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Kids are helping design a hospital through the power of VR

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At a hospital in California, kids are using VR to inform the design of a new hospital wing. Health Tech World hears from the doctors and researchers at the heart of the study. 

A  groundbreaking approach to hospital design is bringing children into the design process of a hospital wing, using virtual reality (VR) to gain a deeper insight into patients’ needs and emotions.

In the first-of-its-kind study, the XR Lab at UC Berkeley is working with doctors and patients at UCSF Benioff Children’s Hospital to understand how the clinical space impacts quality of care.

As a population, children are a difficult group to understand. They lack the same means of expression as adults so parents are often relied upon to gather data about their kids. Technologies like VR and biometrics are now emerging as effective methods for gauging how kids really think and feel.

Rather than relying on subjective data gathered through traditional methods like surveys and focus groups, the study uses VR headsets to allow young patients to explore new hospital designs. The researchers record eye movement, facial expressions, heart rate and other physiological reactions to understand how children respond emotionally to different designs.

“The goal is to understand what young people want from a hospital room to feel calm and comfortable,” said Dr Luisa Caldas, director of the Berkley XR Lab.

“When we can truly connect with them, we can harvest not only their ideas but the way they feel things and the way they perceive things.”

What do kids want from a hospital ward? 

Paediatric wards are among the most important facilities to get right.

A ward is an unfamiliar and sometimes frightening place for a child. A poorly designed hospital environment can have a significant negative impact on that child’s well-being.

“If you take a step back and think about hospitalising a child, it fundamentally goes against everything it means to be a kid,” said Dr Kurtis Auguste, a paediatric surgeon at UCSF Benioff Children’s Hospital.

“To be trapped in a room, how much torture must that be for a kid not being able to run around and play?”

These restrictions are only magnified for oncology patients going through chemotherapy. A vulnerable immune system means they may not be able to leave the ward or even their room.

“They are further and further confined,” Dr Auguste said. “The mental health aspects of being in that situation, I can only imagine, are devastating to the individual child.

“We are obligated, therefore, to make this space as pleasant and as engaging as possible.”

The study seeks to understand various design elements, including spatial layout, facades, privacy, control, social support and positive distractions like wall art and ceiling art.

It aims to identify what elements are most important to children and how these can be incorporated into hospital room designs.

Given the restricted nature of paediatric facilities, it came as no surprise to the researchers that large panoramic windows resulted in significantly lower heart rates among the young participants. Artwork and visible nurse windows also contributed to positive emotional responses.

The results of the study were not consistent across the board, though.

Preliminary results found that children’s preferences for room design vary based on age, gender and personality. Some children may prefer spaces that make them feel cosy and protected, while others may seek more exciting and open designs.

“There isn’t going to be a one-size-fits-all all,” Dr Auguste said. “Some of us are extroverts, some are introverts. There are going to be some rowdy kids and some quiet kids.

“But I think there are some core principles at the foundation that resonate with the majority of folks.”

The study is taking these differences into account.

“We’ve been really surprised by how much we learn about how children of different age ranges […] perceive space in the different dimensions,” Dr Caldas said.

“We can adapt that content to age and even adapt it to the height of the child. We realised that a five-year-old at a certain height relates to a wall in a very different way than a six-foot-tall teenager. So, we asked, how can we vary the design or the content according to the scale and to the perception of that particular individual?”

The study is moving towards completion, with initial findings to be shared by the end of the year.

The technology

Traditional approaches to gathering patients’ perspectives on design rely on subjective data through focus groups and surveys.

The XR Lab takes a more objective approach, using biometric data from VR simulations and combining these with traditional approaches such as interviews.

“We still ask them to rank the solutions and their preference,” Dr Caldas said.

Dr Luisa Caldas

“We have a conversation about what was positive, what was negative, and I think it’s the crossing between that traditional interview or survey and then using the data, which may or may not support the survey or may introduce things we weren’t aware of.

“That has been so enriching.”

The VR technology is provided by HTC, including its VIVE Pro Eye headset with eye tracking and EMG sensors.

Dr Caldas said: “We are looking at eyesight, where people are looking, their attention.

“We are looking at their facial expression, their muscles. We are looking at heart rate.

“We felt those are unique ways to engage with children. Much more than a dialogue or with a survey.”

Dr Auguste also emphasised the importance of engaging children in the design process.

VR allows children to be at the centre of decision-making, he said, while the immersive nature of the tech helps overcome language barriers. As opposed to written surveys, VR is a universal language for understanding patient preferences.

The study aimed to be culturally inclusive, engaging patients who speak different languages and come from diverse backgrounds.

The power of VR doesn’t stop there

VR is already in use throughout the UCSF Benioff Children’s Hospital. Headsets are used as distraction therapy during procedures in addition to it being a recreational activity offered to patients.

“We’ve shown a reduction in the use of opioids and medications for sedation when using VR headsets,” Dr Auguste said.

“We’re also in the design process of creating VR and AR modules for our inpatients who are confined to the Oncology ward due to their immunocompromised state from chemotherapy.”

The technology has additional uses in patient communication.

The VR experience enables Dr Auguste to take families on virtual journeys through their conditions and surgeries, reducing anxiety and empowering them with knowledge and understanding.

As the technology advances, Caldas anticipates a more widespread adoption of VR in healthcare settings.

Paediatric care facilities will be at the forefront of this transformation,” she said.

“By providing immersive and interactive experiences, VR can transport young patients beyond the confines of their hospital rooms, offering a greater sense of freedom and adventure,” Caldas said.

“This integration has the potential to alleviate feelings of confinement, reduce stress and improve overall well-being during hospital stays.

“VR’s ability to create positive distractions and foster emotional connections can significantly enhance the patient experience, making it a promising tool to revolutionise paediatric healthcare environments.”

Bringing research into reality

XR Lab’s research is considered a proof-of-concept study, but the results gathered will play an important role in the design of a new facility at the Oakland campus of UCSF Benioff Children’s Hospital.

The lessons learned from the research “would be invaluable to inform the design of future inpatient settings,” Dr Auguste said.

Once results are published, the researchers will encourage other institutions to use the findings to build better facilities for children.

“I would love for this to generate a kind of cheat sheet; a cheat code of sorts,” Dr Auguste said.

“If you want to build a really interactive and engaging hospital space for kids, these are your fundamental lessons learned from the UCSF and UC Berkeley experience.”

XR Lab intends to bring this approach to other medical facilities once the study comes to a close.

“While we are currently focusing on our research at XR Lab and the collaboration with Benioff Children’s Hospital, our goal is to explore collaborations with other medical facilities and expand our studies to different healthcare settings,” Dr Caldas added.

“We believe that involving multiple institutions in this research will enrich our understanding and allow us to create patient-centric environments that positively impact the lives of paediatric patients and their families on a broader scale.”

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