1. Inside the built environment: considerations for child- friendly hospitals Dr. Penny Curtis Reader in child and family health and wellbeing University of Sheffield UK

2. Child-friendly hospitals? Provide a context within which children and young people …. “can experience hospitals differently according to age and where they are cared for, not as a homogenous group of individuals, but as members of families” (Department of Health, 2003:9).

3. “From the minute a family drives up to a great children’s hospital, ideally they should realise that it is a very special building that does not look institutional. Once inside the lobby, which is the second most important impression, there should be a sense of wonderment, surprise and diversion.” (Komiske 1999 p.147).

4. What is known about children’s use of space in hospitals? Very little! – Post Occupancy Evaluations (POE) children’s hospital’s family healing garden (US) (Whitehouse et al 2001) healing gardens, associated with paediatric healthcare facilities (US) (Sherman et al 2005) – Behaviour mapping in Glasgow children’s hospital wards (Canter 1972) – Before-and-after evaluation, Bristol Children’s Hospital (UK) (Redshaw 2004). – Child-centred evaluation of the atrium of the Toronto Hospital for Sick Children (Adams et al 2010) … where do children go within hospital spaces, what do they do, and with whom …

5. Space to care: An ethnographic study 3 hospitals in the north of England 255 children aged 4-16

6. Derby OPD clinics and general reception area

9. Main reception. Morning observations 9.45-12.15. Serving ENT, General Medical and ENT clinics computers Reception Entrance

17. Main entrance Where do children go?

18. Exit Colouring table Counter Nintendo Toys Reception Sheffield Blue (am and pm: orthopaedic) clinic. 09.15 - 16.30

24. Older children’s spatial use was very similar to parents’ spatial use

25. Age and space: decoration Visual cues signify intended age of the users and occupiers of a space ‘If it is plain, it’s not nice for children’ (9-year-old girl) ‘It’s colourful… It’s more like for children’ (13- year-old girl)

26. Age and space: opportunities to ‘do things’ Spaces are seen as ‘boring’ unless there are recognizable, understandable and age-appropriate opportunities for ‘doing’ things ‘It’s got pool tables, games, and loads of bigger stuff, yes – for bigger people’ (11-year-old girl)

27. Age and space: the iconic child Babyish spaces ‘I don’t like the baby toys in the place where I first came in’ (six- year-old boy) ‘Most toys are for babies. There is nothing to do for us bigger ones’ (nine-year-old boy). ‘babyishness’ noted particularly in the more specialist settings

28. Signifiers of ‘babyish’ spaces Signifiers of spaces for older children and teenagers Baby mats Baby toys Balloons Cats Children’s television programmes Clowns Colouring Horses Penguins Pictures on windows Plastic toys Play areas Potties Pushchairs Rabbits Toys everywhere Videos/DVDs for little ones Yellow Young children’s pictures Board games and computer games Computers Décor ‘like in the adolescent room’ Football Table Magazines Music Plain but colourful walls Plainer decoration Pool table Pop posters Posters Slot machines Teenagers television programmes Televisions Videos/DVDs for teenagers and adults Signifiers of spaces suitable for all age groups Colourful décor (but not too many colours all in one space) Computers Some Disney characters and characters from popular, young people’s media culture Televisions

29. ‘Look at the size of the pool table. It’s a kiddie one!’ (14-year-old boy). Older children accept younger children’s different needs, but are not active in ‘babyish’ spaces themselves.

30. Older children’s spatial use was very similar to parents’ spatial use

31. What do children do?

33. The organisation of features:

34. Derby Yellow. Morning (general medicine) 09.30 – 11.00: Colouring table Train and car track Play centre Garage Toy crate Entrance

35. Colouring table

36. With whom do children interact? Children and parents

37. Nurses’ Station

38. Children and children Hospital spaces do not, however, work to encourage social interactions between children A young boy of 7ish talks to a girl of a similar age about something on the computer, he asks her to ‘Look at this’. She is embarrassed and leaves.

39. Children and hospital staff

41. What works? …. for children and young people ….

42. Interstitial spaces

43. ‘Homely’ spaces with a sense of enclosure work well for younger children

44. Nurses’ Station Spaces for older children ……