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Bates Smart’s Mark Healey on normalising the clinical environment

Bates Smart studio director Mark Healey has carved out a unique CV having worked on some of Australia’s best healthcare projects, alongside multi-res and commercial work. Here he opens up about the latest design thinking behind our changing healthcare landscape.

Render of Cabrini Hospital patient room.

Render of Cabrini Hospital patient room. Courtesy Bates Smart.



BY

December 10th, 2018


Mark Healey’s design approach is centred on empathy with a human-centric focus. He brings an incredible breadth of experience across many sectors but has been at the forefront of the healthcare design revolution in the last 10 years.

Mark Healey, studio director at Bates Smart.

Mark Healey, studio director at Bates Smart.

Aleesha Callahan: How have you seen the briefs and requirements for hospitals changing?

Mark Healey: They are definitely becoming far more patient-centric. Research worldwide is really starting to point towards the experience of the patient and the way in which a patient can actually experience an institution. That is number one, really, and then attached to that context is the idea of creating spaces for wellness, as opposed to only creating spaces to treat disease. So the key projects that Bates Smart has worked on in the past 10 years or so have really taken on that role of trying to create places for healing as opposed to just treating disease. And that is all based on the concept of salutogenesis.

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“The key projects that Bates Smart has worked on in the past 10 years or so have really taken on that role of trying to create places for healing as opposed to just treating disease.”
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This medical sociology concept has driven much of our thinking, especially within the healthcare realm. But now even corporations are starting to understand the benefits of designing for wellness, and the idea of actually putting a cost on spaces that improve the lives of their occupants, be it staff or patients.

Royal Children's Hospital patient room, designed by Billard Leece Partnership and Bates Smart. Photo by Shannon McGrath.

Royal Children’s Hospital patient room, designed by Billard Leece Partnership and Bates Smart. Photo by Shannon McGrath.

I would say that it is a process that people are now coming to understand better, as well as the economics of it. It’s becoming much more about the understanding of the human, and how they interact with the built environment. This kind of thinking has been a driving force of ours as well, to ensure that these things find a way into these large institutional projects. But it does come back to the fact that cost and efficiencies need to be met.

Quite often parts of a project will get compromised, so it’s very important to have strong research or evidence to bring to the table during the planning phase. We need to be able to present evidence to clients, to encourage a connection to nature, and a connection to natural light and a connection to excellent views. These things are just inherent in being a human being. It’s not rocket science.

Royal Children's Hospital Melbourne by Billiard Leece Partnership and Bates Smart. Photo by John Gollings.

Royal Children’s Hospital Melbourne by Billard Leece Partnership and Bates Smart. Photo by John Gollings.

Something that stood out to me in the Bendigo Hospital project is the integration of art. How did this initiative eventuate?

It was quite fluid in that it wasn’t part of the original bid. Whereas on the Royal Children’s Hospital, the two major pieces of art in the internal street were always embedded in the bid and so were financed from the very beginning. With regard to Bendigo, however, it was a bit more open in terms of when we realised that there was a need for art.

There are two major pieces. One is a large mural, done by a young artist called Esther Stewart. There was a competition run for this piece and we employed an art consultant, Emily Cormack. Some of those shortlisted were from the local area, which was part of the brief, and the brief also spoke about creating a future-focused, energised space. That piece references the local environment, in terms of how it depicts some of the flora from the region. It also depicts some of the graphic motifs from the older civic buildings found in Bendigo. This gave a really beautiful connection to the past, while being carried out by a youthful artist who was talking about the future.

Bendigo Hospital by Silver Thomas Hanley and Bates Smart, with Esther Stewart's artwork. Photo by Shannon McGrath.

Bendigo Hospital by Silver Thomas Hanley and Bates Smart, with Esther Stewart’s artwork. Photo by Shannon McGrath.

It did cause a bit of a shock in that some of the executives struggled to understand it. But I think good contemporary art should have a degree of the ‘shock of the new’, and I think it has actually really helped in terms of creating a more non-institutional, normalised environment, which was the intent. That idea of creating a non-institutional feeling space was very much one of our drivers as well – the normalisation of these environments.

Anecdotally, we got a small confirmation that this was achieved during the official opening. There was an amazing welcome to country by an indigenous leader, and he spoke exactly of that – how important it was for his people to feel that they could come to this place and not be over-awed by the sense of institution. It was an incredible learning from him that we had done our job.

Bendigo Hospital by Silver Thomas Hanley and Bates Smart with xxx artwork. Photo by Shannon McGrath.

Bendigo Hospital by Silver Thomas Hanley and Bates Smart with Noel Skrzypczak’s artwork. Photo by Shannon McGrath.

Another young artist did the other piece, Noel Skrzypczak, which is focused directly on the stairwell, on the first landing of the stair. For this one it sits on a level one bridge that is heavily utilised, it has a lot of foot traffic so by positioning a piece of art there, the aim is to encourage people to use the stair as opposed to the lift. It also creates a step between the ground and first floor in a visual sense.

Art is extremely important in creating these environments while also giving it a reference to the past. But you also have to consider that these environments will be around for many, many years, so it must have a degree of timelessness, and a sense of being quite future-focused.

How did these learnings come into play with the latest hospital project you’ve been working on – Cabrini?

Cabrini has the oldest average age of patients in Australia. The project started out as a research initiative, to investigate how to minimise falls in a hospital. It didn’t end up eventuating quite like that but they did come to us asking, “Can you design us the safest possible hospital bedroom?” The bedroom in a hospital is typically where people fall, and if people fall they typically have a rather adverse reaction to their experience of that hospital environment.

So firstly we wanted to try and create the safest environment. When you look at it, most patients fall when trying to get from the bed to the bathroom, bearing in mind that these are often elderly patients who are heavily medicated. So we started really thinking about how we could make that route much more intuitive.

Should someone wake up and be a bit disorientated or confused, how can they figure out where they are and where they need to get to quickly and seamlessly? Therefore, we positioned a line of sight to the bathroom from the bed, together with a new kind of sensor technology. It works when a patient moves to get out of bed, which activates a gently illuminated handrail guiding them directly and smoothly.

Cabrini suite, photo by Peter Clarke.

Cabrini suite, photo by Peter Clarke.

Other things that come into play in Cabrini is the consideration for the patient’s perspective, so the façade was also designed with butterfly angles, which creates a screening effect. This means that the windows are angled and open so that the patient’s view from the bed is enhanced.

We also made sure to conceal many of the services that make the space feel overly institutional, by hiding a lot of the medical equipment and integrating it beautifully within the design. This was something that we worked really hard on for the kids’ hospital, especially because some of that equipment can become quite overbearing and kind of scary.

Cabrini bathroom, photo by Peter Clarke.

Cabrini bathroom, photo by Peter Clarke.

This meant that we worked very hard with our services engineers to minimise the visual impact of equipment. So we’re trying to normalise not only the public spaces within a hospital but also these private more intimate spaces as well. It’s what we call the normalisation of the clinical environment.

Experience an immersive VR of the Cabrini suite here.

For more insights into the changing healthcare sector, grab issue #75 of Indesign magazine. Or be inspired by design leaders: Sign up for our newsletter.


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