Students are to gain an understanding of hospital life, systems and
services. The aim of this research will be to improve medical care
at hospital with emphasis on safety and dignity. Research will be
undertaken at both Tallinn University of Technology and the North
Estonian Medical Centre (PERH).
- Prof. Martin Parn
Team: Dyre Magnus Vaa, Kristel Laur, Matthew Mccallum & Mike Negrello
Supervisors: Martin Pärn, Janno Nõu TTU Design & Engineering
We are a multidisciplinary team with backgrounds in industrial design, architecture,
carpentry, building science, interior decoration and psychology.
Where we started
Before our initial research visit to the hospital we shared our personal experiences and
perspectives of hospital care. Based on these discussions and our skill sets we chose to
focus on patient dignity.
Patient dignity is feeling
valued and comfortable
psychologically with one's
physical presentation and
behaviour, level of control
over the situation, and the
behaviour of other people
in the environment.
Understanding Patient Dignity
In this chapter we will explain the different aspects and
terminology that define patient dignity such as privacy, control,
empowerment and the environment . We will also discuss problem
areas at PERH and other hospitals and the developments being
made to overcome them.
To understand the concept and importance of dignity for our project we undertook
research using a variety of methods including:
• Visits to PERH to observe patient care, equipment, environments and services
• Discussions with staff and patients both past and present.
• Simulating a ward interior in 3D CAD software based on PERH floor plans.
• Theoretical research from the perspectives of psychology, product design, interior
architecture and hospital policy.
• Analysing innovative approaches and solutions in areas such as public and private
• Through the following chapters we explain our findings, process and analysis.
Our first visit to the hospital focused on
documenting efforts towards maintaining
or reducing patient dignity. We split into
two groups to cover the multiple patient
and staff areas. after the three hours
spent at the hospital we combined our
photographs and notes with each other
and fellow classmates to form a broad
understanding of different aspects to
improve and develop.
One issue that raised questions and our
interest was differentiation in private,
single-bed and multi-bed wards. This was
supported by the increase in private single
bed rooms from one to three on the newly
renovated wards. We also noticed that in
the shared four patient rooms that there
was a dramatic lack of curtains (fig.1),
control over environment and the shared
Another interesting point was the lack
of improvement between the old and
renovated rooms in terms of privacy and
patient dignity. However, the difference
between furnishings of the private and
shared is further exaggerated.
These observations inspired further
research into room layout and creating
personal space and privacy between
On our second visit we focused mostly on
what patients bring to the hospital and
where and how they store their things.
Some examples of things that people take
with them to the hospital or have/keep
close to them are: mobile, laptop, book
and magazines, drinks and glass, toiletries,
some food/snacks, a hair brush and a few
We noticed that many people have multiple
electronic devices such as computers,
smartphones and tablets in addition to
what items hospitals recommend. These
use of these devices also raises questions
over their benefits for personal privacy
and the impact on others dignity. Patients
could potentially be using technology to
escape to a virtual world or to participate
in work or socialise with others. However,
the presence of these devices highlights
the lack of suitable and secure storage
available to patients. These devices also
require regular access to a power source
which further complicates the security and
working environment for the nurses.
The other problem the current storage
cabinets create is their low height
cupboards and non-ergonomic limits
access for patients whom are disabled
or bedridden. The combination of these
discoveries inspired further research
into patient storage facilities and usage
Table: The main differences in single-bed and multi-bed ward.
factors and social
6m squared per person
Work table- chair
Chair for visitors
Wardrobe for your clothes and
Bedside light on wall
Plastic chairs for visitors that are
shared with other patients
Room light (often regulated
outside the room)
Bedside light on wall (which is not
BATHROOM - Private
BATHROOM - shared with others.
Toilet, shower, sink, shared fridge
in the corridor with other patients
on the floor, dividers (2 pieces per
floor) - usually only in intensive
care, general lighting, windows
(fresh air + natural light), door, TV
(that is not yet present)
Patient controls all aspects in
Patient can’t control all aspects
physical environment in his/
in physical environment in his/
her room (including windows - her room ( windows - fresh air +
fresh air + natural light, door)
natural light, door, general light,
- patient is not seen, heard by noise from others etc)
- Patient can control bed and
- Patient can choose when
to see, hear, smell etc. the
others(patients, visitors) - Patient and his/her personal
except doctors, nurses, some space is like a “stage” for other
other hospital staff.
patients/their visitors at room
- Patient can use his/her
personal space/territory for
personal activities, without
permission of others or he/she
does not have to worry about
bothering the others.
