HCD Expo Highlight - Aesthetics of Joy by Ingrid Fetell Lee

We are back from the Healthcare Design Expo and Conference in Phoenix! We met so many people and listened to a number of workshops and talks, but for those who missed this year’s conference, or as a reminder to the attendants, we wanted to share our highlight: The opening keynote speaker Ingrid Fetell Lee. Her speech shared the extensive research on the aesthetics of joy, and its applications within healthcare design. For our team, Ingrid’s speech was the most captivating and relevant towards our development as manufacturers of interior products. We thought we would give you an overview of the talk and show you how we have been inspired to add more joy to the products we offer.

“Colour is life; because a world without it appears to us as dead.” Johannes Itten

Ingrid Fetell Lee is a designer and founder of The Aesthetics of Joy, former design director at Ideo, and author of ‘Joyful: The Surprising Power of Ordinary Things to Create Extraordinary Happiness.’ Her speech focused on the way physical environments can potentially affect our well-being. Beginning with an excellent example of Tirana, Albania. A city which was in a desolate state of high crime rates, rubbish filled streets and no money to repair the damage. In 2000, a newly elected Mayor Edi Rama took a small amount of funding for Historic Preservation and painted vibrant designs and colours on the cities buildings. The city slowly came back to life after a period of deep decline. The citizens stopped littering, businesses began to open and crime began to decline. It was a joyful revival, the city became the inspiration for the people to thrive.

Tirana, Albania

Tirana, Albania

This story echoed with an experience Ingrid had at a review in her first year of design school, when a professor made an offhand comment of her work: “Your work gives me the feeling of joy.” How could a word which is fleeting, intangible and ephemeral, describe such ordinary objects and what had evoked such a feeling. Through this connection between her work and joy she discovered a breadth of research that demonstrated the link between our environment and our well-being, that joy has the potential to change the way we feel physically and emotionally.

Ingrid laughingly describes how she started her exploration of joy by asking a number of strangers: What brings you joy? Collating answers like sunsets, sandcastles on beaches, candles on birthday cakes and rose gardens. Discovering that though the feeling of joy is ephemeral, we can access it through physical things. Designers use the term aesthetics - the properties that define the way an object looks and feels. She quotes Florence Nightingale, who often talked about the effect of variety on illness. That monotony is the deadliest thing for patients. As designers we have pushed form over function, aesthetics to being subordinate to the function, especially in healthcare. Ingrid however has found that deprioritising aesthetics left joy out of design, that form and function should be balanced in design.

Often the physical world has little or no impact on our inner joy, which seems strange in a healthcare space which we can spend a considerable amount of time recovering in. These environments are typically minimal settings to maintain cleanliness and sterility, but in this they can lose their joy. In her talk, she focuses on three of her identified aesthetics of joy - ten categories which have distinct connection with the feeling of joy and tangible qualities - to help inspire the way we should be designing healthcare spaces: Energy, Abundance and Freedom.

With each word she presented examples of spaces changed from an injection of joy.


Publicolor at Frederick Douglas Academy in Harlem.

Publicolor at Frederick Douglas Academy in Harlem.

Publicolor is the nonprofit launched by Ruth Lande Shuman, who became aware that middle schools in East Harlem resembled prisons. She decided to transform these underserved New York City public schools with bold, vibrant paint. The effect of this? The perception of the space changed, the danger began to dissipate and a more focused environment was created.

Here in the UK we have a similar organisation Global Street Art, which exists with a mission to live in painted cities. Working across the UK and worldwide on projects with councils and other public bodies. For example: Their Art for Estates program is a new initiative which aims to increase the amount of public art on London's housing estates. Organising over 30 murals in one Chalk Farm Housing Estate in Camden!

At KwickScreen we do the same to hospitals, with large format vibrant printed partitions, that Global Street Art and Publicolor do drab city spaces.

Global Street Art, Our Art for Estates Programme.

Global Street Art, Our Art for Estates Programme.

Referencing  Energy , the Nature collection from our catalogue.

Referencing Energy, the Nature collection from our catalogue.


Emmanuelle Moureaux renovation in Shinjuen Nursing Home, Kawagoe-City.

Emmanuelle Moureaux renovation in Shinjuen Nursing Home, Kawagoe-City.

Emmanuelle Moureaux, a French architect uses the principle of abundance when designing her spaces. An example presented by Ingrid is her renovation of a care homes visitor area, where she added vibrant colours and confetti like artworks. After the renovation, they found the families who visited the residents stayed longer; becoming an inviting space of comfort and healing for both patients and staff.

Referencing  Abundance , one of the Children’s collection from our catalogue.

Referencing Abundance, one of the Children’s collection from our catalogue.


Roger Ulrich conducted a seminal study in 1984 of gallbladder patients, looking at their well-being in relation to their environment. In the study, some patients rooms had a green view while others had a brick wall. He found the patients with the open view healed faster after surgery and needed less pain medication compared to the other patients, their sensory experience had a direct effect on how they felt physically.

