Parrot Murals and Feather Floors: Co-designing playful wayfinding in the Queensland Children’s Hospital

Abstract

This chapter describes a collaborative project to improve the way that sick children and their families could find the various entertainment facilities located on Level 6 of the Queensland Children’s Hospital—Starlight Express Room, Kidzone, and Radio Lollipop studio. Wayfinding is an important part of the interior design considerations for hospitals, and this project paired designers and artists with hospital administrators and facilities management team members to create a playful way for each of the entertainment facilities to be easily found, while also making navigating the entire floor stress-free, including identifying the lifts, which are the main access point for the floor.

With their intricate layouts, numerous departments, units, and floors, hospital environments can be challenging to navigate—especially for visitors, who are already dealing with illness, injury, and/or emotional stress, and often find themselves “getting lost”. Ineffective wayfinding in hospitals can result in missed appointments, frustration, and stress for patients and their families, as well as reduced productivity for hospital staff who provide directions [1, 2]. This chapter outlines the origins, processes, learnings, and impacts of a project designed specifically to improve the hospital wayfinding experience at Queensland Children’s Hospital (QCH), a specialised 389 bed paediatric hospital in Brisbane, Australia that provides tertiary and quaternary-level care for the state’s sickest and most seriously injured children.

Completed in 2014, the multi-award winning twelve-level 95,000m² QCH was designed with two generous atriums, numerous double-height spaces, and a series of roof terraces featuring public and private gardens, multiple playgrounds and green spaces, and a signature green sloping roof. Conceptualised around a ‘living tree’ nature-inspired design, the two atriums stand like two distinguished tree trunks, featuring a network of plant-inspired cladding, wildlife-themed artworks, and double-height trunks and branches to assist wayfinding, with several large Eclectus parrot sculptures perched up through five floors. Despite design thematics intended to assist with wayfinding, the hospital reported that visitors could still get a little lost navigating to the non-clinical spaces that comprised the Entertainment Precinct on Level 6.

The Entertainment Precinct is co-located with several clinical spaces, including neuroscience, child development, oral health, and allied health outpatient services. It features three separate, dedicated places to facilitate play: Starlight Express Room, Kidzone, and Radio Lollipop studio. These three charities offer purpose-built facilities for patients and their families, providing options to engage, play, learn, and relax. These lively environments are filled with artmaking, music, dance, play areas, radio, and distraction methods across a wide spectrum of activities—fun places to experience and explore for children of different ages. There were, however, consistent problems with newcomers having difficulty finding these spaces—which resulted in fewer visitors and less opportunity for children to access the playful experiences essential to their treatment journeys. Six years after the hospital opening, staff and families reported that finding one’s way to each charity organisation was challenging. Additionally, the floor as a whole was not communicating the desired atmosphere of playfulness and wellbeing—there were no visual cues to signal that this area offered spaces for fun and games. For example, as Fig. 1 illustrates, the Level 6 lift entrance to the space communicated an arrival experience that was similar to every other floor in the hospital, rather than the desired atmosphere of fun and play on offer at the Entertainment Precinct.

Fig. 1

The lift entrance A on Level 6 Entertainment Precinct, QCH—before any wayfinding interventions (top), QUT Design and QCH hospital team members in Level 6 Entertainment Precinct (middle and bottom)

As the Entertainment Precinct is an important area for supporting the children and families attending the hospital, the project team was tasked with the challenge of creatively reimagining wayfinding for this space. This chapter details this hospital wayfinding and placemaking project, highlighting the critical importance of taking a co-designed and holistic approach in developing effective, user-friendly, and playfully creative navigation solutions for hospitals. The specific goals of this project were to change the current experience of Level 6, in order to (1) better direct visitors to specific locations on that floor and (2) shift it towards an atmosphere of play that could enable distraction from the challenges of health treatment. It also needed to (3) create a strong visual identity that complements and extends the hospital architecture, character, and branding. This combination of aims meant that not only was a new wayfinding design intervention required, but additionally it needed to be a playful and joyful wayfinding experience.

