The future of emergency departments in Australia

By the time the design and construction of a new hospital is completed in Australia, it may already be outdated due to a lack of flexibility and the rapid development of technologies and services. Design and construction limitations were highlighted during the pandemic, and in the shift from face-to-face services to remote telehealth services.

While telehealth services continue to grow as important tools for providing care to our growing population, who knows what’s coming next?

In order to think beyond the present, this study focused on an often under-utilised resource - the patients themselves. Ordinary people can imagine extraordinary possibilities, without being weighed down by economic limitations, or with expectations formed by existing systems.

Sara Chirichilli, Masters of Design scholar from Edith Cowan University (ECU) recently collaborated with designers from Hames Sharley who participated in peer review sessions and post-hoc discussions relating to her research topic, Future of Australian Emergency Departments: A Practice-Based Speculative Design. ECU co-supervised the research study with Hames Sharley’s Research & Development and Health Portfolios, based on collegiate contributions from leaders in education and industry.

Sara’s study identified existing and potential future gaps in the transition to optimising ED healthcare modalities of the future and the design of Australia’s EDs. The patient-focused study applied a speculative design methodology to explore complex problems and generate community discussion. Gaining insights from patients’ perspectives on ED design is largely ignored by the extant research, and current published policies and guidelines typically emphasise the viewpoint of the primary medical practitioner.

This research explicitly focused on the views of the ‘end-user’ (recent patients) and how their experiences could be incorporated into the design thinking process. The study co-designed workshops to initiate conversations about complex issues, and re-framed healthcare to speculate on what ED technologies and services could be like through different versions of the future; utopian, dystopian, the current trajectory, and how embracing technology in health services could affect doctor-patient relationships. With long-term ‘future-proof’ design solutions in mind, the research aimed to respond to future challenges as medical technologies and their applications continue to evolve.

The co-design method allowed participants in the workshops to be actively involved in the design process, and their insights were developed into infographics and three complete models depicting the various future ED scenarios. The study contributes to the body of knowledge and discourse relating to speculative scenarios in future health-related technologies, how this technology-based medicine affects doctor-patient relationships, and the provision of ED, and modalities of service design that inform hospital built form.

Key Findings:

  • For current and future technologies to work in tandem with an ED spatial design, a comprehensive plan casting foresight much further into the future is required
  • Increased implementation of technology and telehealth improve service scalability and optimises doctor-patient connection, but face-to-face care is still essential
  • “sterile” and “distancing” qualities of technology-driven care, will further emphasise the significance of spatial design for human connection in doctor-patient relationships
  • To ‘future-proof’ EDs, the spatial design must be forward-thinking and involve community collaboration to consider the possible future uses of space—including technology.
  • A pathway towards the envisioned utopian future of ED service design requires a holistic approach to technological implementation that facilitates user-friendly design, data sharing, and clear communication.
  • Cooperation is required in the integration of technologies and systems across different sites; good communication within this digital ecosystem are the major differentiators.
  • Substantial changes will be required in aged care systems and preventative community healthcare to decrease chronic and low-acuity patient numbers requiring centralised emergency healthcare, and to support growth in our ageing population.
  • Drawing richness from (former) patient-based qualitative data and insights can benefit designers and medical practitioners, leading to a better understanding of future services.
  • This study and methodological approach, and empathy-based model develops prototype for a larger-scale study, that distils complex concepts into digestible community dialogue.

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