2m squared per
- Doctors, nurses and other
hospital staff are free to visit
- You can’t always use your
personal space for your personal
activities without permission or
thinking of others. They can also
Single vs double rooms
The nurses mentioned that private rooms
are becoming more and more popular and
the prefered option. In the renovated ward
the cost for this room is currently fifty euro
The nurses also felt that the patients did
not mind not having curtains but they
wished they had more of the portable
dividers (fig.9) to divide male and female
We also discussed the nurses thoughts on
arranging the beds in different ways and
in non-perpendicular to the wall scenarios.
They felt that this would be ok as long as
access to the services panel behind the
patient was maintained.
New and old wards
The nurses had mixed reactions to the
changes between the old and renovated
wards. We received comments about
the ventilation being worse such as “the
walls don’t breathe the same”. as well as
comments about the ceiling height and
lighting conditions. (fig.10,11)
This inspired us to want to have a positive
impact on the renovation of the remaining
There is no universal description of the
term ‘‘privacy.’’ However, a commonly
accepted aspect of privacy is that it is a
fundamental human need and right. The
term is generally described as the ‘‘state of
control,’’‘‘freedom of choice,’’ ‘‘withdrawal of
interaction,’’ and ‘‘a zone of inaccessibility.’’
Types of privacy, based on Akyüz and
Erdemir research (2013).
or social status. Furthermore, it has been
used to describe states characterized by
possessiveness and control over an area
of physical space. An individual wants to
arrange an appropriate environment for
himself or herself, form a social circle and
maintain this order, and to control his or
her interaction with other people.
Psychological privacy concerns the ability
of human beings to control cognitive and
Physical privacy is the control of the
affective inputs and outputs, to form values,
individual over their surrounding physical
place; it also refers to physical contact with and the right to determine with whom and
under what circumstances they will share
other people and the intimacy level of this
contact. Physical privacy includes the terms thoughts or reveal intimate information.
Burgoon(1982) links up the concept of
‘‘personal space’’ and ‘‘territoriality.’’
privacy with the functions it performs.
Sommer (1969) described personal space
These have to do with the development of
as an invisible place surrounding the
personal autonomy, growth, self-evaluation,
human body, an individual area separating
self identity, and self-protection.
people from one another.
The concept of territoriality refers to a
Social privacy means managing social
physical place such as the home and
relationships and controlling the parties,
room, or a place in an official building (e.g.
frequency, duration, and scope of these
a hospital); sometimes, it has also been
relationships. Altman and Winsel suggested
used to refer to a certain knowledge area
that social privacy combines the control
of both personal social skills and social
partnership. Social privacy necessitates
evaluating people as individuals and groups
according to cultural factors. The level of
this privacy depends on the individuals’
limits of managing and controlling other
people’s activities, whether directly or not.
and Erdemir research (2013), additional
authors have pointed out.
Physical privacy in healthcare settings.
The patient’s room at a hospital differs
from his or her room at home in terms of
its order, plan, illumination, color, heat, and
the people in it and is not an environment
arranged according to the patient’s own
Informational privacy means that an
will and control. Restricting the personal
individual controls other people’s access to places of the patients at hospitals (setting
his or her personal data and can protect
physical restrictions) and interfering
himself or herself against revealing such
with those places (the patient’s room
data. Informational privacy has been
or body) mean interfering directly with
defined as the right to decide how, when,
their privacy. Lesley Baillie’s thesis (2007)
and to what extent one reveals personal
is an important material about results
data. Developments in and increased
from different researches about dignity
access to communication technologies
and privacy matters. Here are some of
present potential risks to data security: how the highlighted results. Patients have
data are recorded, which data are to be
been found to dislike wards that allow
used, and by whom.
inadequate privacy and personal space
(Douglas and Douglas, 2004) and small bed
Privacy in Hospital Context
spaces leading to close proximity of beds
threaten dignity (Seedhouse and Gallagher,
Aküz and Erdemir (2013) research
2002; Woogara,2004). Woogara (2004)
describes, how within health-care
highlighted the open nature of wards which
environments, people experience
are designed for observation not privacy
complicated and private events, and nurses and Johnson (2005) suggested such designs
are central to these experiences. Such
provide unacceptable levels of privacy by
environments include inequalities between today’s standards while acknowledging the
the service provider and receiver, and new
tension between promoting privacy and
roles and expectations, thus threatening
the autonomy and privacy of individuals.
