The healing experience
The world economy is moving from a service economy to experience economy. Why? Because an experience economy provides a new source of value. Companies find if they engage their customers in a memorable way, customers come back and pay a premium for the experience they enjoy. Consider Starbucks or Bass Pro Shops.
An experiential design creates an environment that is intentionally crafted as a platform to engage an individual. Like the theater experience, it may use services as a stage and goods as props to engage the person. The more memorable the experience is, the higher value people place on the experience. We call this scripting the experience.
What makes a memorable experience?
Healing environments are experiential. Healthcare commodities, such as medication, diagnostics, and caregiving are still provided. But what memories will the patient take home? Will kind caregivers, good medicine, beautiful surroundings, and astute diagnoses make the healing journey a pleasant transition from illness to health? Or will the journey be filled with fear, trepidation, confusion, discomfort, and anxiety from being separated from loved ones and familiarity?
The healthcare environment is a powerful place that can be considered a “stage” in the healing journey. A patient can be engaged actively or passively in a number of ways. Passive participation includes viewing a garden, a window, or art. Active participation includes walking a labyrinth or participating in pet therapy.
The level of connection uniting the patient with the activity affects the patient's experience. Viewing a video wall, where images and sound morph through sight, or listening and watching a live piano performance creates a captivating experience. Blending these interactivities can evoke feelings of entertainment, education, escape, and estheticism to achieve a uniquely personal experience.
Working with the dimensions of active and passive participation, as well as absorption and immersion, can present an opportunity to stage a memorable experience. These components may create positive distraction and perhaps a joyful moment.
Design the experience
The most memorable, richest experiences are those that include elements of education, entertainment, escape, and estheticism. Consider the following in the design of a healing experience: The beauty of the experience matters as it is what first attracts the patient into the experience. The experience needs to look inviting. The image and the atmosphere must be inviting and attractive to the senses. For example, a beautiful water feature may attract a visitor.
Once the beauty attracts the patient to the experience, the design needs to provide the “escape,” or positive distraction. This allows the participant to focus on a pleasurable diversion rather than the medical component of their visit. A fish aquarium may attract the patient and provide a positive distraction.
A learning component is also important. Education can take the form of interactive videos that describe recommended surgical procedures or lifestyle activities.
The playful component of the experience provides the pleasure. Typically the component is passive in that the patient does not have to do anything but enjoy. However, an opportunity exists to make the healthcare environment more enjoyable. Can you imagine a healthcare environment where we asked patients at their dismissal if they enjoyed their stay? Entertainment examples in healthcare include visiting clowns, animal therapy, and piano concerts.
Themed environments are experiential
Themed environments can contribute to a positive experience in a medical space. The validity of themed environments for healthcare facilities may be called into question; they may be appropriate for Starbucks, Barnes & Noble, and Disney World, but hospital and medical institutions are not retail outlets or theme parks. However, much can be learned from the themed environment. Medical facilities need to create an experience that does not scream sterile, institutional, and dismal design.
Take the case where a client requested a spa-like space complete with a spa-quality soft white terrycloth robe hung in each room. Another hospital, built on the shores of a river, had a unique identity in the community. A scripted participatory story is a “themed” design, and these increase the experiential value to the patient.
For a themed space to provide a healing environment, a natural story relevant to the community of users needs to meld with medical protocol. For example, in the case with the spa theme for the women's center, we used fusion artifacts: shoji screens, Japanese lanterns, Zen gardens, natural materials, and Asian-styled furnishings (figures 1 and 2). These supported the functional women's suite and appealed to the female culture of the area. The theme also altered the patient's sense of reality, allowing the women to feel pampered rather than institutionalized.
The waiting room at the High Point Women's Center in High Point, North Carolina, is an example of a themed environment expressing “Fusion” design using Asian artifacts
This postpartum room at High Point Women's Center shows a room designed for the “spa experience.” Medical gasses are hidden behind the backlit headwall, and elements are present to elicit the relaxation response
The successful themed space alters the user's sense of time, space, and matter. This can alleviate the boredom while waiting, the stress of the medical environment, and confusion of medical procedures. Unifying time, space, and matter through design provides an altered yet natural sense of reality, the ultimate in positive distractions.
