In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject.

Lisa Sundahl Platt is the managing partner of UMNSystems (Nashville, Tenn.), a human factors research, strategy, and design consultancy working predominantly in health and continuing care. Here, she shares her thoughts on usability analysis in healthcare environments, accounting for human factors in healthcare, and what it means for design to be truly “resilient.”

  1. Prevention and performance through design

Designing and managing “High Reliability Environments”—or environments that perform as expected regardless of the situation—in complex and dynamic systems like healthcare is extremely difficult. One reason is because being able to plan in a “what if” cause-and-effect manner for every possible scenario is difficult in structures that are organizationally complex and whose outcomes are hard to foresee due to their variability. To be able to predict outcomes with any degree of certainty requires performance modeling that’s based on both integrative and differential understanding. As the need for assurance in the effectiveness of care environments increases, I think we’ll see a continuous uptick in organizations that are skilled in safety-critical systems outcome forecasting and analysis assisting healthcare planning teams to create care environments that can perform under any conditions.

  1. The EOC as a vector for UX

When presenting on our firm’s research on “Persuasive Experience of Wellness Systems Designs” (link to study here) at the International Symposium on Human Factors and Ergonomics in Health Care earlier this year, I was struck by the insight of a statement by a fellow presenter: “Usable design saves lives.” Data-driven conceptual iterations, observational assessments, and stakeholder surveys/interviews are great strategies for developing master, unit-level, and product planning. However, usability analysis of the environment of care (EOC) and its integral components is also essential. If environmental systems’ design is not highly usable long-term, staff will find compensatory strategies to deliver and/or support optimal care. This could cause the user experience (UX) of patients, their families, and staff to suffer and potentially erode, which could also result in other more serious problems.

  1. Expanding the need for human factors in healthcare

Increased integration of technology, evolving care delivery architypes, as well as changing patient demography and expectations are necessitating an increased consideration of cognitive ergonomics, or how humans perceive and mentally respond to their environment, in healthcare design. For example, there are many opportunities to improve clinical staff “signal detection” regarding patient safety status in health systems design through the introduction of innovative Internet of Things (IOT) or augmented reality-based haptic (tactile) or visual technologies. However, without taking into consideration cognitive ergonomic factors like alarm fatigue or automation complacency, these solutions may have a rate of diminishing return on long-term effectiveness and may also decrease user experience.

  1. Redefining the healthcare environment

Wellness centers, home health, telehealth, microhospitals, mobile health, retail clinics, and rehabilitation centers are examples of relatively new or evolved paradigms in healthcare. These healthcare delivery environments, which are meant to increase convenience of care access and better accommodate changing population health, also need to support new and dynamic human safety needs. For example, the incidence of certain community acquired infections and drug-resistant bacteria is on the rise. Environmental interventions designed to reduce potential contamination from surfaces to humans or impede pathogen spread within HVAC and plumbing systems can assist healthcare providers in their ability to adaptively respond to this growing concern and help better protect both patient and caregiver safety.

  1. Resilience planning

Humans, especially those working in healthcare, are capable of remarkable achievements. However, humans are also prone to error, response inconsistency, burnout, and flawed situational judgement. This is especially true during unpredictable and/or stressful events, which we know are common in healthcare settings. Anticipatory planning, adaptive design, and extensible environmental systems that not only account for “known-unknowns” but “unknown-unknowns” are essential for high-performance healthcare design. Research supports that for a system to be truly “resilient” it needs to have both well-tuned, competent human operators and well-designed systems that support the ability of human stakeholders to consistently perform at their best.


Want to share your Top 5? Contact executive editor Anne DiNardo at for submission instructions.