Hospitals have limited resources to control In healthcare settings, patients are
the physical environments of patients,
generally expected to share their
and patients are mostly deprived of their
bedroom with complete strangers and is
privacy and experience stress in hospitals,
perceived by some patients as a loss of
and that intruding into personal spaces
privacy(Jacelon, 2003; Kirk, 2002; Woogara,
results in personal trauma and causes the
2004). Two studies in terminal care found a
person to withdraw from social interaction. preference for single room accommodation
They suggest that privacy in the field of
(Kirk, 2002; Street and Love, 2005) and
health care should be considered within
participants in some acute care studies
its physical, social, psychological, and
also expressed that single rooms offered
greater privacy (Matiti, 2002; Woogara,
In our project we focused more in physical
and a bit in social privacy. During our
Social privacy in healthcare settings.
research and project development we also Social privacy means the control of the
see how these different privacy aspects
individual in an interaction, and this
are related as research material refers.
control passes to health-care personnel
The following definitions, descriptions,
in healthcare settings. Enabling and
and examples are based mainly on Aküz
maintaining privacy in professional
relationships is a right, and every right puts
others (professionals) under an obligation
to perform (positive right) or not perform
(negative right) a specific task. In multi-bed
ward social privacy is affected also by other
patients and their visitors.
space and entering somebody else’s
personal space are indicators of perception
of the relationship between the people.
A person’s personal space (and the
corresponding physical comfort zone) is
highly variable and difficult to measure.
Estimates for an average Westerner, for
Psychological privacy in health-care
example, place it at about 60 centimeters
practices. Violating the privacy of a patient
on either side, 70 centimeters in front and
may result in deep trauma, whether
40 centimeters behind. Personal space is
apparent or not. The fact that health-care
highly variable, and can be due to cultural
personnel violate or fail to consider this
differences and personal experiences.
right of the patient may result in the person Personal space refers to the space an
feeling undervalued, social withdrawal, or
individual maintains around him or herself,
loss of self-confidence. As a result, patients while territory is a larger area an individual
may constantly feel uncomfortable and
controls that can provide privacy (for
restless while at hospital, which may lead to example, an office or a specific chair in
permanent problems, depending on their
the conference room). Invading another’s
territory may cause that person discomfort
and the desire to defend his or her space
Informational privacy in healthcare
(by turning away or creating a barrier, for
practices. Health-care practices are based
example) (Argyle, 1988).
on information, and the management
of collecting and distributing data by
Hall (1966) describes the subjective
the rapid developments in information
dimensions that surround each person and
technologies and by electronic records is
the physical distances they try to keep from
precarious. Another aspect of informational other people, according to subtle cultural
privacy relates to informing the patient.
rules.There are different zones: intimate
Information is very valuable for the
space (for lovers, children, close family
patient. Patients’ expectations regarding
members), personal space (for friends,
family, to chat with associates, and in group
privacy include not only confidentiality of
discussions), social space (reserved for
their medical records but also facilitating
strangers, newly formed groups, and new
and supporting their physical, interactive,
acquaintances), public space (used for
and psychological privacy by informing
speeches, lectures, and theater; essentially,
them of related procedures and decisions.
public distance is that range reserved for
Territory and Personal Space (Proxemics)
Related to physical and psychological
privacy there is an important concept
about personal space. Personal space is
the region surrounding a person which
they regard as psychologically theirs (Hall,
1966). Edward T. Hall, calls this area of
research, that examines how people use
space, proxemics, which he defines as the
study of people’s use of space as a function
Most people value their personal space
and feel discomfort, anger, or anxiety
when their personal space is encroached.
Permitting a person to enter personal
Credit: Google image search
In privacy context there is need to define
perceived control and privacy regulation
Perceived control is the belief that one can
determine one’s own internal states and
behavior, influence one’s environment,
and/or bring about desired outcomes.
Already in 1987 Wallston et. al. mentioned
that theoretically, and to some extent
empirically the perception that one has
control over what occurs in a given health
care setting results in a better adjustment
to the setting (e.g., less anxiety or other
forms of distress; greater satisfaction and
well-being; less reactance behavior such as
noncompliance or other forms of “acting
out” or expressing anger or frustration)
than not perceiving control. Future trends
in social and health care are moving more
to patient empowerment approach (for
example European Network on Patient
Empowerment). Our topic and challenge
in this context has a small part, but is still
“Patients who have a
sense of control recover
more quickly. “One of
the worst things about
being a patient is that
you don’t have control
over what is happening
to you or around you,”
- Doug Bazuin,
Senior Researcher at Herman Miller.
important in the main approach.
We believe that giving more and accessible
control over your personal space and
territory empowers patients and supports
their recovery process and wellbeing.
As some research material in general
empowerment field have shown (Wang et
al, 2007, Wallston et al. 1987).
Here it is also important to mention the
social privacy aspect because in multi-bed
wards patients are “forced” to be together
with strangers and often their privacy and
personal space is threatened or violated
by other patients and their visitors. At
the same time the these people can play
important role in positive socializing,
helping to avoid loneliness feeling.
