Overall, patient social and physical activity was low, with little to no use of communal spaces. However we found more physical activity in patient rooms in the Ward B environment. Given the potential for patient activity to drive brain reorganization and repair, the physical environment should be considered an active factor in neurological rehabilitation and recovery. Implications for Rehabilitation Clinicians should include consideration of the impact of physical environment on physical and social activity of neurological patients when designing therapeutic rehabilitation environments. Despite architectural design intentions patient and social activity opportunities can be limited. Optimal neurological patient neuroplasticity and recovery requires sufficient environmental challenge, however current hospital environments for rehabilitation do not provide this.
Key workplace design features that matter to RAC staff in a 'shared workspace' exist. Increasing demands upon RAC requires evidence-based workplace design policy and evaluation approaches that support RAC staff to work in RAC shared workspaces.
Knowledge produced within the field of evidence-based design seeks credible data to support decision-making in the architectural design process. When directed towards the design of healthcare settings, such knowledge can support both the optimisation of patient healing and the improvement of staff performance in ways that correlate positively with patient safety and well-being. Spatial configurations that improve co-worker proximity, visibility, and communication can have a positive influence on staff perceptions of work culture, available support, and workplace safety that, in turn, support the delivery of patient care.1 Spatial proximities also have a direct influence on the types and frequencies of socialisation that will take place within spaces between patients, family members, and staff.2 This can support or hinder the formation of social support networks that can assist patients and family members to cope with stress, and healthcare workers to cope with stress and work-related grief.3 Evidence-based design researchers have also argued that design can be utilised to improve infection control, reduce falls, and minimise errors in medication dispensing.4 A clear disparity exists, however, in the quantity of evidence available to guide the designers of hospital-based palliative care and hospice facilities relative to general hospitals.
As the dominant research paradigm within the construction of contemporary healthcare facilities, evidence-based design (EBD) will increasingly impact our expectations of what hospital architecture should be. Research methods within EBD focus on prototyping incremental advances and evaluating what has already been built. Yet medical care is a rapidly evolving system; changes to technology, workforce composition, patient demographics and funding models can create rapid and unpredictable changes to medical practice and modes of care. This dynamism has the potential to curtail or negate the usefulness of current best practice approaches. To imagine new directions for the role of the hospital in society, or innovative ways in which the built environment might support well-being, requires a model that can project beyond existing constraints. Speculative design employs a design-based research methodology to imagine alternative futures and uses the artefacts created through this process to enable broader critical reflection on existing practices. This paper examines the contribution of speculative design within the context of the paediatric hospital as a means of facilitating critical reflection regarding the design of new healthcare facilities. While EBD is largely limited by what has already been built, speculative design offers a complementary research method to meet this limitation.
Balancing the competing demands of research and teaching has long been lamented by academics. The challenges associated with Covid‐19 will make this increasingly difficult. An integrated approach to research and teaching, where students are directly engaged in the production of research, may provide a useful strategy to support ongoing research within the design disciplines whilst befitting student learning. The production of original research requires a willingness to engage in – and manage –uncertainty. Contemporary higher education acknowledges that global challenges are increasing in complexity and, thus, students require opportunities to learn to productively manage this complexity. Utilising teacher observations and student feedback, this article reflects critically on a studio model, iteratively refined over two semesters, with the deliberate intent of exacerbating the complexity already present within studio pedagogy for the production of new knowledge. It outlines a set of strategies for making manageable this uncertainty for students to ensure it is beneficial for their learning. It also identifies a number of challenges educators can face when assuming a duel role as teacher and research partner; and provides advice for negotiating these challenges.
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