People in architectural drawings, part 5; common requirements

By Gordon Rugg

This article is the fifth in a short series about finding out what people would really like in life, using architectural drawings and fantasy buildings as a starting point.

The first article discussed how this gives you insights that you wouldn’t get from an interview or questionnaire. The next articles looked at regularities in people’s preferences; at changes in preferences over time and at obsolescence; and at complicating factors that you need to keep in mind when using this approach.

In today’s article, I’ll look at ways of identifying common user activities and requirements that should be incorporated into the design process, and that can be handled cheaply and simply, producing significantly better designs as a result.

This article gives a brief overview. I’ll re-visit this topic in some later articles, which will work through some specific cases in detail.

A thing of beauty is a joy forever: Waiting rooms, however, usually aren’t…banner5 v1Sources of original images are given at the end of this article

For today’s article, I’ll use the underlying theme of a visit to the doctor, focusing on two particular activities.

If you watch what happens when people go to visit the doctor, you see two stages in the process that are familiar to pretty much everyone. One stage is checking in, to let the medical practice know that you’ve arrived; the other is waiting for the doctor to call you through.

Different practices have different ways of handling these stages.

Arrival

One common arrangement is that when you arrive, you let one of the reception staff know that you’ve arrived. That’s a perfectly sensible arrangement. However, if you start thinking about the details of how this is handled within a given medical practice, you soon start noticing potential problems.

Within the compass rose approach to requirements gathering, one thing you need to look for is the worst cases. In the case of anything medical, one of the worst cases is having to talk about your private medical issues in front of people who shouldn’t know about them.

An obvious way of handling this worst case is to make sure that the reception area is out of earshot of other patients. Some practices handle this by having different rooms for the waiting room and the reception area. Others don’t.

A related issue is waiting in a queue to report to the receptionist. Queues are a much richer, deeper topic than most people realise; there’s an entire body of maths called queueing theory, which deals with the best ways of managing queues not just of people, but also of things such as internet traffic.

One deceptively simple-looking part of managing human queues is how someone in the queue can tell whether or not it’s their turn to go forward. The railway station at Stoke-on-Trent is an example of getting it right. There’s a queueing line outside the ticket office; there’s a glass wall between the queue and the ticket office, so people in the queue can see when one of the ticket staff is free. This arrangement is simple and effective, and ironically gives more privacy to ticket purchases than patients get in most medical reception areas.

A less obvious problem with knowing when it’s your turn involves people with sensory issues, such as visual impairment. If you have visual impairments, you’ll probably have difficulty telling whether or not a receptionist is trying to catch your eye to tell you that they’ve finished the paperwork from the previous patient and are now ready to see you. If you have hearing impairments as well, you’ll quite possibly have problems hearing the receptionist telling you that they’re ready for you now.

One response to this is to ask how often this particular combination of problems is likely to occur. A lot of design, both of buildings and of software, is carried out by healthy young males, who are used to dealing with healthy people in their workplace. Workplaces are a very different proposition from places such as medical centres, which by their very nature will deal with a high proportion of people who have assorted impairments.

With hindsight, issues like these are fairly obvious. With foresight, though, they are easily missed.

This is where there are advantages in using a systematic framework to tackle the requirements gathering, so that you can identify key types of requirements. Within the compass rose model, for instance, one key type of requirement involves very common activities, where design should usually focus on making those activities as smooth and problem-free as possible. That may sound obvious, but a lot of common activities are easily overlooked precisely because they are so familiar.

An example is “landing zone” activity within a building; when people come in from outside, they often pause or stop just inside the building to close umbrellas, undo coats, work out where to go next, etc. When you start watching out for this activity, you see it everywhere; however, most people are unaware of it until it’s pointed out to them. I’ve blogged about this previously in more detail.

For a very readable and fascinatingly insightful detailed discussion of this topic, Paco Underhill’s book Why We Buy is well worth reading. It’s about his work as an anthropologist studying what people do when shopping. The “landing zone” is one of the things he noticed and described.

There are numerous approaches to systematic observation, ranging from very broad scale observation of how crowds behave, down to extremely detailed observation of how people perform small physical and mental tasks. I’ve blogged about this previously, describing how you can systematically observe and record activities using task analysis and timeline recording.

When you combine these approaches with representations such as schema theory and script theory, you soon start to identify long-term regularities in requirements at different levels of detail.

For instance, one common requirement for buildings such as medical centres involves transport. At a coarse grained level, there’s a requirement for somewhere to park visitors’ private vehicles. This requirement has been around since at least Roman times, and across a wide range of cultures. At a finer-grained level, however, there have been changes over time, with the schema for private vehicle changing from various types of coach or cart to various types of car. Many parts of the schema, though, have remained largely unchanged despite the changes in technology, such as the amount of space required for each vehicle, and the need to have the parking area close to the building.