Photo collage indicating methods of
Social psychologist Irwin Altman (1975)
developed Privacy regulation theory, that
shows how the physical environment and
control over it can support privacy including
hospital context. This theory explains why
people sometimes prefer to stay alone
but at other times like get involved in
social interactions. Traditionally, privacy is
regarded as a state of social withdrawal
(i.e., avoiding people), but Altman says that
privacy is not static but “a selective control
of access to the self or to one’s group”.
Therefore, people might want to avoid
other people at a particular time but desire
contact at another time.
Altman believes that the goal of privacy
regulation is to achieve the optimum level
of privacy (i.e., the ideal level of social
interaction). At the optimum level of
privacy, people can experience the desired
solitude when they want to be alone or
enjoy the desired social contact when they
want to be with others. If actual level of
privacy is greater than the desired one,
is an approach that
aims to establish the
patient’s autonomy and
that feel a sense of
control over their care
and can become more
faster and will have a
- Peritoneal Dialysis International, Vol. 27 (2007),
people will feel lonely or isolated; on the
other hand, if actual level of privacy is
smaller than the desired one, people will
feel annoyed or crowded.
In order to regulate privacy successfully,
people use a variety of behavioral
mechanisms such as verbal, paraverbal
and non-verbal behavior, environmental
mechanisms of territoriality and personal
space, etc. By combining these behavioral
mechanisms (i.e., techniques), they can
effectively express and control their desired
privacy level to others.
If we talk about privacy and personal space/
territory there is often present the need to
“sign” one’s territory. People seem to have
a human need of personalization. There
are not much specific studies in hospital
context. Brunia S. & Hartjes-Gosselnik
A. (2009) tried to explain this concept
in their research in workplace context.
They found several research materials
that a regularly mentioned motivation for
personalization is the feeling of control and
creating a territory. Following references
supported their research. People can feel
a psychological ownership over a certain
space or workplace (Spicer and Taylor,
2006). Also Wells (2000) mention that a
feeling of personal control is an important
motivation for personalization. Wells
(2000) adds that personalization can be
used to feel like an individual rather than
a “cog in a machine,” to cope with stress
by relaxing and inspiring, to reminding of
lives outside the office and to enhance a
person’s attachment to the environment.
Personalization is used to make sense
of space. We can argue whether this is
also valid in hospital context, but we can
consider this aspect during our project
development, but we can’t overlook this.
There is also study of how personhood
is maintained in a hospice, Kabel and
Roberts (2003) found that patients
personalized their space with photos and
items from home, which could be a way
of patients exerting some control over
their surroundings, as well as reducing
We also believe that through the
personalisation of patients space there
could be an improvement in visitor
orientation and reduce cases of mistaken
The built environment significantly affects
the healthcare experience of patients
and staff. Below we will present some
research results. There is a big opportunity
and challenge of improving healthcare
experience and satisfaction through better
Quan et al (2012) mentioned in their
article several studies and evidence
that indicates that healthcare physical
environment plays an important role in
improving the experiences and satisfaction
of patients and staff. Research has also
identified patient satisfaction with the
physical environment as a significant
factor in determining a patient’s overall
satisfaction with healthcare services—
ranked only behind nursing quality and
clinical quality (Harris, McBride, Ross, &
Curtis, 2002). Lawson and Phiri (2003)
concluded that patients who are happier in
their environment transfer these feelings
to their assessment of other aspects of
their experience. In addition, staff may feel
more positive in a better environment and
portray this to patients in their behaviour.
According to Baillie (2007) environmental
factors such as a lack of privacy,
inadequate resources both physical
and human and a dehumanizing ward
culture and organisation have all been
found to threaten dignity. Based on
Reiling et al (2008) theoretical research
findings, patients and families tend to be
more satisfied with single-bed rooms,
that enhance patient safety and create
environments that are healthier for
patients, families, and staff by preventing
injury from falls, infections, and medical
errors; minimizing environmental stressors
associated with noise and inefficient
room and unit layout; and using nature,
color, light, and sound to control potential
Douglas & Douglas (2003) described
in their research results that patients
identified having a need for personal
space, a homely welcoming atmosphere,
a supportive environment, good physical
design, access to external areas and
provision of facilities for recreation and
leisure. Responses suggested that patient
attitudes and perceptions to the built
environment of hospital facilities relates to
whether the hospital provides a welcoming
homely space for themselves and their
visitors that promotes health and wellbeing.