Referencing  Freedom , the Landscapes collection from our catalogue.

Referencing Freedom, the Landscapes collection from our catalogue.

A presentation slide from Ingrid Fetell Lee’s speech at HCD Expo, Phoenix.

A presentation slide from Ingrid Fetell Lee’s speech at HCD Expo, Phoenix.

To liberate the senses and bring aesthetics back into the equation of how we design these confined strained circumstances, we may be able to create a level of calm and joy for patients. Ingrid concluded her talk with: “On the most basic level, the drive toward joy, is the drive towards life.”

Michael grabbed a selfie with Ingrid after her speech!

Michael grabbed a selfie with Ingrid after her speech!

Ingrid signed a copy of her book for us.

Ingrid signed a copy of her book for us.

The KwickScreen team who ventured out to Phoenix have come back inspired, and with a signed copy of Ingrid’s book! What we felt most prominently about Ingrid’s talk was the effect patterns, texture and colour have on people, such as the patients, staff and families.

Here at KwickScreen we manufacture flexible partitions to solve privacy and isolation issues. The products are unique in that they offer a hygienic surface suitable for all healthcare environments, with a large surface area for high quality printed imagery. Previous screens have featured landscapes, block patterns and corporate branding; to introduce images into the most intimate of healing spaces. We hope so far we have created some joyous spaces.

We were so energised by Ingrid’s speech that we felt you should at least have a taste of the stories she shared, and definitely suggest reading her book! There is a deeper look into each of her ten aesthetics of joy, as well as helpful tips to apply to your own area of design. It was a pleasure to be boosted at the beginning of the conference, and to see that there are a variety of colour, pattern or textures that cane bring joy to the most difficult of spaces!

We’ve also decided to curate a more joyful collection in our image catalogue, in honour of becoming more joyful! We hope to surprise you with it soon!

If you want to check out Ingrid’s speech, watch the video above. Or check out her TEDTalk below, for further information about The Aesthetics of Joy.

And we would definitely recommend buying her book Joyful: The surprising power of ordinary things to create extraordinary happiness.

Buy book in USA Buy book in UK

Smart Ideas and Clean Hands: How Environments Impact Disease Control

Screen Shot 2018-09-27 at 11.13.40.png

Infection control is the effort to stop infections from transmitting from person to person. My long-term research interest has looked at ways to prevent antimicrobial resistant bacteria spreading, either through use of devices, new practices, or different uses of antibiotics.

In the United Kingdom, microbiologists spend a lot of time liaising with doctors who care for infected patients. We provide a bridge between the microbiology laboratory and the hospital wards. We see patients ourselves, as well as advise on antibiotic treatment, prevention of infection transmission, and how to keep our antibiotics active by preventing development of resistance. We are on the front lines of combatting infection transmission. We see the problems while seeking the solutions.

Amongst the chief issues is that only about 25% of UK hospital beds are in single rooms. The rest of the beds are located in shared, open accommodations like bays or wards. This is in contrast to the private sector, where essentially all beds are in single rooms, and it is much easier to stop an organism from spreading.  

The reason for the difference in the risk of spread between bays and single rooms is threefold: First, staff are reminded to wash their hands in these environments. Second, they do not simply walk near patients on their way to somewhere else. Lastly, doctors and nurses must make a particular effort to go into the single room.

‘A temporary solution can offer permanent benefits’

Conversely, people constantly walk through wards that accommodate up to five patients at a time. If even one of them has an infection, or the person walking through did not wash their hands and has touched a contaminated surface, the chances for transmission are greater. We believe environmental contact is how most infection is transmitted. It’s also easy to forget to wash your hands when walking from one bed to the next bed, and unwashed hands account for two thirds of transmission. The remaining one-third is airborne. But a physical barrier between beds reminds people to wash their hands and reduces air transmission as well.

We identified a need to either temporarily increase the number of single rooms or to discover ways to encourage people to wash their hands as they move between patients within these bays. However, the public health system simply lacks the funds to convert all hospitals into single rooms. The vast majority are mixed.

On top of the limited funding, we now see increasing antibiotic resistance. We need new antibiotics, but there are far fewer being developed as we would like. It’s critical that we do everything in our power to stop these resistant organisms from spreading without relying on antibiotics. Naturally, we need to be both scientific and creative in our approach to this problem. 

Quantifying Innovation: Testing Smart Ideas   

There have been many proposed solutions. It is common for most infection control departments to introduce bundled approaches, a series of five or six evidence-based measures used together to encourage infection prevention. Education programmes have been reasonably successful. The average hand hygiene compliance has improved from approximately 25% to 60–80% over the last decade. 

Much of our investigation has focused on optimising surfaces in an effort to make them less hospitable to the survival of the organisms. For example, a rough surface easily allows the bacteria to stick to them and they do not stay long on a smooth surface. So adapting physical surroundings have been a top priority. While it is too expensive to build more hospitals with more single rooms, it is less so to introduce barriers between beds. 

