Emergency futures: An ethnographic design exploration of a public health crisis

Overcrowding in emergency departments is becoming a public health crisis in Aotearoa New Zealand. As demand for acute care continues to rise, and hospitals are running over capacity, emergency department patients requiring admission to hospital wards have nowhere to go. Healthcare workers are being forced to use unsafe interim solutions like corridor stays. Despite numerous attempts at intervention, the situation is not improving, posing serious risks to patient safety and staff wellbeing. This research explores, first, what we can learn from the voices of frontline healthcare workers when trying to understand the problem of emergency department overcrowding and, second, how design might enable us to imagine possible futures for emergency care as a way to reflect on the values and assumptions underpinning the current system. Through in-depth interviews and onsite observations, I discovered that the key challenges staff face relate back to the relationship with patients, staff, and the organisation. Moral distress, victimisation and scepticism towards change were the key themes constructed across these different levels. My research suggests that speculative design can offer a fresh approach for the healthcare sector to ask questions and open up space for thinking about how things could be radically different, as well as building new connections between the disciplines of healthcare and design.