Play is recognised by paediatricians as a fundamental part of a child’s development and relationship with their family (e.g., [3]), and their rights by the United Nations [4]. The child’s development and growth does not stop when they are in hospital undergoing treatment for a health condition. This highlights the critical opportunity to design paediatric hospital experiences for children to support their ongoing development through play while also alleviating the stress from ill health—and indeed, as we will show, children’s hospitals across the globe are increasingly turning to creative/playful wayfinding and placemaking to do so.

1 Wayfinding in Children’s Hospitals

Wayfinding is the system that assists people to find their way from one place to another, often through a complex or new environment. It is a design specialisation, also known as environmental graphic design, sign-systems design, or architectural graphics, that effectively directs people through a space. The phrase was originally coined by urban planner Kevin Lynch [5] who argued that wayfinding is the process where one forms a mental picture of a place based on memory and sensation:

In the process of way-finding, the strategic link is the environmental image, the generalized mental picture of the exterior physical world that is held by an individual. This image is the product both of immediate sensation and of the memory of past experience, and it is used to interpret information and to guide action [5, p. 3].

Wayfinding tools, such as maps, placards, and route signs are designed to assist people in navigating through space, and, with technological advances, now include moving images, GPS, and web connectivity, as well as more transdisciplinary, socially aware, and creative imagery/branding [6]. Contemporary approaches to enhance the hospital wayfinding experience typically include: (1) integrating wayfinding visuals on all surfaces, including the floors and roofs; (2) playful wayfinding; and (3) integrating a narrative and/or memorable landmarks at key navigational decision points, thus creating journeys that are easily describable in one simple sentence. Designs seek to acknowledge diversity, culture, and inclusion, and often use digital technology (e.g., interactive screens in multiple languages, personalised hospital maps on apps showing the path from car park to ward).

For example, at Evelina Hospital in London, the ‘Evelina Gang’¹ are cartoon characters who welcome young patients and their families and help them find their way around. While the original 2005 wayfinding designs included colourful, fun, non-clinical names and pictures for each floor and lift signs (ocean, beach, forest, arctic), families still found navigation challenging—so the 2013 redesign led by Bill Greenwood Ltd. focussed on developing the novel and child-friendly ‘Evelina Gang’ of varying ages and abilities, which were co-designed with patients.

Also in the United Kingdom, Landor Associates created different illuminated and interactive animal characters—hedgehogs, horses, rabbits, and more—to assist with wayfinding at Great Ormond Street Children’s Hospital (GOSH), and co-created short stories about their adventures with patients, their families, and staff (both paper and audio books). GOSH has also installed a 50-metre digital ‘nature trail’, a LED-illuminated wall (created by Jason Bruges Studio) on the way to the operating theatre. A mix of custom graphic wallpaper and seventy integrated LED panels at varying heights, this motion-sensitive interactive installation creates animated patterns of light to reveal animals (horses, deer, hedgehogs, birds, and frogs) through the trees and foliage of the digital forest.

In America, the Nationwide Children’s Hospital² approach to wayfinding, placemaking, and identity was inspired by flora and fauna native to Ohio. Designed and detailed by RAA, it features large-scale double-height wooden trees and animals, and three-dimensional experiences/media projections (of glittering leaves and fireflies), as well as a soundscape of rain and wind, and leaves on the floor for fun wayfinding. As research has shown that children across all stages of cognitive development consistently preferred art with nature [7], and of course nature is intrinsically calming—see biophilic design [8], it is perhaps not surprising that hospital wayfinding schemes often centre around our natural world.

