effects of a participatory facility design process at a community hospital in British Columbia, The

HD, Feb 2005 by Miller, Aaron, Gamble, Leslie

Focus group sessions were held from May 2004 to February 2005 for each department separately every three weeks, lasting approximately an hour and a half with only members from the design development team, EKRH administrator, architects, facility planners, and two ergonomists in attendance. Occasionally, the department manager would sit in on the session. Each session was led by one of the architects presenting the drawings to the team members with another architect rapidly drawing iterations as concepts were brought forward and another architect taking minutes. During the sessions, the two ergonomists would provide recommendations and facilitate the focus group process by assisting staff with the drawings, asking for solutions to design problems, and probing for answers to various questions posed by the architects/planners.

During each focus group session, there were questions on each iteration of the architectural design drawings. The architect would ask the design development team members during what specifically they thought about the new iteration of the drawings room by room for each department. An example of this type of questions would be: "What sort of monitors would be needed for the beds in emergency and what side of the bed should they be located?" Based on this question, the staff member's response was: "Wall mounted monitors would work on the right hand side of the bed". These recommendations, in addition to the ergonomie, anthropometric, workflow, and human factors considerations, formed the recommendations for the changes to each iteration of the architectural drawings. As storage and proximity of necessary equipment and supplies is frequently a concern in healthcare facilities, considerable time was also spent on determining equipment and supply needs, the space requirements of these needs at the bedside as well as the space requirements and location of the storage of the determined equipment and supplies. In some situations during the focus groups, one of the architects would quickly produce an iteration of the drawings in response to a staff member's answer to determine if that recommendation would meet both staff and ergonomie needs. This group process enabled the architects to create a space that met both their physical and psychological needs by including as much input as possible during the process. After each focus group session the architects were able to produce different iterations of departmental designs, sometimes creating various options to be presented at the following focus group session. Once the design development team had agreed on the final design of their department, they had to physically sign off the architects drawings to indicate that they were in agreement with the drawings, and that it represented the needs of their department. This created accountability and responsibility for those on the design development team.

INFORMAL INTERVIEWS

In between focus group sessions, the two ergonomists spoke with staff about the physical layout of their department, what they liked, what they did not, and what they would like to potentially change and the reason for the change. The ergonomists were able to sit down or "shadow" these staff members through their work tasks on an informal one-on-one or group basis to discuss their job, roles, and what sort of design problems they encounter in their department. Based on these sessions, the ergonomists were able to take notes and form the basis for design recommendations. By examining current risk factors in the physical layout of each department, the ergonomists were able provide solutions through the redesign of workstations and areas within each department utilising feedback from the staff. To further enhance their recommendations, the ergonomists used a digital camera to photograph the current workstations and areas within each department to create a visual record of each department. These photographs were used to make comparisons between the current department and the proposed changes in the architectural drawings and how they could be improved.