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Pediatric Design for Improved Patient Experiences: An interview with HOK’s Karen Freeman

Karen Freeman, AIA, ACHA, a practice leader for Healthcare based in HOK’s Atlanta office, has dedicated much of her 20-year career to the design of spaces that support the health and wellbeing of children, collaborating on pediatric healthcare projects across the globe.

Freeman shares her thoughts on the complexities of designing healing environments for children, how design can support a child’s emotional and developmental journey, and the role of big data and informatics in children’s healthcare.

What’s your favorite part of designing pediatric healthcare environments?

I love the complexity of pediatric projects. Our end user extends far beyond children to include patients into their 20s, and the needs of their parents, siblings and extended family. We’re also designing for the medical staff, creating spaces that help them do their job efficiently, allowing them to spend more time and attention on patient care. Designing for these varying groups, creating flexibility, and understanding complexity is a challenge that stimulates innovation and creativity in the design team. Ultimately, in architecture and design we provide a service—and what more fulfilling service is there than designing an environment to promote healing and wellness for children?

You mention the complexity of pediatric care. How do you design for that?

As pediatric patients present with more acute diagnoses and require more complex care, there is often a multidisciplinary team with a coordinated care plan treating these children. This impacts the kind of spaces we design. We’re seeing an increasing number of acuity-adaptable spaces to accommodate these diverse teams. In the outpatient setting, more sub-specialty ambulatory buildings are being built, and healthcare institutions are aggregating sub-specialists into a single location, allowing patients to see several providers at one time. Children also have different psychological and social needs than adults, which requires us to tailor the emotional journey differently.

Can you discuss that a bit more – the emotional journey as it relates to pediatric patients?

Our ability to process information is not fully formed until our teenage years. So, breaking down the medical experience into moments that can be easily understood allows children to interact with their surroundings in a more meaningful way. Children are inherently more social, even when they are not feeling their best. Creating environments that promote positive social interactions—through touch, talk, and meaningful communication—can engage both our pediatric patients and their families.

Could you give us an example of design that improves the emotional journey?

Sure. Most medical journeys require some amount of time in waiting rooms. Yet waiting can be particularly difficult for children. Research shows that by using positive distractions such as sound, graphics, art, opportunities for passive and active play, and—perhaps most importantly—views to nature, we can mitigate the stressors and boredom of waiting. Another example is how we address patient flow and wayfinding. Children are looking to their parents to guide them through unfamiliar processes and places.  If a parent is stressed trying to locate their intended destination, it erodes trust in the bond between parent and child.  A simple, easy to understand patient flow allows the parent to focus on their child’s wellbeing.

There is a lot of talk these days about Big Data and bioinformatics and its impact on healthcare. How is Big Data impacting pediatrics?

Gathering, analyzing, and leveraging data in pediatrics is particularly important as infants and children are often not equipped with the same tools to effectively communicate their comfort levels in the healthcare environment. By leveraging trends realized through big data, another avenue is opened to communicate with patients and effectively plan for their care. Big data can also leverage experiences across multiple health systems for the benefit of the patient; each individual hospital may not treat enough patients with a rare or complex condition to allow them to generate a large enough sample size to effectively reach conclusions.  While sharing data across multiple systems can be one of the largest hurdles to the implementation of big data, the reward is that knowledge discovery can be accelerated.

What is something in pediatric design that cannot be emphasized enough?

Going to the doctor or being in the hospital can be a very stressful time for children and their parents. I love that through design, we can make that experience better. We can create whimsical, uplifting environments for the social and psychological needs of children, while also building trust and conveying clearly to parents that their children are receiving high-quality medical care. The importance of the patient and family experience is not to be overlooked and is at the core of our designs: how can we make the process as simple as possible, how can we assist the medical team and the quality of their care, how can we reduce anxiety, and ultimately how can we uplift and inspire?

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