Interestingly, despite growing awareness of the importance of designing hospitals as humane, salutogenic (health-promoting) places [8], and the importance of thoughtful architecture, art, and design in this process, only a handful of studies have documented the process and impact of creative approaches to wayfinding in hospital. In New Zealand, Short et al. [9] focused on how communication design could improve the outpatient experience in a children’s hospital where the current experience was challenging: wayfinding instructions were often given verbally by staff, with the route complex and unintuitive, with poor placement and overwhelming visual stimuli making it difficult for visitors to identify important waiting area signage communication. There was no cohesive design identity as vinyl art works and ad hoc posters competed for attention. Short et al. [9] completed an experience journey map documenting the current outpatient experience, from referral to the service to leaving the building, and then mapped possible interventions against the wayfinding task. They tested a revised appointment letter and a large blue vinyl wayfinding sign, which ultimately was not implemented into practice. In reflecting on the project challenges, Short et al. noted that hospital stakeholders in a traditional, hierarchal organisation were not familiar with the collaborative process and potential of design, that building trust across such different professions/approaches takes time, and there was “often a tension between balancing the design process (the focus on making and understanding the user) and stakeholder buy-in” [9, p. 2567].

2 Our Approach: Co-Designing Playful Wayfinding at the QCH

Prior to this project, the QUT team had built trust and buy-in through other collaborations with hospital stakeholders. This was extended as all parties continued with further investment: the HEAL project—a joint effort between QUT Design Lab and state government body Clinical Excellence Queensland provided a paid internship for a research student, while the hospital design team also had a production budget available for the print and installation of final vinyl decal designs. We were therefore able to use these resources to support Kirsten Baade—an artist and design research student—to create and produce a playful wayfinding strategy for the QCH Entertainment Precinct, mentored by her design supervisor and academics along with the hospital’s design team as we collaborated on this interdisciplinary project.

The collaborative approach was a fundamental tenet in how we worked, and stakeholders from charity partners, clinicians, children, and their families, as well as strategic hospital committees, were consulted and engaged with throughout the process. The space we were designing for includes two lift areas (places of arrival and departure on Level 6, as pictured in Fig. 1—top), junction points along corridors where people would change direction depending on where they were headed, and the outside surrounding each of the three charity partners.

Firstly, the new experience design for this precinct needed to signal to the children, young people, and their families that they have entered an area that is a place for fun, while also assisting people with finding their way through the precinct. The design research team engaged in multiple site visits and photography to gain a better understanding of key junction points and the experience design challenges, with artist and designer Kirsten Baade embedded into the hospital team—spending significant time on site, designing as a creative resident alongside the hospital’s Design Manager Matthew Douglas. As the project progressed, Kirsten—who created the imagery—returned to measure walls and doorways for high accuracy in planning out the visual designs so these would fit around doorways and fixtures. This creative making was highly situated and bespoke to the hospital, the specific floor, and diverse stakeholders, something that was likely critical for a successful design outcome and staff acceptance.

Secondly, in directing people to the precinct partners, the design would also need to provide appropriate graphic representation for those partners and to playfully direct visitors across the floor, and, in the case of the Starlight Express Room and Radio Lollipop, around the corner. Thirdly, sensitivity to the aesthetic context was a critical consideration, as any proposed design solution would need to complement the existing artistic scheme for the hospital with its ‘living tree’ design, network of architectural ‘trunks and branches’ coming off the interior atrium, and its differently-coloured floors. QCH also has a contemporary art collection installed throughout. This aesthetic sensibility provided further context and opportunity for a creative design solution, as we employed a range of creative arts-based approaches in the workshops and in creative design processes in trying to come up with opportunities for designs that would create a playful experience to engage and distract the children and their families.

Finally, pragmatic and clinical concerns also informed the design—solutions would additionally need to meet the hospital’s health and safety requirements, such as to be non-invasive, antimicrobial, able to support deep cleaning, and fall within the hospital’s allocated budget for decal printing of visual design solutions. The clinical services on Level 6 treat children and young people with sensory processing disorders, developmental delays, and neurological conditions that can be triggered by particular visual stimuli. Consequently, intense consultation was necessary with local clinical teams both before and after design development, and this feedback was quite influential. It is also important to note that this project ran during the Covid-19 pandemic (across 2020–2021), which added another layer of complexity to the engagement, consultation, and design processes, as access to the hospital was restricted to visitors (not including parents and guardians), and the health service itself was preoccupied with pandemic planning and management.

