Australia is a privileged society. We boast first world health care with some of the world’s leading medical practices, but we are still far from perfect. Many hospitals, while delivering outstanding medical outcomes, are drab, soulless places.
What can we do to fill the void of emotional care and wellness in our hospitals, and how can we keep providing outstanding medical care whilst giving respect and dignity to the person to whom we are delivering that care?
Some of the answers may lie in reverse innovation from our northern neighbours. While medical outcomes are not always better than ours in Australia, where there are fewer resources, there is often greater resourcefulness in the way care is delivered.
Throughout my career I have been involved in hospital design throughout Australia, Papua New Guinea (PNG), China, Indonesia and other parts of South East Asia. In this time, I have seen six key principles we can learn from our neighbours in regard to hospital design and delivery of care:
Beyond Patient-Centred Care
We know that patient-centred care delivers better outcomes for the patient, and many hospitals have brought patient-centred care into their practice. However, if we could bring the family carer model from the South Pacific and Papua New Guinea (PNG), we could integrate best practice medical care with a personalised care model which values the patient at an individual level.
From a design perspective, providing facilities for family and friends as carers means including space for them become a part of the activities within the hospital in order to attend to the physical and emotional needs of their loved ones. It also means providing accommodation and facilities for family members who choose to care for their loved ones during their hospital stay and can assist staff and even reduce support staff needs.
Education is crucial in PNG and the South Pacific, where patients are often released into family care for the majority of their convalescence. Structured education about hygiene, nutrition, care and disease prevention starts at the hospital entrance and continues throughout the whole hospital. What’s more, education is integrated with cultural and religious beliefs and delivered in the language of the family by educators and counsellors who are an integral part of the delivery of service.
Due to long-held cultural fears about hospitals as ‘houses for the dying’ in PNG, new hospital design incorporates a welcome to the whole family from the front door. Several years ago, I was involved in the master plan of the hospital in Mt Hagen, a place where patients and their families are treated with dignity and respect by people who speak their language, identify with their culture, and provide understanding, direction and a sense of hope.
Religious beliefs are supported by the existence of faith centres, family accommodation and even regular market days within the hospital. Hospitals can be designed to make patients and their families feel welcome and safe rather than lost in a maze of corridors and information.
Through my involvement in hospital design throughout Asia and the South Pacific, I have seen close attention paid to orientation, ventilation and natural light as a key priority in patient wellbeing. Over many years in Australian hospitals, balconies have been closed off and windows shut permanently to allow cheaper operation of heating and cooling systems. Greater attention to natural light and ventilation is also known to decrease hospital stay length, reduce depression, improve sleep, and lessen agitation and pain, as well as increasing the quality of the working environment for the hospital staff.
Other sustainable design principles all contribute to the wellbeing of patients and staff as well as reducing operating costs in the long run.
Reflection of Senses
It seems to be common sense that a patient who is bathed in natural light, can feel a breeze, hear the birds, see the trees blowing in the wind and can smell the aromas of foods would have a greater sense of wellbeing. However, for much of the 20th century, hospital gardens and green spaces were largely forgotten. On visiting several hospitals throughout the South Pacific, I noted that the position of hospitals was often conducive to a heightened sensory experience by the colocation of large green spaces, even in semi-enclosed buildings in China and South-East Asia.
While much of PNG and the South Pacific still relies on quite basic health technology which experiences regular reliability and support issues, China and South-East Asia have hospitals which operate at the other end of the spectrum, including integrated technologies more advanced than our own.
Imagine if Australian hospital design could incorporate the best of western medical technology, practice and placemaking as well as incorporating reverse innovation from our South Pacific and Asian neighbours.
We could see the creation of health, knowledge and living campuses which include a public and private hospital, an aged care facility, a research and education precinct and a retail centre, incorporating sustainable design and a multi-sensory experience for patients, carers and staff.
Giant shopping centres could be transformed into bustling retail, residential centres with aged care facilities, commercial premises and university education.
The opportunities are limited only by our imagination.