Designing for Impairment

AfH stepped onto Danish territory for their latest event: another informative and thought-provoking evening, sponsored by Guldmann and hosted by the Danish Ambassador, within the iconic Arne Jacobsen Danish Embassy.

Following the Ambassador’s welcome address -making reference to Denmark’s long history of and commitment to healthcare and caring environments- John Cooper, AfH chair, cited the Paralympics as the catalyst for this year’s AfH focus on “designing for impairment”.

The evenings’ presentations were initiated by the first of our five speakers, Dr Jan Gawronski, clinical lead for the London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital. Jan shared his clinical view on the pace of progress for spinal cord injury patients with the culture of rehabilitation being about far more than survival and existence.  These were Inspirational stories of patients with catastrophic spinal injuries becoming medal winning Paralympian’s, within the space of a few short years. Jan promoted a change in mindset, from thinking of “disability” as what can’t be done, to a universal experience approach of “there should be no category of things people can’t do.”

Stephanie Williamson, Deputy Project Director at the Royal National Orthopaedic Hospital, provided an invaluable insight into the RNOH journey and change of focus from pure surgery to promoting holistic independence. This is being achieved through the PFI process of translating their patient needs into a design brief and the 3 R’s; Restoration (surgery), Rehabilitation and Re-integration. Their ‘psycho-social cradle of care’ requires a dynamic environment and a ‘wheel-based’ approach to movement.

Tom Hagedorn Danielsen, architect and senior partner at C F Moller, treated us to a visual feast from their portfolio of schemes. Taking us from Vetruvian man, evidence-based design and knowledge based design through some inspirational schemes applying their ‘off-stage’ – ‘on-stage’ approach to healthcare projects including the Acute Infection Hospital at Malmo with it’s circular wards and open air circulation. His presentation concluded with a touching presentation on their Hospice success stories, which are actively prolonging life.

With all the presentations we were reminded that, although we are dealing with life-changing serious events, a common theme of care, humanity and humour prevail. Tom’s cartoon of a poorly patient in a Hospital bed, with a perplexed doctor at their side saying “you’re looking really bad, better call for an architect!”, had us laughing and questioning what we do at the same time.

Dr Sue Hignett, Reader in Healthcare Ergonomics and Patient Safety at Loughborough University, presented research on ‘ergonomics versus the human factor’. She championed ‘universal design’ whilst discouraging un-conscious actions for tasks that require vigilance: a real challenge in the face of conflicting evidence, for us all to respond to. With reference to her ‘Dial F’ model, where the building is identified as the one stable element within healthcare, Sue challenged the audience to ‘embrace inclusive design, promoting it, not as the gold standard, but as the minimum standard’.

Allan Vinther from Guldmann Technical, enlightened the audience on how interesting ceiling mounted hoists could be, as equipment to enable and promote rehabilitation within a safe, and literally supportive, environment. Allan highlighted areas where hoists could be used to “release time to care”, whilst explaining the science behind not only manual handling and lifting, but also the shear forces which cause bed sores.

A lively discussion followed covering a broad range of topics, from the exceptions to 100% single rooms being best, to the cost effectiveness of ceiling hoists. The discussion culminated in two fantastic comments in relation to designing for impairment: Firstly, from Stephanie Williamson, “within our village square, we are trying to promote the sense that the Paralympics happens every day at RNOH.”;  and finally an observation that in designing for impairment, “we should concentrate on maximising the gain rather than mitigating the loss”.

Our thanks go to the Danish Embassy, the Danish Ambassador, the speakers and Guldmann, for making the evening a resounding success.

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