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How Design Affects Communication

Talk for seminar 'Building Blocks for Clinicians', 8 June 2018, held at Murphy Philips architects, London

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How Design Affects Communication

  1. 1. How design affects communication Sailer, June 2018@kerstinsailer How Design Affects Communication and Clinical Workflows Dr Kerstin Sailer Reader in Social and Spatial Networks Bartlett School of Architecture, UCL Building Blocks for Clinicians, Murphy Philipps Architects, London, 8 June 2018
  2. 2. How design affects communication Sailer, June 2018 The Relationship between Architecture and Human Behaviour Embedded and embodied experience
  3. 3. How design affects communication Sailer, June 2018 The Role of the Built Environment What we see Where we go Who we meet Who we interact with How we perceive the world Embedded and embodied experience
  4. 4. How design affects communication Sailer, June 2018 Space Syntax: Analysis of layouts and experience Spatial configuration: The way in which spatial elements are put together to form an interconnected system of spaces (Hillier1996)
  5. 5. How design affects communication Sailer, June 2018 Space Syntax: Analysis of layouts and experience Different overall configurations create different experiences Sequence Grid Tate Modern British Museum
  6. 6. How design affects communication Sailer, June 2018 text Regular grid to create isovists Floor plan Syntax model: Strategic visibility IntegratedSegregated Space Syntax: Analysis of layouts and experience
  7. 7. How design affects communication Sailer, June 2018 Example 1 Hospital in Netherlands (and Canada)
  8. 8. How design affects communication Sailer, June 2018 Example 1: Hospital in Netherlands Newly built hospital in 2010: “integration of new technologies that put the patient first”; building that supports new care concept and general sense of wellbeing
  9. 9. How design affects communication Sailer, June 2018 A Tale of Two Hospitals Hospital A: small town in Netherlands; new built hospital (2010), open layout, ‘knowledge centre’ Hospital B: large city in Canada; built in phases (since 1912); tower; corridor layout
  10. 10. How design affects communication Sailer, June 2018 Hospital A – Knowledge Centre Entrance lobby Waiting Exam rooms
  11. 11. How design affects communication Sailer, June 2018 Entrance lobby Exam Rooms Hospital B – Corridor Layout WaitingReception
  12. 12. How design affects communication Sailer, June 2018 Research Questions How are spatial practices embedded in and shaped by the layout? What affordance does the layout provide for care processes? How much do work activities in out-patient clinics resemble each other or differ? Can potential differences be explained by spatial configuration?
  13. 13. How design affects communication Sailer, June 2018 Data: Shadowing Caregivers 12 different caregivers (6 doctors, 4 nurses, 2 clerks) shadowed in each clinic; total time of 90 hours in hospital A (activities n=5350) and 85 hours in hospital B (n=2890)
  14. 14. How design affects communication Sailer, June 2018 The Spatial Layout of the Clinics HOSPITAL B [CA] Av CONN: 140 Av MD: 2.99 HOSPITAL A [NL] Av CONN: 491, av MD: 2.19 5 out-patient clinics investigated in each case; example: Cardiology
  15. 15. How design affects communication Sailer, June 2018 Differences in Care ProcessesHOSPITALA[NL]HOSPITALB[CA] Cardiology Orthopedics Immunodeficiency Internal Medicine Pulmonology Surgery Care processes differ from clinic to clinic, but more similarity within hospital than within speciality
  16. 16. How design affects communication Sailer, June 2018 Differences in Care Processes Mean duration of all activities Hospital A Hospital B Mean duration of communication among caregivers Hospital A Hospital B All differences highly significant in t-test / ANOVA (p<0.0001**) 61.2 sec 106.2 sec 47.8 sec 81.6 sec Cardiology 58.1 sec 69.2 sec 34.9 sec 57.7 sec 40.0 sec 90.8 sec 96.6 sec 97.2 sec 57.3 sec 60.6 sec Internal Medicine Orthopedics Pulmonology Surgery Cardiology Internal Medicine Immunodeficiency Pulmonology Surgery
  17. 17. How design affects communication Sailer, June 2018 Activities Embedded in Spatial Layouts Clinics with highest integration tend to have shorter duration of activities (R2=0.52, p<0.0183*) → dynamic work processes supported by configuration In PuCa Su Or In Im Ca Su Pu
  18. 18. How design affects communication Sailer, June 2018 Hospital A Space creates opportunities for communication HOSPITALB[NL] 64% 31% 26% 36% 69% 74% 0% 20% 40% 60% 80% 100% Charting Galley Corridor Exam unintentional intentional Location of communication Unintentional= 44% Intentional= 56% Intentional Unintentional Physicians Nurses Clerks
  19. 19. How design affects communication Sailer, June 2018 Example 2 Comparative study of three NHS hospital ICUs Work by Rosica Pachilova, PhD candidate at Bartlett School of Architecture
  20. 20. How design affects communication Sailer, June 2018 Example 2: Study of three NHS ICU wards UCLH NHNN CW Racetrack layout Max: 5.1 Ave: 3.3 Min: 2.1 SD: 0.59 Duplex layout Max: 5.1 Ave: 3.3 Min: 2.3 SD: 0.48 Corridor layout Max: 4.2 Ave: 2.5 Min: 1.7 SD: 0.57 MeanDepth(strategicvisibility) Work by Rosica Pachilova, PhD candidate at Bartlett School of Architecture Connectivity(localvisibility)
  21. 21. How design affects communication Sailer, June 2018 Example 2: Study of three NHS ICU wards UCLH NHNN CW Racetrack layout Max: 5.1 Ave: 3.3 Min: 2.1 SD: 0.59 Duplex layout Max: 5.1 Ave: 3.3 Min: 2.3 SD: 0.48 Corridor layout Max: 4.2 Ave: 2.5 Min: 1.7 SD: 0.57 MeanDepth(strategicvisibility) Work by Rosica Pachilova, PhD candidate at Bartlett School of Architecture Connectivity(localvisibility)
  22. 22. How design affects communication Sailer, June 2018 Example 2: Study of three NHS ICU wards Work by Rosica Pachilova, PhD candidate at Bartlett School of Architecture Racetrack layout Duplex layout Corridor layout time is spent in f2f conversations Racetrack 53% Duplex 55% Corridor 39% f2f conversations less than a minute long 81% 81% 89% conversations in pairs 76% 73% 78% Face-to-face conversations
  23. 23. How design affects communication Sailer, June 2018 Example 2: Study of three NHS ICU wards Work by Rosica Pachilova, PhD candidate at Bartlett School of Architecture Racetrack layout Duplex layout Corridor layout Connections between room types – from observations linkweight - number of times the healthcare professionals went from one space to the other node size - time spent in the space
  24. 24. How design affects communication Sailer, June 2018 Example 2: Study of three NHS ICU wards Work by Rosica Pachilova, PhD candidate at Bartlett School of Architecture Comparison between layout types RACETRACK DUPLEX CORRIDOR
  25. 25. How design affects communication Sailer, June 2018 Robin Evans “If anything is described by an architectural plan, it is the nature of human relationships.” Evans (1997): Figures, Doors and Passages
  26. 26. How design affects communication Sailer, June 2018 Dr Kerstin Sailer Reader in Social and Spatial Networks Space Syntax Laboratory Bartlett School of Architecture, UCL 22 Gordon Street London WC1H 0QB United Kingdom Thank you! k.sailer@ucl.ac.uk @kerstinsailer http://spaceandorganisation.org/ http://tinyurl.com/ksailer

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