3 The Collaborative Design Ideation Process for Playful Wayfinding at QCH

We conducted workshops with various stakeholders. The design academics led three workshops with key stakeholders including the hospital team, charity partners, and representatives from the executive leadership team and other senior managers, with special attention from the Arts in Health Committee. As previously mentioned, the hospital team additionally conducted early stakeholder interviews and workshops with hospital precinct partners, clinicians, and consumers, alongside multiple follow-up discussions about their experience subsequent to the design completion. Team members worked closely together, as well as independently, to pursue a thoughtful design outcome that was informed by best practice and reflected our shared values of collaboration in design.

The first onsite workshop was entitled “Inspiration and Ideation”, led by four HEAL team members with expertise in design for health, interaction design, art, the built environment, and creative placemaking. Approximately 15 key stakeholders (representatives from all precinct partners, QCH engagement and communication team members, and architectural representatives) engaged in this collective brainstorm about how we could potentially redesign the space so that the wayfinding experience was more fun and distinctive. To set the scene and show the diversity of design ideas available (the inspiration component), the HEAL team started by sharing images and concepts from innovative wayfinding from across the globe (the ‘Evelina Gang’ at Evelina Hospital, Great Ormond Street Children’s Hospital, and the Nationwide Children’s Hospital in Ohio, as well as non-hospital examples of wayfinding in public places), and examples of previous portfolio artworks by the team. This process started an ongoing and important conversation about ensuring that any wayfinding strategy on Level 6 was cohesive, coherent, and consistent with the existing QCH design identity—but also reflected the playful, fun identity that was integral to the Entertainment Precinct.

This first workshop discussed existing exemplars, overall site values/priorities, and desired features: for example, should the wayfinding on the floor be lines, shapes, fun characters, or perhaps connected to the nearby Brisbane river out the window, through a river shape and/or leaves? We also discussed clues in wayfinding, noting how at the Evelina Children’s Hospital: “Whole creatures such as butterflies are to be found at the major arrival point and then progressively dissected as you go further in. Eventually a child might find perhaps one wing under the bed. To get back to the main arrival point, you put the creature back together” [10, p. 101].

We also brainstormed multiple ideas for the wall and floor content and outlined different approaches—from relatively simple mural content to more interactive digital approaches, and large central installations (for example, the large trees that are part of Nationwide Children’s Hospital). Hospital team member Lynne Seear led a reflective discussion about the hospital design and values, which prompted significant thought about whether and how to link to the hospital’s central atrium space, which features large sculptures of Eclectus Parrots. While we knew that we wanted to transform Level 6 into a place of fun and joy, we were, at the start, very open to the types of things to create. We explored ideas such as murals, interactive art, and kinetic sculptures. One idea we considered was a giant nest that people could sit inside. However, there were restrictions on anything that could be touched. There were also budget restrictions, and restrictions relating to public art—it had to be sturdy, sustainable, and people-proof. The problem focuses on creating a sense of fun and joy resonated well with the artist’s painting aesthetics, which often feature bright saturated colours, with contrast and patterning for detail, visual rhythm, and overall harmony of the mural composition.

Figure 2 shows how workshop participant input fed into a bespoke brief for this wayfinding design. Participant ideas were represented on post-it notes by colour (Fig. 2—top) and then the design approach was to cluster, organise, and re-organise these to identify different themes across the ideas and participant groups (Fig. 2—bottom). Through this bottom-up approach, drawing on emergent visual thinking [11] and thematic mapping [12], the different ‘voices’ of workshop participants could be interpreted into some guiding concepts for the design. The emerging themes—in black text in Fig. 2, (bottom)—were play, puzzles, journey, creativity, stories, nature, having a child’s voice, parrots, being inclusive, complementing existing elements, and having distinct partner identities. These would be presented back to the participants as part of tracing the progeny of the wayfinding co-design outcomes.

