In a period of unprecedented pressure on healthcare systems, one project stands as a powerful reminder of what can be achieved when diverse communities-of-practice unite around a shared goal of improving the quality of life for patients at the end of life.
A landmark research collaboration is currently underway, bringing together researchers from clinical, architectural, technical and academic backgrounds. Led by Hames Sharley, in partnership with St Vincent’s Hospital Sydney, Sacred Heart Supportive and Palliative Care Service, a metropolitan acute inpatient palliative care ward, Gabriels Hearne Farrell, Edith Cowan University (ECU), the University of Southern Queensland (USQ), and an Intensive Care Specialist from Fiona Stanley Hospital, the study focuses on the built environment and its effects on sleep, comfort, and clinical care. It explores how environmental conditions, specifically noise, temperature, and lighting shape the experiences of patients, staff, and families in these sensitive settings.
While the findings will be reported in full through forthcoming peer-reviewed publications, the project itself already demonstrates the transformative potential of insights derived from interdisciplinary collaboration in healthcare research and design.
Why this work matters
Palliative care environments are among the most emotionally and physically demanding spaces in healthcare. Patients in these settings are often vulnerable, with complex needs. Families may be navigating grief or uncertainty. Staff are under constant emotional and clinical pressure.
The design of the physical environment is often overlooked or treated as a secondary concern, but it can be a powerful contributor to all occupants. In a truly holistic model of care, the environment is not just a backdrop but an active contributor to comfort, dignity, and wellbeing.
This study is not simply asking whether environments are too loud, too bright, or too cold. It is investigating how these factors interact over time, how they affect perceptions of comfort, and how subtle changes could lead to profound improvements in patient wellbeing and staff support. Sleep is a central focus, recognised as essential to healing, dignity, and quality of life in palliative care.
Informed by global literature and prior ICU-based research, the project recognises that palliative care environments are complex ecosystems. By capturing data over time, across different room types, and involving both staff and patient perspectives, it aims to build a more holistic understanding of what supports (or disrupts) a restful, dignified experience.
A community-of-practice in action
This study exemplifies the power of a community-of-practice model, an approach where individuals with shared interests and complementary expertise work together to produce outcomes that no single discipline could achieve alone. From the outset, this project brought collaborators together in a spirit of open collegiality.
Frontline staff contributed crucial insights into the operational realities of ward life, researchers helped shape the data collection and analysis methods, technical experts analysed and interpreted the data, and designers played a critical role in translating the data into meaningful design-related questions: How do temperature fluctuations affect comfort? Can acoustics be improved without major infrastructure change? What lighting design supports both rest and care delivery?
By grounding the research in real-world clinical settings and involving those who live and work in these environments on a daily basis, the project has ensured that its outcomes are both meaningful and applicable.
Laying the groundwork for change
Although a number of scientific papers are still forthcoming, the project is already laying the foundation for change - it has demonstrated a replicable, low-impact method for evaluating built environments in sensitive care contexts. It has created new frameworks for involving clinicians and patients in evidence-based design. And it has helped all parties’ researchers, designers, and healthcare providers see the care environment not just as a backdrop to care, but as a vital component of care itself.
The ultimate goal is not just to publish academic findings, but to influence practice: from informing future updates to the Australasian Health Facility Guidelines, to guiding the design of new wards, and prompting small, targeted upgrades in existing facilities.
Looking ahead
This work is part of a broader movement towards a more patient-centred healthcare approach. As Australia’s population ages and more people spend their final days in institutional settings, the need for high-quality, supportive environments will only grow.
At Hames Sharley, we are proud to contribute to this vital area of research and advocacy. We believe in the power of design to shape experiences, and in the power of interdisciplinary collaboration to push boundaries and deliver meaningful change.
The first articles from the project will be submitted for peer-review very soon, including the design of the research and methodological approach, and on the environmental performance data and staff feedback gathered. Subsequent publications will include insights from patient and family perspectives.
In the meantime, this project serves as an inspiring reminder: that when we listen closely, work together, and bring our best thinking to the table, we can help create healthcare spaces that not only support clinical outcomes, but uphold dignity, compassion, and care at life’s end.
