W21C: Designing medical care for the 21st century

Sydney Johnson shares how W21C is exploring new approaches to healthcare and creating medical innovations to evolve the paradigms of healthcare delivery.
W21C: Designing medical care for the 21st century
S1 EP3Nov 2017

W21C: Designing medical care for the 21st century

W21C: Designing medical care for the 21st century

with Sydney Johnson, Human Factors Research Associate

Since 2004, W21C has been making waves in healthcare delivery by sparking fresh ideas to improve patient safety and the quality of care.

Based in the University of Calgary’s O’Brien Institute for Public Health and at Calgary Zone of Alberta Health Services, W21C researches and tests prototypes for hospital design, new approaches to healthcare, human factors and other great medical technologies to innovate, create, educate, and evolve new paradigms of healthcare delivery.

In this episode of HealthRedesigned, we speak to Sydney Johnson, a Human Factors Research Associate at W21C who also has a background in UX Design and Service Design.

A medical ward for the 21st century

To get direct access to actual patient care settings and test their innovations, W21C built a living laboratory called the Ward of the 21st Century, a hospital ward located at Foothills Hospital that’s run by doctors and nurses, and occupied by real patients.

An example of a project they’ve trialled at the ward is a year-long interaction design project to drive hand-hygiene compliance. Whenever someone used the hand sanitizer pump at the ward, they’d receive visual feedback in the form of hands that appeared with a sound. The hand would stay there as more people used it, so that everyone could see how many people used the hand sanitizer pump that day.

The project was a success. It encouraged hand-hygiene compliance and was proven to be scalable to other sites to create more effective hand-hygiene monitoring.

W21C also built a separate research and innovation centre complete with a simulation lab and simulation mannequin to preliminarily test projects that may not be ready to be tested on real patients.


More often than not, improving patient care involves expertise that extends outside the field of medicine. W21C’s current 70 projects are managed by a 40-strong interdisciplinary team that has a combined experience in design, medicine, economics, sociology, psychology, engineering and more.

Ideas for projects are initiated by team members at W21C or by physicians or academics who experience challenges in their day to day lives and are interested in finding a solution. The organisation also accepts requests from the public sector, namely the Alberta Health Service, especially when there is a need to solve existing challenges that are a public priority.

W21C also partners with people in the medical industry whether it involves researching an idea or testing an actual prototype’s viability to determine whether it’s successful or not.

Tackling digital health and ageing-in-place

Canada has a very large ageing population, which means there’s a necessity to develop health management solutions that enable senior citizens to age better. Inadvertently, this overlaps with digital health because a lot of ageing-in-place innovations involve digital health. This is a big focus for W21C as they design solutions for better health information management while keeping cost and sustainability in mind.

Within digital health, we’ll work in software and hardware, but we also look at policy and how to support information flow into digital health innovations.

Using Augmented Reality for medical education

Partnering with Scope AR, W21C explored the idea of using augmented reality to teach medical students, particularly about a specific procedure called central venous catheterisation.

Traditionally, medical students would practice on a training mannequin under the guidance of the clinical instructor to learn this procedure. But with the help of augmented reality, students are able to learn at their own pace and without a clinical instructor's presence.

To help bring this idea to life, W21C’s performed a heuristic evaluation of the system, including its interface, workflow, clinical content, and audio and speech recognition with the goal of standardising this type of medical education and making it more cost-effective.

An alternative approach to healthcare design

Through its Human Factors team, W21C evaluates how people interact with medical devices, hospital environments and different sorts of technologies. It looks at changing the things that people use and not the people who use them.

On one of their projects, the team evaluated a hospital building design and realised that the toilets would not be accessible to a handicapped user or someone in a wheelchair. This timely assessment led to the design being changed a day before the concrete for the building was poured and went on to save the hospital C$1.7 million in cost.

Because W21C deals with healthcare, all of its projects have to go through an ethical review board which involves developing a protocol. Sometimes, this could mean determining the end result of a project before it even begins, which could be contrary to design where one might start without much thought of what the end result is going to be.

Despite making sure that a project is heavily supported by research and is ethically sound, the team at W21C tries to leave sufficient space for the project to become something greater than predicted.

Advocating change through user stories

The team has found that just communicating the impact a project would have isn’t enough to bring everyone on board sometimes. One of the best ways to convince a stakeholder about change is to involve the user in the process by sharing real stories on incidents so that they can directly connect with a user’s issues themselves.

As a designer at W21C, Sydney has found that it isn’t always easy to win over people in the industry when it comes to the value of research and the execution of little details that go into experience and service design. But she’s convinced that W21C is headed in that direction and that’s something that’s really exciting for her as the organisation continues to take on more projects that redefine the delivery of healthcare.

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Laïla von Alvensleben

Laïla was a designer at Hanno from 2015-2018, helping us implement ways to work more effectively as a distributed team.