Fig. 2

Workshop participants insights (top), and how these informed themes for the design (bottom)

Further clustering was conducted to consider even higher-level categories. These focused more on the ‘medium’ than the ‘content’ (features) of the design. They were a useful thinking tool internally for the design team to explore possibilities for realising the different qualities that were coming up. For example, while parrots and nature could clearly be implemented through visual content solutions, aspects such as play and puzzles or a journey required thinking about the invisible yet critical aspect of how to ‘experience’ the place (e.g., to be playful, a journey, from a child’s perspective, etc). Additionally, during this early ideation stage, there were many workshop ideas around the medium and materials that we could draw upon for final realisation of the visuals and experiences, from vinyl decals through to interactive art, sculptures, and digital screens.

4 Sharing Design Power: Tracing and Negotiating for Best Outcomes

The collaborative workshops and codesign process were highly effective at identifying concepts to drive the design explorations, and ultimately, design outcomes. A number of potential ideas were raised for the space: there was a little bit of disagreement about the best path forward and whose voice would be dominant in the design decisions—negotiating those kinds of tensions and ensuring that everybody has an equal voice and equal say was a really important priority. As discussed above, by showing how participant suggestions actually constituted the themes such as nature and parrots—tracing those themes back to direct quotes—we could facilitate continued progress, ‘buy-in’, and enthusiasm in the group.

As designers we also had ideas of what could work well, and one of the most challenging parts of the project for us was negotiating on clear design ideas that we had, and how appropriate these were or how these might be applied in a hospital environment. That is part of co-design, but was at times challenging. For example, an initial exciting idea centred on native animals and recent endangered species—but the group quickly focused in on parrots, to connect with a large existing central parrot sculpture that was key to the hospital design—and highly visible and familiar, particularly from Level 6.

Similarly, some of the working group members from the Health Service felt the need to reinforce their obligation to follow mandated internal protocols around approvals and procedures to ensure the outcome would be as risk-free as possible for patients and families. This sometimes meant that things moved slowly. This is the fundamental nature of healthcare (except in emergency situations), and in the end allowed more time for creative development. Any tensions between these different approaches were always resolved by open and clear communication.

Once parrots and nature (specifically the architectural design of a tree which was common across QCH’s existing interior design) had been agreed on as core guiding concepts, in the second and third workshops discussion centred on the visual brand and visual wayfinding designs—to look at parrots within the trees.

Parrot-related characteristics and stories were explored both behind the scenes in further design sketches, and in a collaborative way with the stakeholders in a second workshop. Workshop 2 was centred on co-designing the parrot activities—what were they doing on the walls and floors? What would they look like? The second design workshop explicitly tested these ideas, and the QUT team engaged with the QCH team and stakeholders for their ideas as well on the activities or stories about things the parrots might be doing. We presented mock-ups and gained feedback, which would drive Kirsten’s mural illustrations, and many possibilities were discussed. Parrot activities included singing, playing music in a band, playing sport, blowing bubbles, hanging out, having a birthday party, going for a walk, flying in a flock, reading a book, looking at an iPad, fishing, and painting.

There was much excitement about how this concept would enliven the area, enhancing wayfinding but also potentially providing different ways to connect with the parrot theme. This could include competitions for children to name the parrots, associated colouring-in activities and drawings shown on screens, extending the theme with VR/AR, and large fixed items, such as tree and nature-themed internal seating areas. Through the first two workshops, it became apparent that each precinct partner could have their own parrot in similar colours to their branding: red for Radio Lollipop, purple for Starlight, and green for Kidzone. In response, Kirsten created some early parrot designs for feedback. Each different parrot would lead the way to the specific space, through visual cues on the floors. She designed these wayfinding cues as different coloured feathers, marking out the “journey to fun” at each precinct partner location.

