Over the past 40 years in healthcare, as buildings, products, and services and the roles they play in our lives and the environment have become more intricate, the focus of design in health has changed to include data and research driven processes (Chong et al., 2010; Nicholas et al., 2024; Wang & Groat, 2013). Healthcare services and spaces created through these patient-centered evidence-based processes are models of recovery, reflection, and reimagination. This case study research paper will present several project-based examples that undertake health and design research to implement novel solutions for improved care. This work has arisen from over six years of collaboration with a large local teaching hospital, capped off with 18 months of participation as a part of the American Hospital Association’s (AHA) Age Friendly Care Action Group. Inculcated in these projects is the AHA’s Four M’s of care: medication, mentation, mobility, and what matters to the patient (Penn State Nursing, 2024)
Central to the projects presented here, is a community-driven culture of care for both patients and caregivers (Evan & Fischer, 2022; Fuentes, 2020; Lightburn et al., 2005; Robert Wood Johnson Foundation, 2020). Considered an emerging approach in corporate and health environments, “culture of care” requires that the human necessity for dignity be the leading concern when creating solutions for those in need at all levels of engagement (Evan & Fischer, 2022). Due to the complexity of design practice, especially in the healthcare space, these human and patient-centered approaches to design are increasingly necessary and are often developed through empirical design research such as that shown here (Chong et al., 2010; Frayling, 1994)
Chong, G. H., Brandt, R., & Martin, W. M. (2010). Design Informed: Driving Innovation with Evidence-Based Design (1 edition). Wiley.
Evan, B., & Fischer, G. (2022, March). Culture of Care [Organizational]. Othering & Belonging Institute. https://belonging.berkeley.edu/cultures- of- care/overview/why Frayling, C. (1994). Research in Art and Design. Royal College of Art Research Papers, 1(1). http://researchonline.rca.ac.uk/384/ Fuentes, F. V. (2020). Social and health care coordination: Towards a new culture of care. Enfermeria Clinica, 30(5), 291–294. https://doi.org/10.1016/j.enfcli.2020.09.001 Lightburn, A., Sessions, P., Lightburn, A., & Sessions, P. (Eds.). (2005). Community-Based Clinical Practice: Re-Creating the Culture of Care. In Handbook of CommunityBased Clinical Practice (p. 0). Oxford University Press. https://doi.org/10.1093/acprof:oso/9780195159226.003.0002
Hurwich, T., Nicholas, D., Fleming, F., Gondek, P., Katz-Buonincontro, J., King, D., & Perignat, E. (2022). DESIGNING FOR CREATIVE RESEARCH IN GRADUATE EDUCATION. ICERI2022 Proceedings, 195–201. 15th annual International Conference of Education, Research and Innovation. https://doi.org/10.21125/iceri.2022.0081
Israel, T. (2010). Some Place Like Home: Using Design Psychology to Create Ideal Places Second Edition (2nd edition). Design Psychology Press.
Nicholas, D., & Anandan, S. (2023). DESIGN THINKING AND NEW PROGRAM INNOVATION: CASE STUDY RESEARCH IN HIGHER EDUCATION EVOLUTION POST PANDEMIC. ICERI2023 Proceedings, 6032–6039. 16th annual International Conference of Education, Research and Innovation. https://doi.org/10.21125/iceri.2023.1508
Nicholas, D. (2025). Design Thinking for Health Environments: Case Study Research on Innovation, Design Leadership, and Healthcare Complexity. Antioch University Dissertations & Theses. https://aura.antioch.edu/etds/1124
Nicholas, D., Afzali, M., Aksamija, A., Coleman, N., Mazzi, A., Sanders, E., & Ilhan, I. O. (2024, June 23). Reimagining care through evidence: Design research, patient centered solutions, and a culture of care for healthy societies. Design Research Society. https://dl.designresearchsociety.org/drs- conferencepapers/drs2024/editorials/13
Penn State Nursing. (2024). The 4Ms Explained Age-Friendly Care. https://www.agefriendlycare.psu.edu/the-4ms- explained
Robert Wood Johnson Foundation. (2020). What is a Culture of Health? | Evidence for Action. Culture of Health. https://www.evidenceforaction.org/about-us/whatculture-health
Wang, D., & Groat, L. N. (2013). Architectural Research Methods (2). John Wiley & Sons, Incorporated. http://site.ebrary.com/lib/alltitles/docDetail.action?docID=10684914