In hospital context cleanliness is something,
that is important and mentioned also
through research, for example Douglas and
Douglas, (2004) & Lawson and Phiri (2003).
accommodation is not
need to be redesigned
to allow for a really
wide range of different
patient needs. In the
ward this is often about
better use of small
- Priestmangoode Health Manifesto 2010
Virtual Environments as part of hospital
This was a topic of interest based on our
personal hospital experiences and our
observations at PERH. As computers have
become part of our everyday lives it is
becoming easier for patients’ to continue
work and socialising from within the
hospital context. We thought this trend
to would be interesting to explore in the
context of dignity and potential for virtual
space to influence perceptions of physical
Future trends in the healthcare system
are moving toward tablets, which are
available free or through rented service in
the hospital. For patients that can mean
different outcomes, for example available
reach to medical records and information,
health education, preventive medicine
and recovery instructions/trainings,
entertainment and also possibility to create
your own “bubble” through the use of
digital media devices allowing to connect
with the outside world from the hospital,
create your own virtual territory bigger,
to be connected to the wider world and
Judi Moline, stated already in 1997, in
her report how virtual environments and
related technologies are allowing medical
practitioners to help their patients in
a number of innovative ways (Surgical
procedures; medical therapy; preventive
medicine and patient education; medical
education and training; visualization
of massive medical databases; skill
enhancement and rehabilitation;
architectural design for health-care
Virtual environments present a unified
workspace allowing more or less complete
functionality without requiring that all the
functions be located in the same physical
Digital territory is a vision. It introduces
the notion of space and borders and
other concepts to better understand and
manage future. Digitisation is growing
and becoming increasingly ubiquitous;
in addition, the younger generations are
more familiar with the digital world than
previous ones. Jefferey, P. (1998) explored
in his study, whether the societal norm
of personal space influence behavior
during interaction and communication in
a virtual environment. The results showed
that personal space exists in virtual
environment and it influences behaviour.
Different technological devices work as
nonverbal communication and as “signs”
“Patients who have a
sense of control recover
more quickly. “One of
the worst things about
being a patient is that
you don’t have control
over what is happening
to you or around you,”
- Doug Bazuin,
Senior Researcher at Herman Miller.
and “dividers” in a psychological and
physical sense (as we also mentioned
before). This ideology can be related back
to machine behaviours for example sitting
behind computer, using headphones,
watching your mobile, sitting behind
the wall/cupboard can create a sense of
security and personal space and security
Reviews and Blog posts
In order to gain a deeper understanding
of patients feelings towards the hospital
environment we read reviews and blog
posts by past patients of hospitals around
the globe. This research painted an
interesting picture of the types of problems
patients face in relation to the environment
factors and a obscure usage scenarios
especially in foreign contexts. However,
the same themes emerged regarding
single and shared rooms and the negative
effects of sharing a personal space and the
security of ones belongings.
Existing Hospital Environments
This selection of images was found through Google image search.
In the hospital context, during the crisis
period of an illness, it is often necessary to
divide the territorial space with strangers
and thus, invasion of the personal and
territorial space of the hospitalized patient
suitable for storing common electronic
devices that today’s patients bring with
them such as laptop, tablets, smartphones,
e-book readers etc.
There is also limited potential for
personalising the space around them.
The rights of the patients to privacy,
respect, dignity and individuality are
mentioned in the Universal Declaration of
A current and somewhat effective method
hospitals are employing is the restructuring
or redevelopment of their wards to include
mostly or complete single bed hotel
type rooms. This solution provides many
improvements in for patient dignity such
as the ability to hold private conversations.
The negative effects from this solution
and trend is that it creates the potential
for patient isolation and increases the
workload for a variety of hospital staff.
Throughout our research we have
documented the important link between
dignity, privacy and control. We found that
privacy and personal space/territory have
been identified as an important aspects in
patient dignity, healing process, well-being
Privacy can be violated in a variety of
ways. For example: the right to enjoy their
property; the right to protect their medical
and personal information as confidential;
the right to expect treatment with dignity
during intimate care; and the right to
control their personal space and territory.
The research materials also highlighted the
importance of the patients having control
over their environment and interactions
with others whenever possible, reducing
stress and conflict, and disturbance by
others on sleep or relaxation.
Through different research materials
patients have been consistently
commented on the positive impact of a
pleasant environment on their health and
Lack of personal space is a common issue
within shared hospital rooms. Here we
found that patients have little control
over noise, vision, smell and lighting of
their environment creating a feeling of no
personal or private space. This is further
exaggerated by the dysfunctional storage
that restricts patients access to their
belongings. The storage is not secure or
The main problem for most hospitals
including PERH is the they cannot provide
single bed rooms for all their patients
without major redevelopment and
Our research also has helped define and
explain two key areas we believe most
concern patient dignity. These are patient
privacy & control or patient privacy and
We also broken those two into main
contributing factors as listed below or the
next stage of our project we will use these
factors as a criteria to develop concepts
and analyse their effectiveness.
