Universal Design for Health Care Facilities

The 2015 Universal Design International Seminar has obtained written consent from the speaker to publish the summarized and edited content

SPEAKER: NAM Min (Principal of Seoul City Eunpyung Hospital)

[Start of Universal Design at Eunpyeong Hospital in Seoul]
The perception of the psychiatric ward is not positive - not only does it bear the social stigma of a dangerous disease, but also the medical environment surrounding the ‘mentally disabled’. Psychiatric facilities are often underdeveloped, and while things may be changing, the doctor-patient relationship is often one-way, with the patient seen only as the ‘recipient’. 

The need for change in the medical environment triggered by the mayor's visit to Eunpyeong Hospital led to an opportunity to gather opinions from citizens who actually use the hospital. Seoul's Eunpyeong Hospital was designed to allow medical staff to check the bathroom (in common with the requirements of psychiatric hospitals), and many people expressed negative opinions about privacy violations in that the most sensitive areas were exposed to others. Many patients expressed their wish to go home during their hospitalization period, which averaged around 40 days.
Also, the medical staff responsible for the treatment had their own difficulties. Although they want to protect the patients’ privacy, they have a duty to prioritize their safety, and in the process of treating patients who complain of compulsion and isolation, medical staff were exposed to risk of violence. In order to narrow the gap between stakeholders and users, Eunpyeong Hospital recognized the need to move away from the image of a "strict hospital" and an "uncomfortable hospital" to "not like a hospital" and "happy to be hospitalized”. Eunpyeong Hospital in Seoul decided to try to shift the paradigm to a human centered perspective, changing the patient’s behavior through changes in the environment, allowing patients to feel comfortable and make progress in treatment as their behavior changes. 

[Design in Medical Space]
The medical sector has a dual personality. Although shaped by the demands of commerce, the reality is that it is difficult to generate profits because hospitals are regulated as a social safety net at the national level. Hospitals have started to introduce Service Design based on design thinking to generate maximum revenue at a low cost and/or enhance customer satisfaction to facilitate the management of medical institutions.

Since the 2000s, various innovative service improvements have been attempted through the communication process of observing or collecting opinions from medical staff and patients in hospitals. As a result of actively listening to design thinking, there have been a surge in cases of identifying problems and establishing processes that can lead to innovation and improvement. 

Through this process, minimal design factors appearing in the current medical space are ensuring accessibility for people with physical disabilities (such as installation of wheelchair-accessible roads and elevators), securing accessibility for the visually impaired (such as installation of Braille Signs and sound signals), the introduction of universal design concepts for medical devices and medical supplies, and the adjustment of spatial elements such as indoor illuminance to create a feeling of comfort, the coordination of patient flow, the reconsideration of common spaces, and so on.

[The Turning Point of Eunpyeong Hospital in Seoul]
When Eunpyeong Hospital attempted to introduce universal design, many insiders already understood the application and concepts of universal design in public institutions. The goal of change was established, to be achieved through the remodeling and reinforcement of the building.
The internal investigation required for remodeling of Eunpyeong Hospital gathered opinions on matters such as the modernization of underdeveloped facilities or equipment, the expansion and reorganization of professional treatment spaces, the reallocation of space, securing the safety of staff and patients, and the expansion of amenities and rest areas. Data was also sought on public perceptions of the mental hospital as a place that functions as a preventive space against mental health problems, a space welcoming to local citizens as a closed environment, and the comforting image of protecting the mental health of Seoul citizens. Patients in hospitals also wanted to escape from medicalized environments, to return to the community after discharge, and to move towards patient-centered thinking: a space for relaxation and social integration; a human-friendly mental hospital.
After collecting opinions from these stakeholders, Eunpyeong Hospital wanted to introduce universal design, and in 2014, it held an international academic competition called "Happy Space Project 1.0" with the aim of becoming a hospital that values the human rights of its patients, not only in hardware but in software. Before applying Universal Design, Eunpyeong Hospital expanded its knowledge and embodied its plan for change by visiting various mental institutions or examining cases as follows.

Example 1. Komakino Hospital in Japan ())
Komakino Hospital in Japan has been reborn as a hospital where everyone can share the hospital's space with local citizens, and it can be seen that it provides comfort to hospital users by realizing a comfortable atmosphere like a home.

Case 2. Ibaraki Prefecture Kokorono Medical Center

Case 3. St. Andrea Hospital in Korea

Case 4. Myongji Hospital

[The Case of Service Design at Eunpyeong Hospital in Seoul – Day Ward]

It is true that the daytime ward of Eunpyeong Hospital, which patients can use from 10 a.m. to 4 p.m. was formerly used by the hospital as the funeral hall, meaning it had a stark atmosphere before the change. Considering the position of patients who have to stay in the hospital for six hours, the first case was made because it was urgent to change and improve. The daytime ward was re-organized into four spaces to increase the effective use of space. The entrance section, which corresponds to Area A, has an intense red color, and Area B, an active space, consists of programs such as music therapy, art therapy, and joint treatment. Areas C and D differ in color, where personal resting areas are available for patients to use appropriately.

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