I’ll return to this theme in more detail in a later article. Now, though, I’ll focus on another recurrent theme in requirements, namely sensory issues.

Waiting

The design of waiting rooms is another fine, rich area in terms of opportunities for getting it right or getting it hopelessly wrong.

I’ll focus on one issue involving a common task that interacts with sensory issues which tend to be overlooked in the design of waiting rooms. That issue is knowing when it’s your turn to see the doctor.

One obvious way of doing this is to use a visual method, such as a screen which announces that doctor X is ready to see patient Y, or a ticketing system. That works well if you happen to have reasonable eyesight, and you happen to be looking at the screen when the announcement is flashed up. Those are big assumptions, though, especially in a medical waiting room. A lot of the patients will by definition be in poor health, often with poor eyesight. A fair number of patients will be young children, so the parent or carer with them will have to divide their attention between keeping an eye on the child and keeping an eye on the screen to see if it’s the child’s turn.

Overall, this is a regular source of stress, especially if patients don’t know what happens if they miss their name being announced – will they miss their appointment completely, and have to come back on another day? The medical practice staff will know the answer to that question, but very few patients know it.

Another obvious way of letting patients know when it’s their turn is to use an auditory method, such as an intercom announcement that doctor X is ready to see patient Y. Again, this assumes that you have reasonable hearing, which by definition will often not be the case, and it assumes that you’re within earshot, which you might not be if you’ve had to go to the toilet (again, quite likely among patients needing to see a doctor). There’s often a lot of background noise as a further problem – for instance, other patients talking to each other, or children crying or playing, and muzak or a permanently-on TV.

A lot of these problems can be reduced via the design of the rooms and the choice of technology.

For instance, architects are fond of atria and light wells, which look dramatic, but which often play hell with acoustics. Architects are also fond of big open spaces, which again look dramatic, and which are often cheaper than spaces containing dividing walls, but which cause a lot of problems with noise levels. These also often cause problems in terms of the distance between a patient and the announcements screen.

Architects and medical practices are usually fond of smooth surfaces which can be easily cleaned – a big issue in a medical context – but again, these are often a problem in terms of noise, because they tend to reflect sounds rather than absorb them.

The other senses can also be a significant issue in a medical context. Some children on the autistic spectrum, for instance, are highly sensitive to smells; so are some pregnant women.

Sensory issues have been a constant feature of requirements for a long, long time; a good example is Classical Greek and Roman theatres, whose design deliberately incorporated very sophisticated acoustics. A lot of sensory-related requirements have remained pretty much unchanged for thousands of years, so it’s unfortunate that the designs of many modern buildings don’t make significant allowance for them.

Closing thoughts

In later articles, I’ll work through some cases in detail, showing how a building’s requirements can be handled cleanly and systematically. (I’d originally planned to do that in this article, but doing it in detail will require a fairly lengthy article, so I’ve concentrated on the overview this time.)

The take home message from this article is that if you use a combination of the compass rose model and of systematic requirements gathering via the methods described on this blog, you can quickly identify key requirements that are likely to remain unchanged for the expected lifetime of the building, even if other requirements change. A lot of those long-duration requirements involve clusters of activities that are so common that people don’t give them a second thought; however, it’s precisely because they’re so common that it’s important to incorporate them as smoothly as possible into the design.

In terms of sensory issues, I’ve focused in this article on the senses of the people using the building. However, it’s very tempting to speculate about sensory issues and architects. A lot of architecture looks more like monumental sculpture than like a construction designed to facilitate human activities. Many skyscrapers are more like machines for looking at than machines for living in or for working in, to rehash a famous architectural quote. There’s a strong visual element in those designs, to the exclusion of other important senses, and to the exclusion of many aspects of functionality.

I have no objection to buildings looking striking and beautiful; quite the contrary. However, I have strong opinions about buildings that impose needless difficulties on the users because an architect wanted to build a really big sculpture.

In the next article in this series, I’ll pull together the various themes so far, and consider what we can infer about people’s dream lives, and what we can do about any knowledge we gain from this.