The workshop collaborations enabled the direct, active involvement of the broad stakeholder team in the design process, while the QUT Design team continued with design ideation and content creation in parallel and in response to those sessions through sketching and mock-ups. At the same time, senior hospital staff conducted extensive collaboration with families, patients, and clinicians, seeking input on awareness of the services and subsequently on the design proposal. Detailed feedback from those sessions was incorporated into the final design. This feedback gave the artist a very clear sense of what hospital stakeholders would like to see. While perhaps an unusually collaborative approach to the artistic creative process, it aligns well with the ethos of using co-design in healthcare. As Kirsten noted, she had to dive deeply into the habits of parrots, the adventures they could get up to, and the importance of empathetically listening to stakeholders:

To be more aware of the idea of telling a narrative with my illustrations. Initially, my ideas were too abstract. People want to see and engage with characters doing things. This is feedback I received. So I learnt how to make parrots look expressive. I learnt a lot about Australian parrots. The hospital already had large sculptures of Eclectus Parrots hanging in the atrium. Australian parrots are playful and intelligent. They will hang upside-down for fun. They are colourful. Some of them gather in huge flocks—budgies and rainbow lorikeets do this. They are noisy. They are cavity nesters. They don’t make nests, rather they use holes in trees. These are all things I depicted in the illustrations …I learnt how to change their eyes and beaks to make them look cheeky or surprised or joyful. I figured out how to draw parrots doing human activities like playing the violin or reading a book or going fishing. I gave a parrot a broken arm even though parrots don’t have arms. I personified the parrots (see Figure 3—top right).

Fig. 3

Parrot drawings for form and project partner identities, illustrations by Baade (top left), explorations of parrots doing human activities, illustrations by Baade (top right), initial concept mock-up for the lifts as places, image by Seevinck and Baade, (second from the top), work in progress template for lift A, by Baade (third image from top), and final ‘waterfall’ design for Lift A zone on Level 6 features waterfall imagery adjacent lift doors and on the wall opposite, photographic images by Sarah Osborn (bottom image)

Learning to let go is an integral part of both collaborating with others and design. Many early ideas were discarded as we worked through the project. We also had some pre-existing ideas of scenes and activities for the parrots at play on the walls—for example, wearing red and white hats to symbolize Christmas, and parrots cycling, or with a broken arm, or Easter eggs etc. There was feedback that some parents aren’t religious (also echoed in the literature about designing for cultural inclusion), and so the final design does not include such features.

Playing in nature was an important value all stakeholders agreed on, and we collaboratively ideated how the design outcome might relate to its context. Initially, we followed a common architectural practice to look at the immediate physical site and worked to connect the concept and imagery to the views of nearby South Brisbane’s Cultural Centre, streets, and civic parklands outside. Images of parrots riding bicycles in the park or hanging out across bridges were explored. The workshop participants felt this more reflective of inner-city Brisbane (the hospital site) and not reflective of Queensland; so these images were also discarded, as the hospital services and represents the larger state-wide context. The emergent interest in nature as a theme therefore became a great inspiration as we explored this for a Queensland context. Some of this included exploring depictions of native fauna, such as the Cassowary from Far North Queensland through to the Sea Turtle in mid-Queensland. As the group discussion shifted to focus on the parrot (emblematic as it is embodied through the atrium sculptures) and tree (reflected in the architectural spatial layout), we ended up shifting our exploration of nature to look at habitats or Queensland places instead of fauna. The rainforest and the Southern Downs were the result—and these two iconic places came to characterise each of the lift zones respectively.

5 The Lift Zones: Arrival Landmarks

Level 6 of the QCH has two main points of access, the A and B lifts. These became a focus for design consideration: they are significant as navigation landmarks with strong potential for conveying the atmosphere of play. As Fig. 1 shows, the level was somewhat a ‘blank canvas’, however some walls and floors were taken up with existing artwork and the wayfinding colour orange which denotes this floor across the whole building.