Develop a new solution to improve patients feeling of control and
personal space within a shared hospital room.
Potential Outcomes: Improved patient feelings in shared rooms,
functional & flexible environments, tools that empower patients
and promote independence.
In the following chapters we will explore alternative methods
for creating personal space within a shared hospital room
environment. Our process will begin at a macro level where we will
look at the design of the whole ward and space. Next we will focus
on the design of the room both single and shared. lastly we will
explore the micro level or space within arms reach of a patient.
Our solutions will aim to be more human centered than user
centered by also considering benefits and effects for hospital
staff and visitors. We also want to reflect the values of PERH
such as being innovative and creating a supportive and healing
We started our concept generation process with inspirational moodboards reflecting the
criteria defined by our research.
The images used to compose the mood boards are from Google image search.
Macro - Ward Design
These concepts involved developing a 3D CAD model of the current hospital ward to explore new layouts and potential space saving. The aim was to create a separate physical
space for each patient. All the other services: toilets, shower rooms were collected together ( like in gyms, spas etc). In the middle of the ward situates the medical areas and
The patient bubbles are moveable and you can organize them according to the medical
condition of the patient or social needs. The ideas are to improve visual privacy based on
an open floor plan that will give natural light to more areas.
This concept was the most innovative and challenging one for the hospital as well as for
us. We saw huge potential with this concept and what it offered in terms of changing the
hospital experience for patients, particular for when new hospitals are built as apposed
to renovations as It would have had a long time frame for implementation and would
be economically costly. These were the main reasons we decided not to develop this
concept any further.
Local - Ward Design
These concepts explored a variety of methods to improve privacy and personal space .
We particularly were interested in solutions that also give natural light to everybody and
keep the area accessible and supportive to hospital staff. Some ideas were also based
on changing to way we use existing curtains and dividers and if they can offer more to
patients than what they currently have. These ideas were also explored in more detail
than the prior theme so we have used a key for each concept.
A) Inflatable dividers
Description: Dividers that are easy to inflate (because hospital has oxygen-lines/tubes
next to each bed. This condition helps to protect privacy in different ways: visual, smell,
noise/sound (from outside and also supports private discussions inside). Also we tried to
keep the accessibility, natural light to everybody and hygiene aspect.
The main problems appeared with inflatable-function - it can be noisy,it costs more
because you need a engine that continues to pump air in it, some controllable and
accessibility complications, quite difficult to keep it clean.
B) Self Standing Dividers
Description: Self-standing constructions that offer improved visual privacy and give
patients better control over their space. We also thought it may be possible to integrate
with cupboards to create multi purpose solutions. We explored using a variety of
materials such as textiles and construction techniques that could offer noise absorption
Below are dividers that are connected to the wall and that patient can open them to
create more private space.
Also more conventional dividers that are based on self-standing-construction idea.
Material: metal, wood, textiles, fabrics, plastic, paper.
Whilst these solutions offer improved patient dignity they were often clumsy and are
limited by the limited floor plan and design of the room.
C) Telescopic Curtain
Telescopic curtain solution from the ceiling or from the wall.
Construction and cleanliness are a big issue.us.
D) Horizontal Curtain
Description: Unusual concept, dividing room in horizontal way, using textile material, that
is easy to clean, change and that is comfortable. It also relies on the shape and textile
qualities to control noise and visual privacy. By placing the curtain closer to the patient
this concept offers an improved sense of control. The solution could also be changed
between patients increasing the sense of hygiene.
Psychologically too clinical and strange, also makes potential territory smaller and can
disturb hospital personnel work and efficiency. Can be difficult to manage by the patient,
if there are extra equipment and difficulties to move.
• Textile - noise/sound absorbing, dirt repellent, easy to clean (washing), “cosy”feeling,
not so expensive (that can reuse or replace easily), light reflecting (with metal colour),
textile can have a light and wavy feeling.
• Plastic - reasonable cost, easy to clean, you can use as transparent material, light,
inflatable, soft/hard, easy to create different atmospheres (prints etc)
• Combining textile & plastic
Micro - Patients Reach
These concepts explore ways can hospital furniture be designed and arranged to create
personal space. We feel that if patients can access and use their belongings easier then
they may be able to create a more comforting and personal space within the shared
In multi-bed ward the main things that belong only to one patient are a bed, chair,
Due to the renovations of the currently happening at PERH the room size will remain
unchanged, that means also that the space for one patient will remain almost the same
as previously (approximately 50 cm in both sides). The other consistent factor is that
patients will always require access to their belongings in some form. We decided to
looking for new possibilities how to improve personal space/territory and privacy through
This concept was the result of removing material from around the patient and what
remained was the storage cabinet for their belongings. The opportunity was clear, if we
lifted the cabinet up it has an added function of being able to block visual privacy from
other patients. There was also added feelings of hygiene as the belongings were raised
from the floor and allowed for better cleaning of the room. The challenge now was to
design a solution that kept or improved the functionality of the existing cabinets but in
this new location.