Themes that saturate the environment support the experience. In the marketing world, this technique is called “branding.” Putting a fish tank in the center of the waiting room may be a positive distraction, but it does not create an experience.
Eliminate negative experiences
Between cancer centers, rehabilitation facilities, emergency rooms, and others, medical facilities treat the most negative experiences of life. How can we reduce the negative experiences from these environments? Design cannot eliminate disease, but it can alter the experience the hospital guests have as they journey through the facility and embark on their own healing journey. Medical equipment provides one of our greatest challenges. Scripting the experience must address the equipment and culture of the institution.
Artifacts to support the experience
Artifacts and memorabilia are important components in the experiential environment (figure 3). A place devoid of artifacts is a space without meaning. Healthcare institutions are overwhelmingly empty of artifacts and memorabilia.
The family room at High Point Regional Cancer Center, High Point, North Carolina, shows how artifacts provide a homelike setting that destresses an otherwise institutional environment. The setting encourages family members and patients to relax, engage in conversation, and share stories
Since memorabilia can harbor bacteria, be broken, or even stolen, why use them? Artifacts and memorabilia provide a lasting meaning to support the experience. People collect, purchase, and respond emotionally to memorabilia as a tangible component of the experience. Artifacts can also provide meaningful landmarks, reduce stress, and provide positive distractions. Memorabilia is a way to make the experience social.
Artifacts are especially important in senior living (figure 4). In assisted living, dementia care, and nursing homes, “memory boxes” that house personal artifacts provide meaningful identity of highlights of the patient's life. They also mark the residents' room or apartment.
The clock tower at MeadowView Dementia Care Center, Cedar Rapids, Iowa, creates a landmark in the town square. The iconic clock tower and other antique reproductions also provide meaning and landmarks for the residents
Antiques and reproduction of antiques provide spice to senior living public space. These artifacts not only add to warmth and ambience of the room, they can actually trigger memories. For example, religious articles in a worship space support the spiritual function. Cracker barrels and food tins add charm and remembrance to kitchen and dining spaces.
Hospitals would benefit by adding artifacts similar to hotels and resorts. Items such as mirrors, sculptural art, dimensional art, crafts, and vases all support a more hospitable and welcoming environment.
Engaging the senses support the experience
The more effective designs are at engaging the senses, the richer the memory will be. The sound of music playing on the lobby piano or piped into parking lots; the smell of fresh-brewed coffee as you enter the waiting room; the visual delights of art, fish, and water features; the comfortable furnishings; and access to comfort foods provide simple cues that can heighten the positive experience. The five-senses design can provide both the animate and inanimate cues to the experience, supporting the positive and reducing the negative sensual elements of the healing environment.
The experience model can lead to transformation
If healing environments are experiential, how do we move from the service model to the experiential in healthcare delivery? The current healthcare model provides medical services with little attention to the individual. The experiential model relies on individual customization for the whole patient, family, and staff.
Experiences we have on our journey through healthcare environments affect who we are, how we respond, and what we can accomplish. If our experience confirms that we are merely a gallbladder, a heart attack, or a room number, our humanness is devaluated and our memories of the experience are negative. However, if the experience supports the human ability to support learning, growth, development, improvement, and healing, these memories are positive.
As critical as the experience is to the healing environment, it is not the final outcome. When the positive experience is carefully crafted—scripted for the desired outcome; designed to engage the senses; customized for the individual; filled with family, friends, and caring staff; supported with artifacts; spaces that provide comfort and embrace the spirit—the experience becomes transformational and healing is possible. It is this life-transforming experience that the hospital patient is truly seeking.
The environment, as powerful a “place” as it is, cannot create health. Transformations cannot be forced, delivered, or prescribed. However, with the right set of experiences, caregivers can help guide the patient through a healing transformation.
Experiential design is the new frontier in design, and consumers savor the memorable experience as they expect more and are willing to pay more for the experience. It is my belief that the concepts of experiential design will prove to provide memorable experience and improve the quality of life in all areas of healthcare. HD
Barbara J. Huelat's Alexandria, Virginia-based firm Huelat Parimucha, Ltd., specializes in evidence-based healthcare interior design and architecture.
For more information, visit http://www.healingdesign.com.
Healthcare Design 2009 February;9(2):10-15