Evidence regarding the therapeutic value of social support within the pediatric hospital is not sufficiently sophisticated or conclusive to inform guidelines for the provision of social space with pediatric hospitals. There is an urgent need for targeted research to inform evidence-based design guidelines; this will demand a broad disciplinary approach.

ObjectiveThere is an increased expectation that contemporary hospital design will improve clinical outcomes and patient experiences and support staff well-being. In response, this study examined innovative approaches in the design of in-patient palliative care facilities.MethodsAn ethnographic study comprised the identification and analysis of 30 architectural precedents, 24 qualitative, semistructured interviews with key stakeholders and 11 site visits, during which field notes and photographs were taken. Data were analysed using the framework approach, to identify design solutions that move beyond standard practice, to offer insight into the possibilities and challenges of processes of design or refurbishment in palliative care settings.ResultsThree thematic areas of focus were derived from the analysis: (1) planning solutions that support privacy plus connection; (2) enhancing comfort through the use of non-standard materials—and managing the risks associated with those and (3) shaking off tradition in hospital design.ConclusionsMyriad constraints resist innovation within the contemporary construction of hospital and hospice facilities. Drawing on a series of real-world examples, our findings point to the value of broad consultation and collaboration throughout the design process in achieving design solutions that go beyond standard practice for the benefit for patients, families and staff.

Objective: Ulrich’s (1991) definition of “positive distraction” includes that which “elicits positive feelings and holds attention,” implying that the capacity of an environmental feature to hold attention is a necessary component. This article examines whether, in the context of a pediatric hospital, a distraction needs to “hold attention” to secure positive benefits for patient well-being. Background: Data collected from 246 patients at Melbourne’s Royal Children’s Hospital (Australia) revealed a discrepancy between what children and young people told us they did, and valued, within the hospital, relative to the time they spent engaging in, or paying attention to, these same features. This motivated a closer interrogation of the relationship between well-being, distraction, and socialization within the pediatric context. Method: Data were collected using a mixed-methods approach that included 178 surveys, 43 drawings contributed by patients/siblings within the outpatient waiting room, 25 photo-elicitation interviews with patients, and 100 hr of spatial observations within public and waiting room spaces. This was supplemented by interviews with architects and hospital staff. Conclusions: The mechanism by which we have understood positive distraction to contribute to well-being within the pediatric hospital environment is more complex than existing models accept. Within this context, environmental features that can positively transform expectations of visiting the hospital—that can ignite the imagination and incite a desire to return—can offer significant benefits to well-being. This is particularly relevant in the context of absenteeism from outpatient appointments and in reducing patient resistance to future, or ongoing, treatments.

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BackgroundIt is essential that the physical environments in which inpatient palliative care is provided support the needs of patients and the facilitate the multidimensional delivery of palliative care. This review aims to identify the features and characteristics of inpatient palliative care environments that enhance or detract from the patient experience; and identify opportunities for progress within this field.MethodThree databases were searched: MEDLINE (1946–2020), PsycINFO (1806–2020) and CINAHL (1937–2020). Articles were screened by title and abstract with included studies read in full for data extraction. Data synthesis involved thematic analysis informed by the findings of the included literature. Inclusion criteria were studies with empirical methodology examining adult palliative care in the hospital, hospice or nursing home environment. Studies that examined palliative care delivered within the emergency department, ICU or within the home were excluded, as were those related to paediatric palliative care.ResultsFour main themes were identified: the provision of privacy, facilitating interactions with family, facilitating comfort through homeliness and connections to nature.ConclusionsThe board acceptance of single rooms as the preeminent design solution for supporting privacy, dignity and family interaction, alongside current conceptions of homeliness that typically focus on matters of interior design, are limiting possibilities for further design innovation within palliative care settings. Research that investigates a broader set of design strategies through which the built environment can support care, alongside enhanced interdisciplinary collaboration, could positively contribute to patient and family experiences of inpatient palliative care.

Good teaching requires pedagogical dynamism: a willingness to vary one's teaching approach relative to the context (and cohort) at hand, and to any new challenges that may arise from that context. This requires that teachers obtain a broad knowledge of teaching strategies and tactics. Given the demands of contemporary higher education, finding the time to obtain this knowledge can pose a challenge to full-time academics. This is exacerbated in the case of part-time and practitioner-teachers who often work in varying degrees of isolation from the communities of learning to which they contribute. An analysis of the teaching practices of eight high-performing practitioner-teachers, alongside data obtained from 74 students, within a master's-level architectural course at a large Australian university, has been used to delineate five strategies for optimising student learning within the architecture studio. These include: setting up a challenge that clearly articulates the role of the student within it; early and frequent assessment tasks to assist students in rapid skill development and reflective practice; communicating clear expectations around performance; facilitating a strong peer culture; and enhancing motivation via high expectations. This article details the tactics by which these strategies can be achieved. This article delivers directly applicable advice for architectural educators, but it also provides practical insight into the specifics of architectural teaching that may assist educators working in other disciplines.

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.

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