Hanson, J

English

UCL Discovery

Ethical and MethodologicalIssues in Data Sharing BetweenTwo Research ProjectsJulienne Hanson, UCLChris Parker, University of ShefﬁeldJudith Torrington, University of ShefﬁeldReem Zako, UCLRoute Map• In the next ﬁfteen minutes I shall:– Set the context for our joint research project into therelationship between care home layouts and QoL;– Brieﬂy introduce the ‘space syntax’ tool for analysing buildinglayouts, that has been developed at UCL over the past 30 years;– Illustrate how space syntax is used to retrieve socialinformation from plans, using hospital wards as an example;– Explain how the method was adapted to investigate a sampleof care home layouts, gathered by Shefﬁeld as part of anearlier  project (reported at previous BSG conferences) on therelationship between architectural design and the QoL ofresidents / morale of staff;– Describe the principal ﬁndings from this study;– Sketch out some of the ethical and methodological issues thatwere raised by the sharing of data on the project.Background to the Study• EPSRC EQUAL funding allowed UCL to analyse theplans of an existing database of 38/36 care homes thathad already been gathered by the University of Shefﬁeld:– Shefﬁeld’s study had already shown that aspects of the designsuch as the location of the home, its orientation andpositioning within the site, and the detailed design of internalcirculation routes, residents’ lounges and private roomsimpacted on the QoL of residents and morale of staff;– Did the overall built form / building footprint (shape) and thegeneral accessibility afforded by the internal layout of thebuilding have any impact (as architects believe that theyshould) on the QoL of residents or staff morale?– Simple idea, to take Shefﬁeld’s existing data, add an analysisof the whole building, come up with some candidate measuresand re-run Shefﬁeld’s multi-level regression analysis, to see ifour measures were related in any way to the residents’ QoLmeasures and staff morale scores for each building.What is Space Syntax?Why did we think this was worth doing:– ‘Space syntax’ was originally developed as a tool to represent,describe and quantify key properties of the layout of buildings(and places) in ways that retrieve their embodied socialfunctions directly from the plans;– We can show what it is about the way a building or place isdesigned that makes it lively or quiet, easy to navigate orlabyrinthine and how organisations can take advantage ofspatial layout to support the programme of work that they do;– The substrate for analysis – the plan - is the same as forarchitectural design. Design intuitions therefore translatenaturally into analytic insights, and the ﬁndings from researchcan inform design proposals at the drawing board;– At the start of the project, we were less sure about whethersyntax could shed light on buildings with such a strongorganisational programme / regime as care homes.Hospital Wards• Illustrate the method by reference to a recent study bySSL of hospital wards, as (unlike care homes) these arequite small in scale and have relatively simple layouts:– This study set out to investigate the internal spatial layout ofdifferent types of hospital ward, in terms of the way the bedswere organised and grouped and related to the nurses’ basesand the general pattern of circulation within the ward.• SSL were particularly interested in understanding:– The effects of different types of layout on the pattern ofaccessibility and spatial integration of the patients’ beds;– The effect of locating the nurses’ base in a more or lessstrategic position from where they could see the patients’ beds;– Whether the design of the ward had any relationship toobserved patterns of movement and co-presence, including theamount and duration of interaction among patients, betweenpatients and staff and within the various staff on the ward.How Space Syntax WorksThis is what happens on a typical space syntax study:– Sample of 12 wards, 3 different ward layouts, the old-fashioned open Nightingale ward, wards subdivided into multi-bedded bays and wards made up of single rooms;– Carried out a computer generated spatial analysis of the layoutof each ward, coloured up so that red = most integrated,through the rainbow spectrum to blue = most segregated.Colours represent a purely mathematical, spatial measure ofthe relative accessibility of the different parts of each ward;– Made on site observations, taking 10 minute snapshots of allthe activity on each ward on an hourly basis from earlymorning to late at night, according to the type of user (doctor,nurse, patient, visitor etc.) and what people were actuallydoing. Observers also traced the routes taken by all the nurseson each ward over 4 x 5 minute sampling periods each hour.– Correlate spatial measures of access/ integration with thedirectly observed patterns of use on each of the 12 wards.Snapshots of Hospital WardsNightingale  Multi-bed bays Single roomsFindings• Interaction among patients was low, and did not seem to beaffected by spatial factors such as the type of ward they were on,or their spatial proximity to one another. Spatial integration didnot necessarily result in social interaction, suggesting thatinteraction is a complex mix of opportunity, patient’s personalityand their capacity to initiate conversation;• Contrary to expectations, nurse-patient interaction was in aninverse relationship to integration. Patients in more integrated(red) areas actually interacted less with nurses than those in moresegregated (green / blue) areas, especially if their beds were alsolocated in more remote positions on the ward with respect to thenurses’ base;• What seems to have been happening is that in well integratedareas, supervision happened in an informal way which did notinvolve conversation, but in more segregated parts of the wardnurses had to make a speciﬁc journey to see patients, at the end ofwhich, interaction was more likely to take place.