New St. Paul's

Frontline staff and Emily Carr University of Art + Design researchers help shape new St. Paul’s Hospital

Design researcher and ECU student Linh Phan (centre) with frontline staff at St. Paul’s Hospital.

The new St. Paul’s Hospital Project Team and frontline hospital staff have partnered with a team of design researchers from the Emily Carr University of Art + Design (ECU) to help design the future of health care in British Columbia.

St. Paul’s Hospital nurses, respiratory therapists and nurse educators worked with students and staff from ECU’s Health Design Lab (HDL) over an eight-month period to design department care spaces at the new hospital, located in the False Creek Flats.

A life-sized mock up of a procedure room at the new St. Paul’s Hospital.

The Shaping Scopes + Procedures at the New St. Paul’s Hospital project looks at how the new Scopes and Procedures space on the fifth floor would function. This newly combined unit will be home to all day procedures which require sedation or local anesthesia, such as colonoscopy, gastrointestinal, endoscopy and others.

“The Health Design Lab team excels at drawing out ideas and insights from staff to improve systems and services,” says Miriam Stewart, Chief Clinical Planning Officer for the New St. Paul’s Hospital Project. “Staff feedback was crucial in designing the new hospital and is even more critical in planning how teams will work in these new spaces.”

A human-centred approach to design

When it comes to service design, figuring out what works and what doesn’t is key to unlocking opportunities to improve workflows, services and access to care. That’s why the HDL team conducted a variety of onsite co-learning exercises and workshops with frontline staff across six departments at the current St. Paul’s Hospital in downtown Vancouver.

Clinical teams from St. Paul’s Hospital provide feedback on service design of the new hospital.

These sessions included inviting staff from different departments to collaboratively walk through care scenarios and suggest how they could work together in the new space, including who would need to be involved and how new equipment and technology could be used.

“By centering the perspectives of frontline staff, we’re adding a human-centered design lens to this project,” says Nadia Beyzaei, co-lead of the Scopes + Procedure project team. “Translating on-the-ground perspectives to upper-level leadership is where design can support change that reflects the current needs of staff in a transparent way.”

Design students gain firsthand hospital experience

By invitation from St. Paul’s Hospital staff, the HDL student team also shadowed nurses and other staff to observe their workflows and on-the-job decision-making firsthand. Based on this layered engagement approach, the HDL developed a series of recommendations for the St. Paul’s Hospital Operational Readiness team to consider when launching the newly combined Scopes and Procedure unit.

Since the new St. Paul’s Hospital will bring together departments that haven’t previously shared space, including staff in the design of these new spaces is crucial for ensuring better patient experiences and improving health outcomes.

Rob Paquin, project co-lead and an emergency nurse and paramedic for many years, knows from experience why this matters.

“When I was working frontline, my colleagues and I would say multiple times daily, ‘Why are we doing things this way? If we just did X, we would be able to see more patients and care better for them,’” he says.

“Service design is about respecting and elevating the voices of frontline staff, which is essential in this crisis where people are leaving health professions at alarming rates. It’s also about improving patient care. It’s possible to design a hospital that provides better health outcomes for patients and reduces opportunities for negative consequences of care.”

Design student Mark Hanbunjerd, whose work as a research assistant included donning scrubs to shadow nurses during their shifts, says he witnessed these effects firsthand.

“The last time I visited the gastroenterology clinic, the nurses told me, ‘We really appreciate you being here because we thought you would’ve left by now and we’d never hear from your team again,’” he says. “Going back over and over really built trust that maybe — with all the change going on — staff voices are being considered.”

Design student Linh Phan, who had accompanied nurses to the Bronchoscopy Suite for a procedure earlier in the day, says the value of service design for all participants cannot be overstated.

“Quality improvement and research projects can be collaborative, fun and meaningful, not only for the project team but for the people being engaged,” she says. “From a student perspective, getting to practice in the field is an experience you cannot compare to classroom learning. Designing, to me, is learning through making. You actually have to be there. You actually have to do it.”

Service design transforming Canadian health care

Service design has long been a part of health care elsewhere in the world, but the work of design researchers like HDL is now helping to bring design thinking to the Canadian health care space.

Paquin says Providence Health Care, which operates St. Paul’s Hospital, has been an ideal and open-minded partner for this work.

“I would argue Providence is one of the most advanced thinkers in this way in BC. They’re not a big health authority, but they punch well above their weight with what they’re willing to try and do. They’re extremely innovative.”

With final recommendations now being delivered to leadership at St. Paul’s Hospital, Paquin notes there may be opportunities to replicate the project on other floors at the new hospital, as well as elsewhere in the province.

“You can see change starting to happen,” he says. “It’s baby steps, but I’m cautiously optimistic this might be a game changer going forward.”

This story was adapted from an Emily Carr University of Art + Design news release.