The Department of Health instituted a program called SmartIdeas Project in 2010 to bring about different solutions to be implemented at the hospitals and studied for future application. We identified three notable innovations. In an effort to innovate novel ideas to reduce infection transmission, they provided a fund and invited inventors to take on the challenge. A panel—including myself—judged the wide variety of ideas and inventions, which included temporary side rooms, glass LCD privacy screens, and retractable room dividers. The successful inventions got a bit of help along the way. We would test them in our hospital, allowing the companies direct access to front-line healthcare workers so they could observe and utilise their feedback to adapt their product accordingly. 

One of the promising solutions in the program was KwickScreen, the retractable room divider that fits into a mobile, cylindrical container. The end of the screen is on a small pair of wheels and can easily be pulled out. When we had a patient who needed source isolation in a bay and we did not have a single room to put them in, we would use a KwickScreen as a means to provide physical separation. Another option was the temporary single room, but it could only be assembled if there was enough space.

KwickScreen installed at Bradford Royal Infirmary

KwickScreen installed at Bradford Royal Infirmary

‘Strong visual aids can improve doctor hand hygiene’.

A Study in Hygiene Psychology

Interestingly, like the other inventions, KwickScreen did improve hand hygiene. The simple presence of a screen reminded individuals, particularly the doctors, that they needed to wash their hands when approaching a particular patient and upon leaving. KwickScreen also mounted alcohol hand gel on the leading edge as a second cue to encourage staff to wash their hands. Hand hygiene compliance increased from 50% to approximately 75%. When we watched doctors coming toward the patient, none of them washed their hands if there was no visual reminder, like the screens or the room. When we put in one of the three solutions, doctor hand hygiene increased to 70%, overall. Clearly, doctors were not necessarily aware that they were approaching a patient with a potentially infectious pathogen and that they needed to wash their hands. 

Doctors should wash their hands with every patient, but they need to be reminded of the requirement. The large physical presence in the form of a barrier is effective in a way that notices on the end of the bed are not. You can't miss this visual reminder. We published a paper (ref 1) reflecting the outcomes of the SmartIdeas Project and conducted trials with a number of patients who did need source isolation. We distributed questionnaires for both patient and staff feedback so we could gauge whether they could be used in practice in addition to our hand hygiene study component.

We also analysed whether people would decline to have them around their beds. No patient objected to having KwickScreen. A few patients objected to the temporary side room. Staff would not put patients with diarrhoea into the KwickScreen because it was not an all-around solution. They would only put patients into the KwickScreen who had illnesses spread by contact, like Methicillin-resistant Staphylococcus aureus (MRSA), for example. We took all feedback into account.

Another area of focus was the material used for the screens. We did a great deal of sampling from the units themselves to see what organisms would grow on each surface. It was expected that we would find a bacterial presence on the KwickScreen near infectious patients. We had to be mindful of ease of cleaning and diligence in decontamination protocols so as not to spread infection. If you adjust what the screen is made of, that material can make a big difference. The tendency is often to use a rough plastic because they are easier to grip. Your hand does not slip off, but rough plastic can store 10 times as many MRSA as a smooth metal, for example. The best option is to have the smoothest possible surface. Of course, the designers have to judge that against having something that's so slippery you cannot even pull it. There was some compromise to consider.

One of the greatest aspects of a program like SmartIdeas is that products are tested in real-life scenarios. All of these challenges identified were opportunities for the inventions to improve their offering based on real-world experiences. 

The Move to Modernise and Protect

KwickScreen has taken that feedback and now has a more robust offering. They've produced artwork on the formerly blank screen, which helps to make it more acceptable to the patients who were split on whether they preferred a clear screen versus those who wanted additional privacy. We also scrapped the addition of disposal sinks that were attached to the KwickScreen, as individuals would rather use the plumbed ones. 

KwickScreen has gone for a smooth, easy to clean plastic for the screen material. It is always a tradeoff, however, since rough surfaces are less likely to transfer bacteria onto hands, with the opposite being true for smooth surfaces. 

Retractable room dividers can be used for infection control purposes in certain cases and can also be useful for privacy. A working group followed up on other KwickScreen applications such as privacy and gender separation issues after the SmartIdeas Project. 

The SmartIdea project was a wonderful representation of the innovation that can take place in the NHS. There is a need for a SmartIdeas Project to run again. It has been almost nine years since the last program. Technology has moved on. There are many extremely bright designers out there and I think they need to be encouraged to try and help the staff in the wards with prevention of infection

It's sometimes quite difficult for companies in the UK to get a foothold because products must have a scientific basis in order to become widely accepted. Programs like SmartIdeas Project not only help companies come up with new ideas, but it helps them discuss with active working professional members what is useful. Companies like KwickScreen have been able to utilise the program to test their product, gather feedback, and improve their offering. It’s exciting to think what the future will hold. 

Ref 1: ‘Ward assessment of SmartIdeas Project: bringing source isolation to the patient’. Moore G, AliS, FitzGerald G, Muzslay M, Atkinson S, Smith S, Cryer P, Gush C; SmartIdeas Research Group, Wilson AP.