29 June 2007

PGH: Design by the People, For Nobody

During my entire stay at the Philippine General Hospital, many frustrating experiences have arisen from the simple act of getting around. And once you get the hang of things, you'll be even more frustrated trying to explain to the poor patients and watchers how to get from point A to B. I've said it before and here it is again, for the record in my blog:

Philippine General Hospital design sucks.

Consider the following:

Exhibit A is a new wall treatment the administration chose to cover up the soiled walls of the first floor (it's as close to an approximation as I can get with my memory and my trying to suppress the painful imagery). I used to call it the "Schizont/Plasmodium" wall. Yes, the first floor is painted with these not-quite-arabesque peach and mint green spermatozoa. Why? Is it supposed to make people forget their frustrations in the hospital? Is it supposed to make it a pleasant place? Bitter experience has shown me that it does not. All it succeeds in is making the hospital a hideous place. It does not feel like a respectable hospital as much as it does the outside of a second-rate kindergarten building.

Exhibit B is a sample of the few signs that they have put up on a few posts. One of the elements of environmental design is "Wayfinding." This is PGH's sorry attempt to make it easier for patients to find particular places. It's a failsafe to the Information Desk in front. First of all, given the way PGH is built, those arrows mean shit. Second, it doesn't work. I still get questions all the time as to where is what.

What's worse is that PGH doesn't even bother to make it easy for people to care for their patients. Take, for example, the Arterial Blood Gas (ABG) Laboratory. It's actually located in the laboratory wing but since you can get the results in a few minutes, you have to access it through a separate door. What's worse is that the door leading to the laboratory and the door leading to the ABG room, which are both on the 2nd floor, are not accessible on the same floor-- that is, if you have a bunch of specimens you want to give to the lab and one of them is an ABG, you have to go to the main lab window, give the specimens, go down to the 1st floor, then go back up again on another staircase and give it to the ABG room. This is the type of shit we let the poor watchers go through on a daily basis. SOLUTION: make the rooms all accessible to each other. Simple as that.

The wards have a notoriously unintuitive arrangement. When you enter the main door, you have Wards 1 and 3 on the right, and Wards 9 and 11 (what?) on the left. On the second floor to these wards are 2 and 4 on the right, and 10 and 12 on the left. There is a "central block" further along where the elevators are located, then further than that is Ward 5 and 7 on the right, Ward 14a and 15 on the left, with Ward 6 and 8 on the right on the second floor, and 14b and 16 on the left on the second floor. All you have to assist you if you are a new patient are those piss-poor signs above, there isn't even a schematic map for any of this anywhere. SOLUTION: A map. People can read this better than they can figure out the numbering scheme. There are so many other ways: one is color-coding the wings with a single strip of color running throughout the walls on white. Much classier than the sperm. Then, on the signs, use the colors with the floor number, like Ward 14a: 1(red). Ward 14b: 2(red). There's probably an even better way to do this, I'm just to mad to think about it.

By the way, Ward 14a and Ward 14b? Are we TOO superstitious? Why not just call it Ward 17 and at least we'd be consistent?

Problem: many (in fact all but 2) elevators' call buttons don't work. That is just shameful and I'm pretty sure you have to have elevators checked by a technician EVERY GODDAMN YEAR. Fixing the elevators will ensure that when the patients need to go up ASAP, they are UP ASAP. Before you get television sets for the suites or whatever, you need to make sure that NOBODY USES A FUCKING COIN TO KNOCK ON THE DOORS OF THE ELEVATORS.

Dr. Alfiler said that he'll be installing a pneumatic tube system that will allow us to send samples to the lab remotely. Who's willing to bet that it will soon be filled with cobwebs? How about a hole in one of the tubes where a big pile of blood will accumulate? Also, what will this do to the citrate tubes?

Another nitpick: next to the elevators, there should be a list of what each floor contains. Next to none of the patients know that floor 2=more wards, 3=operating rooms, 4=nursery, 5=pulmonology offices (? see, even I'm doubtful), 6=dialysis and cardiovascular offices. It's just stupid not to include those.

Design is more than just the way something looks. It pertains also to the function, the efficiency, the usefulness of that object. It results in a bright light in your head that makes a simple color scheme turn a chaotic mess into a well-oiled machine. Take a look of this design of a staircase from the Rem Koolhass bulding in Chicago designed by Ludwig Mies van der Rohe. It seamlessly incorporates a ramp into a staircase, so without inconveniencing a subset of users, a beautiful design results in cost-efficiency, space-efficiency, and just looks absolutely cool.

(Credit: Ben of Noisy Decent Graphics)

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