One of the challenges we quickly realised was that whatever we put on the wall was going to have to work with the existing signage, art works, and architectural finishes—from notices for hand washing to art decals on varnished plywood. This challenge was particularly significant around the two elevator zones, as these spaces have the added features of signage: lift call buttons, emergency exit information, orange coloured flooring, and a large orange number “6”. The design solution would therefore need be both complementary to these features and finishes, while at the same time distinctive.

The design team developed playful and unique design solutions to make these lift areas spatially distinctive, in fun ways e.g., “come in at the waterfall lift” or come in at “the bush/garden lift”. This design approach makes these places easily describable as journeys—consistent with the best practice we found in our review of contemporary wayfinding design. Many design sketches and concept mock-ups were developed, as possibilities and aesthetics were worked through. As shown below in Fig. 4, we have the original concept presented for discussion at workshop 2, and the final design in situ.

In looking at art murals such as the graffiti of artist Banksy, we also realised that the existing constraints could be leveraged creatively. The aim therefore became to integrate the decal imagery with the existing environmental features. This would be a point of difference to the existing patterning artwork on the plywood walls, to instead leverage the physical and spatial features of the area, such as by having parrots peek out from behind lift openings etc. Also, as a more character-based than pattern-based approach, this would further differentiate this artwork from the existing decal artwork on the plywood. As Kirsten describes:

I wanted the parrots and background elements to fit around the elevators in a precise way. I took measurements several times to ensure everything was in the right place in the design file…. noting the layout of features that would need to be worked around such as elevator doors and signage. I then made templates of the spaces in Adobe Illustrator.

Kirsten’s creative process was fluid and intuitive, using the drawing techniques facilitated by an interactive stylus and tablet to sketch up the ideas. She then took these back to the more precise, desktop environment for vectorising and print preparation—a painstaking aspect of work that, in the end and due to the scope of illustrations she created, became a joint effort with the hospital’s design team:

I transferred the templates from Illustrator into Procreate on my iPad and used Procreate to sketch and then fully illustrate the designs. Once complete, I transferred the designs back to Illustrator and aligned them with the templates. The final step was to convert the images to vectors to make them suitable for large-scale printing. The vectorizing was a joint effort between myself and Children’s Hospital Queensland staff.

The approach to design with the existing architectural design elements led to some novel solutions and creations. In one effort, Kirsten innovated to add images of petals around the large, round orange ‘6’ at lift B, effectively turning it into a sunflower.

Another innovation was her design response to the two-storey pillar in the wayfinding space, which she used as a means to create a tree full of birds doing playful activities. It was inspired by a flock of rainbow lorikeets chattering and playing in a tree. Later, an opportunity arose to introduce animation by adding a large digital screen to a key wall space. In this case, it was created so that the screen could be seamlessly positioned within the illustrated wall decals, with timber bevels extending out from the wall around the lip of the screen. Decals of tree branches extend onto the screen, where three parrots sit. They sometimes move, shuffling, stretching their wings, or singing. They also display messages via speech bubbles. Usefully, these messages can be updated depending on what information needs to be communicated at the time.

6 The Value of Mock-Ups

Communicating new visual design concepts required visual means. Words and verbal explanations only convey so much, so members of the design team created collages. These superimposed images of artwork, or sketches, or design mock-ups onto and into photographs of Level 6. They were at various levels of fidelity, from quick assemblages ‘mashing up’ visuals in Powerpoint to quickly capture an idea (e.g., see Fig. 3–second image from top), through to highly synthesised simulations in Photoshop where perspective and lighting were corrected across the whole.

We created mock-ups early on for discussion, and later for final design presentation and approval. Visual artists Kirsten and Jen both created these, they enabled exploration within the design team and communication with the hospital team. For example, we used photography-based mock-ups to explore ideas of having the parrot imagery interact with building attributes like lift switches, doors, and floors.

Mock-ups support conversation around the concepts that you intend to communicate, as well as prompting new insights. For example, the idea of having the lift zone be a place in nature was initially captured and communicated to the hospital team using photomontages such as those shown. While this immediately communicated the concept behind that, it also raised discussion about the aesthetics and ‘visual density’ of the final design—because it prompted the hospital team to share their knowledge of patients’ sensitivity to sensory overload. This was not something the design team thought to bring up, and having this feedback early on saved considerable time exploring concepts.

