey developed the suit after he saw something similar designed by Loughborough University and the Ford Motor Company to simulate old age. The suit was part of his PhD at Salford University on improving hospital design. He worked with physiotherapists at Derby City Hospital to develop the suit to simulate a series of conditions.
“It was always the intention for an architect to wear the suit and use it to interrogate the design of hospitals,” he says.
Jeffrey is in the process of securing copyright for his design and is negotiating with Derby City Hospital and Skanska over who will own the concept.
He hopes it will be used to design hospitals across the country, but it could also be used for a whole range of buildings with public access, says Derby City Hospital assistant chief executive Brian Ibell. “It could become one of the many tools for the design of all new buildings.”
Ibell hopes the suit will be picked up by the Department of Health and the Private Finance Unit as a “simple and cheap” way to make sure new hospitals are designed properly.
“We are embarking on one of the largest hospital-building programmes in history, and it would be very disappointing if we find we have made fundamental errors at this stage,” he said.
Knowles says the suit can help architects to address a tendency to focus on pure design rather than what people need. He believes it would make an excellent learning tool. “There is a tendency on university courses to focus on technology and style, but the understanding of people in the building is key,” Knowles says.
It also offers a more practical way to make sure buildings meet the DDA — a refreshing change from the “usual box-ticking”.
Before I get back to my normal life, there is one further dignitybashing revelation. Pushing through a swing door, I realise that the automatic door closers pull shut behind you far too quickly when you can’t walk very fast. The closers make it difficult to pull the door open in the first place, but to add insult to injury they knock you on the backside on the way out.
Little things like that make a difference, and this suit helps architects, and their clients, to wake up at last to the vagaries of their own designs.