Person-Centered Health Care Design

Dak Kopec

• Publisher: Routledge
• Year: 2021
• ISBN:
  9780429514784
• Edition: 1
• Topic: Architecture
• Subtopic: Architecture General

Disease, injury, or congenital disorders result in an inability to perform activities of daily living as effectively as others. Most of these activities take place within and are dependent upon the designed environment. This book presents the specialized area of person-centered health care design, which focuses on a person's design needs because of one or more health conditions and requires foundational knowledge pertaining to infection control, bio-physiology, neuroscience, and basic biomechanics.

Whether the designer has engaged in person- or condition-centered design, this book examines the causes that bring about health conditions, such as autoimmune disorders, chronic lung disease, muscular dystrophy, and neurological disorders, and the effects these have on a person's quality of life. Over forty various health conditions are discussed in relation to assorted building typologies—schools, group homes, rehabilitation and habilitation centers, and more—to identify design solutions for modifying each environment to best accommodate and support a person's needs.

Dak Kopec encourages readers to think critically and deductively about numerous health conditions and how to best design for them. This book provides students and practitioners a foundational framework that supports the promotion of health, safety, and welfare as they pertain to a person's physiological, psychological, and sociological well-being.

Chapter 1

Introducing the Health Care Designer

Chapter Objectives

By the end of this chapter, the reader should be able to:

• 1 Compare and contrast the design processes to achieve universal versus person-centered design.
• 2 Discuss competing outcome desires between the different stakeholders.
• 3 Rank by importance the different levels for activities of daily living.
• 4 Explain why interior design is best situated to fill the current gap of person-center design.
• 5 Demonstrate a design-thinking process based on a design zygote, embryo, and prototype.

Introduction

A natural evolution for any profession is the addition of specializations. A deeper understanding of a specific area included as part of a general scope of practice brings about better outcome measures that enforce evidence-based approaches. Within the design professions, the specialization of sustainability, performativity, and hospital-based design (called health care design) have all made significant strides, albeit, without a formalized or uniform curriculum.

Within the United States, the health care design focuses on the different departments of a hospital as well as the different types of facilities designed for the clinical practice of healthcare delivery. Examples of places for the delivery of care are the acute care hospital, community clinic, and rehabilitation center. Each of these environments has concrete goals, needs, and performance criteria required from accreditation bodies. These factors pose unique challenges for the designer of the built environment (general architecture, landscape architecture, and interior design/architecture) charged with the development of new designs or the rehabilitation/renovation of an existing building.

The health care designer is a specialist who has a strong working knowledge of anatomy, physiology, and disease pathology as these relate to the designed environment. The health care designer is a person who has the educational background to specifically develop designs based on the care of one’s health and the health condition that affect one’s daily activities. The primary purpose of these designs is to:

• ■ Prevent health conditions from presenting.
• ■ Aide in the rehabilitation process of a person who has been affected by a health condition.
• ■ To assist in the habilitation/accommodation of a person who has a new normal because of a health condition.

To develop designs for the prevention, rehabilitation, or habilitation and accommodation for different health conditions, the health care designer must focus the design on the healthcare affliction. To address a person’s health concern requires a person-centered approach that embraces the uniqueness and diversity of people while rejecting the idea of human and cultural homogeneity.

Another difference between health care designs and the health care designer is best understood by where the design emphasis is placed. Health care designs focus on the building and performance levels of the building, systems, and functions carried out within the environment. This aspect of the health care design is essential because healthcare typologies in the United States have vigorous standards attached to the facility’s accreditation for state and federal mandates tied to funding. The metrics used to determine accreditation compliance focus on essential but high-level criteria. Because many accreditation criteria are at a federal level or copied from state-to-state, the basic design takes on a comparable quality. The layouts, materials used, and general appearance between hospitals in Atlanta, Georgia, Boston, Massachusetts, Los Angeles, California, and Seattle Washington will have similar looks and atmospheric qualities. If this same degree of standardization were to occur in Europe, then the hospitals in Istanbul, Turkey, Minsk Belarus, Madrid Spain, and Dublin Ireland would look and feel the same (see Figure 1.1). We can achieve more significant outcomes once we understand the differences that are part of the design development within a heterogeneous society.

Figure 1.1 United States and Europe

Many people regard the United States as one set of aggregate beliefs and values. This same generalization, however, is not extended to the European nations. When we place a map of the Continental United States, we can see that Minsk, Belarus is approximately the same distance to Madrid, Spain as is Detroit, Michigan to Tucson, Arizona. If we agree the values, beliefs, and customs differ between Belarus and Spain then we must concede that the values, beliefs, and customs differ between Michigan and Arizona.

Source: Image created by Dafne Odette.

Person-centered Design

There are currently three layers of design based on human end users: Universal, human, and person. Universal designs focus on public spaces where anyone in good standing can use the environment in similar ways as any other person. Schools, courthouses, and government buildings are examples of areas based on universal design. Women’s clinics, drug and alcohol treatment centers, and transitional housing for young adults with Autism are examples of human-centered design. These are environments designed for groups of people who share a specific health condition and require unique environmental supports (physical and psychological).