As we developed the concepts we noticed that building storage on or into the walls made
access for patients more difficult. Another issue was making something that did not look
bulky and clumsy on the wall next to the patient.
During our research we found that patients are more likely to bring expensive electronic
devices with them to hospital. Because of this we wanted to make our solution more
suitable for safely and securely storing these items.
We analyzed security aspect and tried to find solution to lock the cupboard when the
patient leaves the room and has to leave the computer, phone wallet etc.
The concept started from the traditional squared shape of the current storage cabinet.
To develop and improve this design we chose to add smooth and circular lines. This
not only made the cabinet look lighter on the eye but added functionality for cleaning
and reducing areas where dirt can become trapped. This process was prototyped in
cardboard, clay and foam board models at a variety of scales but mostly one to one.
We decided to find a shape that could be also pleasant in appearance.
We also analyzed and tested what kind of dimensions are optimal for the solution. we
questioned whether to give patients the same amount of space as in the old cabinet or
less space but more ‘useable’. This was to reduce the overall physical dimensions on the
wall and weight to make the cabinet light and easy to move. But at the same time the
volume had to be big enough to support privacy and personal space functionality.
Through analysing our concepts we thought it would be good if the cabinet was not fixed
to a single location on the wall but could be moved depending on patient disabilities or
function of the room. The following concepts included rolling or slid out compartments
as well as a free turning design that could pivot from an arm. The last idea could greatly
improve patients access to their belongings and offer other more ergonomic solutions
for eating and lighting control. To further develop this idea we analysed what patients
used or needed near them the most. This was based on our observations at the hospital
and research into what patients were asked to bring with them. The most common and
important item was a water bottle or cup.
Common patient items:
Not often used
• Magazines and books
• electronic devices - phone, laptop,
• Water bottle or drink
• cup for drink
• Toiletries - shampoo, soap, Hairbrush
• Change of clothing
Description:Textile covered solution is based on the idea of having a skeleton structure
that can be covered in a textile skin or membrane. This solution offers much potential for
personalisation and because it mostly textile it can be washed and cleaned easily
The pros of this solution are different material feeling in the hospital environment
especially with the effect of light lighting.. The textile cover could help to absorb noise
and every patient will get their own clean cover upon admission to the hospital. This gives
a more - more personalised feel and could even be decorated by the patient or their
visitors. The problems are that the hospital will have increased cost and workload in order
to maintain the cabinets cleanliness. Because the patients will move the cabinet with their
hands it can become dirty easily in everyday use. The textile design also can look more
fragile or not so stable and may be difficult to manage with different scenarios such as
spilling a glass of water.
These concepts propose modular attachments for drink bottles,
cups magazines etc. These elements add both functionality and
personality to the designs. They can also be removed for cleaning
in a dishwasher.
These concepts explore different methods of using the arm as both a support and
handle for patients. The designs add more strength and rigidity but have a significant
impact in terms of weight, complexity and aesthetics.
to the woll you can connect in two sides (which
are flat or almost flat)
front and side B
we can make it also
more rounder in different sides at the moment B side is not used - no function it can be magnetwall, but then it is more to other people direction /mirror?/ or
just clean surface :)
door can also work as a litlle
front view - more flat
side view A
door opens - 2 ways
I dont know yest
which one is better
a. 350 x 500
side B more flat
about 540 x 430
about 350 x 430
about 620-640 mm
Door/table solutions - can we find the
way how to open it from the bottom or
from computer shelf
open from B side
I didn’t manage to think more through - but this is the shape-idea
what are the deepness dimensions?
I also understand that we need to
modify this bottom part better, for
table use and construction :)
Scale Prototypes & Testing
We now present our innovative storage and privacy concept called
Swivel. This design offers patients a new level of privacy control
and access to their belongings. The shelves have been designed to
accommodate all the essential items a patient needs at their bed
including lighting and retractable power cord. We have included
a large lockable compartment via an rfid mechanism inside the
folding tray table. This will allow patients to safely store their most
important belongings whilst they away. The folding tray table has
also been modified to be easily removed for cleaning and can be
adjusted to suit the patients activities. The construction reduces
the amount of parts and joints greatly reducing hygiene issues and
makes cleaning easier.