Notes and links

Sources of images in the banner:

“Out-patients’ Waiting hall. Western Infirmary. Wellcome L0000310” by http://wellcomeimages.org/indexplus/obf_images/9b/b9/363a1088d7d0b30228dcea2e7a10.jpgGallery: http://wellcomeimages.org/indexplus/image/L0000310.html. Licensed under CC BY 4.0 via Wikimedia Commons – https://commons.wikimedia.org/wiki/File:Out-patients%27_Waiting_hall._Western_Infirmary._Wellcome_L0000310.jpg#/media/File:Out-patients%27_Waiting_hall._Western_Infirmary._Wellcome_L0000310.jpg

“DworzecPKP Miedzylesie wnetrze” by Krystian Kuchta – Own work. Licensed under CC BY-SA 3.0 via Wikimedia Commons – https://commons.wikimedia.org/wiki/File:DworzecPKP_Miedzylesie_wnetrze.jpg#/media/File:DworzecPKP_Miedzylesie_wnetrze.jpg

There’s more about the theory behind this article in my latest book:

Blind Spot, by Gordon Rugg with Joseph D’Agnese

http://www.amazon.co.uk/Blind-Spot-Gordon-Rugg/dp/0062097903

Related articles:

https://hydeandrugg.wordpress.com/2014/05/03/the-compass-rose-model-for-requirements-gathering/

https://hydeandrugg.wordpress.com/2014/03/09/finding-out-what-people-want-in-a-nutshell/

https://hydeandrugg.wordpress.com/2013/09/05/client-requirements-the-shape-of-the-elephant-part-1/

Overviews of the articles on this blog:

https://hydeandrugg.wordpress.com/2015/01/12/the-knowledge-modelling-book/

https://hydeandrugg.wordpress.com/2014/09/19/150-posts-and-counting/

https://hydeandrugg.wordpress.com/2014/04/28/one-hundred-hyde-rugg-articles-and-the-verifier-framework/

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4 thoughts on “People in architectural drawings, part 5; common requirements

  1. Pingback: Observation, stumbles and smiles | hyde and rugg

  2. Pingback: Mapping smiles and stumbles | hyde and rugg

  3. Thank you for this blogpost, it was very timely as I have had several medical appointments in the last two weeks.

    The idea of privacy and confidentiality in primary care certainly has become something of interest to many people. It is as if someone has suggested that this is Very Important and now GP practices are trying hard to show that they have an area where you can talk to the receptionist privately. And yet in secondary care it is still acceptable to have patients being given life changing information separated only by a curtain, as highlighted in this blog post.

    https://illusionsofautonomy.wordpress.com/2015/02/28/overheard/

    As many GP surgeries are in old buildings that can’t be changed easily, perhaps a high tech solution would be to use sound masking equipment.

    Sometimes when tech doesn’t work, it can be tempting to throw even more tech at the problem, and calling patients when it is their turn is one such example. As you have highlighted each system addresses different sensory impairments but it can be hard to take into consideration all patients, the build and the resources all at the same time. Some GPs find that they prefer the old fashioned way to call their patients. That way the consultation starts in the waiting room, with observations of how the patient is getting up from their chair and moving about, who they are with, and how much help they need. The Three Second Consultation http://pmj.bmj.com/content/85/1008/560.full.pdf is something that Dr Jonathan Tomlinson has written about. https://abetternhs.wordpress.com/2014/09/02/beyond-first-impressions/

    Of course this takes longer which makes the 10 minute consultation difficult, but that discussion should be left for another day.

    The third situation I wanted to comment on was the actual waiting time. It is well known among patients and parents, especially those with chronic or long term conditions who frequently see their GP, that the best ones have the longest waiting times and are the most difficult to get an appointment with. Waiting times could be kept down by enforcing the 10 minute consultation time but that results in lower patient satisfaction. A better solution would be to make waiting more pleasurable.

    In my own surgery there are chairs but no tables for the adults, and a low table and chairs for the children. As I regularly wait for up to an hour for my GP (I usually get there early in case there were some DNAs before me) I always take some work to do. However it is very uncomfortable sitting on the floor with my laptop on the children’s table!

    Some more enlightened primary practice waiting areas around the world are seen as a place to meet with other people. They have internet access, comfortable and appropriate seating, wifi access, computer terminals where they can research their own conditions or access their own medical notes, and some even supply refreshments which can also serve to meet some of the psychosocial needs of the patients, especially if they are elderly and this is their only trip out of the house. It seems all we can managed in this country is a TV blaring out health messages and advertising that is of little interest to the patient and gets repetitive and annoying after a short period of time. A tech solution but not a useful one.

    I agree that systematic requirements gathering is very important, but it is how you turn the information into knowledge, and then apply wisdom that makes the difference. High tech can be part of the solution, but sometimes it is the small simple changes that are not expensive and don’t need any new technology that can make the biggest difference.

    For me, I would be happy if my practice had a wheelchair space for my son and a table for my laptop so I could do some work, interrupted only by the smiling face of my GP calling me in for a 20 minute appointment.

  4. Pingback: People in architectural drawings, part 6; conclusion | hyde and rugg

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