Person-centered design is a process intended for individuals and the unique manifestation of their health condition. Clinical health providers have known for a long time that treatments for Sally and Jonny’s asthma must be different because Jonny and Sally have different factors that proceed—and lead up to an asthma attack. In the past, societies found it challenging to justify uniqueness within health conditions because the number of people with that illness was too low to justify. For example, one school may have only had five students affected by asthma. Because Sally and Jonny’s asthma is triggered (caused) by different environmental factors, the solution was for pharmaceuticals to address the symptoms. Today, many children have asthma, and the need to implement or modify designs that account for this chronic lung disease has gained attention.

Adding another level, and perspective, to the inclusion of a design professional’s scope of practice is part of a normal and healthy evolutionary process for professions. In today’s western societies, people live longer, and many live with chronic health conditions. These conditions are made tolerable or worsened by environmental factors. Person-centered design and human-centered design (small groups of people who share a health condition) are about the development of unique designs based on specific criteria. With the increase in health conditions throughout the world, the need for more precise and heterogeneous designs will be needed, thus, providing more opportunities for an interior designer who focuses on health care design. Examples of this specific market include group homes for the physically or cognitively disabled, shelters for homeless and abused women or children, or residential environments within senior living facilities, or as a private dwelling. The design focus is on the end users and their health condition.

For the would-be health care designer to specialize in the person-centered design, he or she must first gain a basic understanding of human biology, physiology, and neurology. The human body, like a building, is a system. Thus, an effective design for the human body requires a fundamental understanding of this system and how it interacts with the building system. Rather than look at these subjects in isolation, this book exposes the would-be health care designer to these subjects as they pertain to the most common health conditions. Because biology, physiology, and neurology are subject areas not usually included within the designer’s educational curricula, this book has many opportunities for the reader to reflect and brainstorm ideas. The goal of this interactive method is to help reinforce ideas and concepts. Because of the conceptual formation, the use of terminology and methods of design differ significantly between the person-centered design and the more traditional design processes. Hence, the writing style is casual and repetitive to help the reader understand and retain essential factors of biological, physiological, and neurological data that pertain to design. To design for a person with a health condition, the designer must first understand that health condition.

Design Professions and Health

Like a detective in a who-done-it novel, the health care designer tries to discover those environmental elements that cause or bring about a bio-physiological, psycho-sociological, or action-reaction process within the human body. The discovery process differs from the role of clinical healthcare providers such as physicians, nurses, and occupational, physical and respiratory, therapists who might disseminate environmental modification advice. For the clinician, the goal is to modify the environment to fit an occupant’s basic and functional needs. The health care designer does this while concurrently assessing and developing an area that meets the client’s psychological and sociological needs and the client’s co-occupants.

In many cases, the clinical healthcare provider must provide a person who has left the healthcare environment (hospital or rehabilitation center) with instructions and home recommendations. From this point, in cases where the quality of life is of concern and modification of the environment is required, the clinical health provider should refer the client to a health care designer. Trained designers in health care designs ensure health and safety measures without unintended consequences to the person’s sense of self and self-determination.

For the professional health care designer to be effective, predesign work is essential for all design projects. The question of what the predesign work entails determines the intended outcome goals for the design. Unlike the medical and social science fields, predesign work for designers can range from the extension of unique and high fashion (form) to the functional needs of the building’s intended population. The form is about the level of artistry versus the function, which is the degree to which the design serves the daily needs of those who would occupy the building. If this debate went on in fashion design, the form would be a glamorous evening gown versus the functional aspects of a burlap bag. For the health care designer, form and function, both address health equally.

With the designed environment (general, interior, and landscape architecture), the bulk of designers attempt to satisfy basic human needs and develop surroundings that inspire pride, happiness, and general satisfaction. Within the subspecialization of designs for health within interior design, the primary goal is to plan for and accommodate the occupant constituency’s needs. However, on the surface, this may appear straightforward and simple; the reality is that the determination of who the primary constituency comprises and the level of consideration required by this population is difficult.

Determining the primary constituency means considering one population over another. For example, one might think that designing a hospital would be about planning for patients and family members. However, these are only two population constituencies. The others include employees who provide care for the patients, such as physicians, nurses, a...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• List of Boxes
• List of Figures
• List of Tables
• Preface
• Acknowledgments
• List of Acronyms
• 1 Introducing the Health Care Designer
• 2 Evolving Beliefs, Lifestyles, and Diseases
• 3 Body Insults
• 4 Muscular Disorders, Joint Deterioration, and Skeletal Dysplasias
• 5 Autoimmune Diseases
• 6 Allergens and Sensitivity Disorders
• 7 Chronic Lung Diseases
• 8 Acquired Brain Injuries
• 9 Sensory Deficits
• 10 Cognitive Disabilities
• 11 Neurological Disorders
• 12 Dementias
• 13 Post-Traumatic Stress and Mood Disorders
• 14 Psychosis and Neurosis
• Crossword Puzzle Answers
• Glossary
• Index