• Do these types of ﬁndings have any relevance for care homes?Adapting Syntax for Care Homes• There were several aspects that made this study unique:– Normally UCL couples building / plan analysis with empiricalobservations of the building in use. Unfortunately, this was notpossible in the care homes study, due to problems in obtainingaccess after Shefﬁeld’s original project had ended;– Normally, we look at the relationship between the pattern ofaccessibility in the building - that is, which spaces are moreintegrated and are more segregated - in relation to the types ofactivity that each supports and how people use the variousparts of the building for moving through and engaging in staticactivities. In this case we needed to come up with a set ofsingle, holistic measures for each building to compare withShefﬁeld’s building’s scores for the various QoL and morale;– Both parties were working ‘blind’- that is UCL did not knowwhich homes had performed well on Shefﬁeld’s QoL scoresand Shefﬁeld did not know which of UCL’s candidatemeasures were expected to give the best results. Fortuitousgood practice!Plan Typology• The 36 care homes were of a wide variety of plan types. Thefootprint and overall patterns of circulation were very differentfrom one another, which suggested that the buildings should beexperienced differently - but would UCL be able to pick this upnumerically and would any differences found be related to QoL?Examples of Care Home LayoutsCruciformCourtyardHybridWhat we Discovered• UCL came up with 10 candidate measures that looked atdifferent aspects of each building’s overall accessibility forShefﬁeld to interrogate using multi-level regression :– None of these correlated with any of Shefﬁeld’s originalarchitectural design variables, which suggested that the UCLanalysis was contributing a genuinely new dimension to theprevious study;– The most important turned out to be the mean (average overall)integration of the public realm of the care home, that is theaccessibility all the spaces that were available for use by everyonein the home (residents, staff, visitors etc.) including all thecorridors, communal lounges and other shared amenities.– This is also the variable that is an important predictor ofmovement and liveliness in external public space and it is aquality architects consciously strive for in a whole range ofbuildings, including sheltered housing / care homes.Integration of the Public RealmResidents• Clear, direct and positive relationship between UCL’smean integration measure and three of Shefﬁeld’scritical performance variables:–  the proportion of residents’ time active;– the frequency of residents’ enjoyable activity; and– the residents’ choice and control over the environment.• What seems to be happening here is that the overallaccessibility of the building, measured by its meanintegration, inﬂuences whether or not residents ﬁnd iteasy to move about from place to place in the buildingand to interacting with others, especially the unplannedinteraction of ‘bumping into’ others whilst en-route to adestination, and also the proportion of time ‘watchingthe world go by’. More accessibility = more opportunityto engage in these socialising behaviours.Staff• Weaker and negative relation between staff jobsatisfaction and integration. This is surprising asintegration = more efﬁcient trips when moving aboutthe building.• The result might be related in some way to the negativeassociation between integration and interaction foundon the hospital wards study:–  Maybe staff in the more integrated care homes felt that theywere more open to surveillance by residents? Maybe theyactually were more open to surveillance?– Maybe, like the nurses on more integrated wards, they too hadfewer conversations with residents because there were fewerreasons to seek out residents living in more secluded parts ofthe home?Unknown Quantities• These are questions that remain unresolved because UCL didnot carry out an observation study of how the various spaces ineach of the care homes were being used.• This illustrates that the two approaches developed by Shefﬁeldand UCL are complementary, and each could beneﬁt bylearning from the other.• SSL’s study needed QoL / staff morale data to interpret itsﬁndings with respect to integration and interaction. Did moreinteraction raise or lower  patients’ QoL / nurses’ morale? Onewould like to think it did, but we can’t take this for granted.• The joint UCL / Shefﬁeld study could have beneﬁtted from anobservation study, to determine how the layout of the differentplan types created or inhibited the interaction that we knowmust have differed from setting to setting, as this is to a certainextent reﬂected in the different QoL / morale scores recorded bythe homes. Again we can infer relations but not demonstrate thelinkages.Ethical Dilemmas• Rather obvious issue of data sharing:– We will never know what added value might have been gainedhad UCL been able to interrogate Shefﬁeld’s raw data.Conﬁdentiality v. economy of research effort. Research projectsof this kind are very expensive and are unlikely ever to berepeated. Ethical constraints are at odds with the need to buildfrom one project to another. Pressure for this set to increase.Should there be more sophisticated mechanisms to allow forsensitive data to be shared?• Whose interests should a building serve?– Here we have uncovered a situation where a key property of thebuilding layout that appears advantageous to one group (residents)is not experienced so positively by another (staff). Facilitiesmanagers in both hospitals and care homes are interested inmaximising accessibility for ﬁnancial reasons (shorter tripdistances) and because they are risk averse (surveillance). Whatabout the views of end users? In the event of different perceptions,in whose interests should the architect act? Who is the client?

Ethical and methodological issues in data sharing between two research

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