Dwelling at Chelsea and Westminster Hospital
Location: Chelsea and Westminster Hospital, 2017
Despite hospitals being a facility saving lives and providing care, general concept of hospitals are regarded as ‘dangerous’ places. Whether the visitor, “who lack control... usually temporary” (Hillier & Penn 1991:33) is a patient or visiting a patient, typically one would not wish to maximise “dwell time” (Sutcliff, s.d.) due to risk of contamination. In marketing, ‘dwell time’ is defined as “how long people are likely to spend looking... buying... etc., especially while they are waiting somewhere”. (Cambridge English Dictionary, 2018)
Exploring charity marketing campaign CW+ Charity, an initial interplay of a relationship between patient waiting experience and dwell time in the Chelsea and Westminster (CW) Hospital Accident and Emergency (A&E) Department will be questioned. This proceeds to studying Space Syntax methodologies of the existing Intensive Care Unit (ICU), to understand if techniques CW+ applied in the A&E could be suggested here.
Meeting with Trystan Hawkins, Director of Patient Experience for CW+, Hawkins explained how a brief was established to design sixteen ‘comfortable’ A&E treatment rooms. This was highlighted in the document ‘Reducing violence and aggression in A&E’ (2011) by the Design Council, where 87% of people said they would be expected to wait for their treatment. It was “advisable to provide some form of entertainment” (Design Council, 2011) to reduce boredom during waiting times.
Fig. 1. Digital Art and Lighting in A&E treatment rooms in CW Hospital (2017)
‘Entertainment’ (Fig. 1) such as changing portraits of animals in their natural habitat offers therapeutic Ambient Art within the rooms. Hawkins continues to explain further use of nature, where proposals for an inactive area on the third floor will be transformed into an indoor garden project. By encouraging these attributes, the typical idea of a hospital departs away from franticness, in this sense, creates opportunities to stay.
To understand the effectiveness of CW+ techniques, developing a methodology to study a correlation with patient experience (survey) and dwell time (measured) would be beneficial. The experience and the duration expected to spend waiting for a doctor and/or looking at art work, would be advantageous towards understanding a measurement as to how CW+ have effected the patient experience to stay in certain hospital settings.
Although the ICU unit is undergoing redevelopment, affordances of the existing space can justify potentials. A visibility graph analysis (VGA) investigates properties of visible locations in a spatial layout. An Intelligibility value can be derived from a VGA, from the correlation coefficient between connectivity, the number of neighbours connected to the space, and global integration, how deep or shallow a space is in relation to other spaces.
Fig. 2. Pachilova’s Chelsea and Westminster ICU Mean Depth Graph (2017)
The studies of Mean Depth through VGA (Fig. 2), conducted by Pachilova (PhD candidate) shows a corridor layout typology, with an Intelligibility R2 = 0.85 at Global Level. The high correlation suggests the space provides greater chance to connect. However, by studying communication patterns the Intelligibility value is scrutinised.
Pachilova’s study indicates that 62% of communication are mainly held at the bays, and the lowest in the corridor at 9%, whereas the Mean Depth measure (Fig. 2) signifies the bays are less integrated spatially (yellow - green) in comparison to the most integrated (red) in the corridor. Furthermore, face- to-face conversations last less than a minute long in the corridor at 89%, which suggests conversations happen ‘on the go’, in passing between inhabitants.
Therefore, the high Intelligibility value shows high integration in the ICU spatial layout. It suggests potentials to apply CW+ techniques, to establish a correlation to enhance patient experience and dwell time. However, when analysing communication patterns and reality of everyday usage, the behaviour of the space changes drastically. With CW+ currently working on the redevelopment of the ICU unit, it is inevitable to consider the importance of patient experience whilst acknowledging the time patients and visitors will stay in the unit.
Adamson, Glenn. (2009). If you build it – will they shop? At:
http://www.vam.ac.uk/blog/sketch-product/if-you-build-it-will-they-shop (Accessed on: 19.11.17)
Cambridge English Dictionary. (2018) ‘Dwell time’ definition [online] At:
(Accessed on 02.01.18)
Design Council. (2011) Reducing violence and aggression in A&E. At:
InAandE.pdf (Accessed on 02.01.2018)
Hawkins, Trystan. (2017) Tour of Chelsea and Westminster Hospital by Director of Patient Experience
for Chelsea and Westminster Plus Charity. [Tour at Chelsea and Westminster Hospital, 19
Hillier, B., & Penn, A. (1991) 'Visible Colleges: structure and randomness in the place of discovery’
In: Science in Context 4 (1) pp.23-49
Pachilova, Rosica. (2017) Buildings for Health. An Empirical Study of Hospital Ward Layouts and Work
Processes of Healthcare Professionals. [Lecture at Bartlett School of Architecture, UCL, 15 November
Fig. 1. Li, Samantha. (2017) Digital Art and Lighting in A&E treatment rooms in CW Hospital. [Photograph] In
possession of: The author: London.
Fig. 2. Pachilova, Rosica. (2017) Chelsea and Westminster ICU Mean Depth Graph. [Diagram] At:
pdf?forcedownload=1 (Accessed on 17.11.17)