Mock-ups were also integral to gaining approval for the design finalisation. While Kirsten finalised her designs on templates from her wall measurements—readily interpreted by printing professionals—it is another matter to understand how the designs might actually look in the space. That need to visualise in three dimensions is typically restricted to the visual designer and artist, but we needed to communicate to the broader hospital team. A mechanism for visualising the designs to assist that communication was needed, and our solution was to create mock-ups. These superimposed the final rendered illustration/design onto a photograph of the space, taken with identical front-on angles. The images were colour-and shape-corrected for lighting and perspective to create a highly convincing visualisation of the outcome. They were highly beneficial to the hospital team’s consideration, and ultimately for final hospital Board approval to go ahead with the design.

7 The Final Design

The final wayfinding design and mural illustrations required approval at QCH prior to being printed and installed on the sixth floor, a process which took additional time but was necessary to satisfy the healthcare service’s careful governance systems. In this design solution, red, green, and purple feather decals populate the floor, while similarly-coloured parrots on the walls lead children, their families, clinicians, and visitors to the lively precinct areas of fun: the red parrots and feathers to Radio Lollipop, green to Kidzone, and purple to Starlight Express. Nature scenes and parrots engaged in various activities—singing, reading, flying, listening to music, cuddling chicks—are located along the corridor walls and columns, distracting the patients and families from their troubles and accompanying them in their journey to fun! (Fig. 4)

Fig. 4

The final design. Bottom images demonstrate the design alongside the central hospital atrium where the Eclectus parrot sculptures reside (photographic images by Sarah Osborn)

8 Conclusion

This design research project occurred at the intersection of creativity and collaboration in design and in health. It is rare for the processes of hospital wayfinding and placemaking initiatives to be documented, with this chapter providing rare insight into the uniquely collaborative co-design process in this project. Co-design in this context is very much about ‘checking your ego at the door’ and remembering that ‘all of us are smarter than one of us’; this was a collaborative process of iteratively ‘reframing’ the possibilities and developing a clear understanding of what the hospital partners really wanted and what could be done to get there. Clearing the path for easy conversation that gives rise to the salient topics forms an integral part of the process. Mock-ups of ideas in context are great to quickly engage people with the topic or idea at hand. As shown, they can also reveal new opportunities and insights. Such contextual visualisations are most efficient for getting feedback about ideas, often also revealing new time and cost saving insights.

When working in a collaborative design context as a designer, success means that the team takes complete ownership of the design solution. Integral to the importance of consultation and the willingness to be collaborative was the willingness to actually change course—something that gave rise to personal and professional challenges. For example, the role of the designer and artist changes in a collaborative project. Normally, in a traditional design project, the artist/designer voice is dominant, but here the voice of the users is a critical part. For a visual artist like Kirsten working in the design context, this required an acceptance of other views and ideas that needed to be incorporated into the final design—as she explained: “it is difficult having to hand over your artwork and step back. I did not like having to trust other people to install my artwork designs in the way I intended. Some things were done differently to my intentions, and I have to be OK with that.” Similarly, the design interaction is less about execution and more about facilitation, as keeping your team engaged and invested is key to project success. As shown, enabling them to see how their ideas influence the design—such as by tracing the progeny of the concepts through the design themes—is a great way to do this.

In the end, the redesign of Level 6 has been extremely positive: as well as being brighter, more welcoming and fun, easy to navigate, and a distinctive, memorable space, visitors and staff have praised the design. Parents have said that their child enjoys going to this space (following the feathers, and spotting different parrots at play), while occupational therapists are bringing their clients down there and having them talk to the parrots on the walls! By documenting our process, learnings, and outcomes, our hope is that other design and health teams will work in partnership to implement more creative wayfinding strategies in hospitals across the globe.