Material & Construction
In order to choose the material we had to check which material on the market was the
most suitable for our cabinet. We opted for a polymer material because it can be very
smooth and produced able to be produced in a single piece. This is important to avoid
crevices where can harbor bacteria and also because it is not so heavy as wood or
metal materials. The material that we decided to use for the cabinet is from the group of
thermoplastic. We decided to use it because this material is easy to work compared to
the thermosetting plastics and also can be produced in a single piece without different
joints. The most common materials in the furniture field for its quality are polycarbonate
or other polyamid that can be reinforced with fibre-glass.
We did some research about how similar furniture designs are produced and found it
was by rotational-moulding. This method allows the cabinet to be produced without joints
reducing critical points for stress and hygiene.
This rotational moulding process is heavily used because it has low production cost
and and can give us almost unlimited design possibilities. This process gives us
the opportunity to manufacture stress-free parts with uniform wall thickness and
complex shapes.Furthermore It produces little waste, compared to other process as
thermoforming and plastic injection moulding, since the exact weight of plastic required
to produce the part is placed inside the mould.
Injection moulding would be our second choice for construction as it still retains many of
the positive aspects as roto moulding but with increased cost. Also this process is much
more complex and requires bigger initial investment to test.
Internal RFID lock mechanism
Rotating reading light
Retractable power cable
180 deg of movement
360 deg of movement
Easy access zones
Easy to clean hinge for
adjustable tray table
Stress & Deformation Testing
In order to calculate the final materials and details for our design we performed a stress
and deformation simulation using ANSYS software package. The cabinet will be hung
from a wall so we wanted to know how much weight the tubular arm can handle without
significant deformation or breaking. The straight part which will be a part of the wall
hanging is set as fixed support, as this will not move in any directions, other than rotating
around its own axis. The force put on the construction is the weight of the cabinet, which
is approximately 25kg + 10 kg worth of contents inside.
The results of the simulations shows that the maximum stress on the construction will be
214,8 MPa, and the highest stresses will be the tensile stress. The maximum deformation
will be on the end where the cabinet is hung from. With the load payload of 10 kg, the
deformation is 16,5 mm. The deformation, and thereby vertically relocation of the cabinet
of 16,5 mm is acceptable.
This project has led to some interesting discoveries both in
research and in prototyping solutions for the hospital. Whilst we
believe our design is very innovative and supports our research
on dignity we believe this is simply beginning of a new system. Our
other concepts show where the hospital has potential to radically
change the way patients can control their personal space but
firstly we must develop our prototype further and look towards
the future of hospital care.
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What kind of disturbing and uncomfortable aspects you have experienced during your stay in multi-bed ward?
SUMMARY OF RESPONSES: PRIVACY & CONTROL PROBLEMS IN MULTI-BED PATIENT ROOMS
knowing that you are not alone in a room
you hear (snoring, other conversations, body sounds, music, other doings etc), smell (body smells, food, flowers, lack of
fresh air etc) , see (everything, everybody)
hospital staff, nurses, doctors are moving in-out
other patients in your room move in-out
other unknown people move around (visitors of other patients)
you have to be ready “sudden” visits
you have your own side - cupboard - but it isn’t locked, your things are seen - so other patients can see your staff or
“take” them, it is not safe to leave them there.
your body and problems are exposed to the others - your condition, examinations, doctor visits, medical procedures,
your personal conversations etc.
everybody can see/hear/smell what you are doing & you also experience the same backwards - (at the same time you
have to control yourself and body, because of the others)
you are dependent of other bathroom habits - you can’t use it always when you want
the room conditions are not under your control - cleanliness, fresh air, lighting, sounds
you hear noise outside your room
you have to eat in front of the others - and when you have your personal food, then it can be uncomfortable.
you can’t enjoy always the things that you would like to do (tv programs, music, my own visitor’s visits, conversations,
working, reading etc)
everybody in room can hear your health problems
if you like to be close to the window, you can’t
bathroom is not locked
different sexes in the same room, using the same facilities (toilet/shower)
you are exposed in your private condition in very weak moment - special condition in general
staff sex and your privacy - man-man, woman-woman
you have to use other patient’s stuff (laundry, clothes, medical things….)
you can’t hide, go away (always)
you have to be social when you don’t want (you have to be polite, nice etc) - because it affects your staying there
you don’t know these people with whom you are there
you have lost control over your body, everyday habits, life
you can’t control many aspects in your physical environment (choose room, bed, etc)
you can’t control many aspects in your psychological environment (roommates, peace, socializing)
you can change the environment as you would like to (colours, smells, lighting, aesthetic part, cosiness, etc - that helps
you to feel like home, or the environment where is nice to be, when you are sick / recovering)
you are always waiting, spending time
you don’t know what is going on? what is the new information? You don’t remember all - you would like to “see” your
situation, need to have some accessible medical record together with explanations.