case study examples for interior design

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Case study in Interior Design - Real examples of our design process.

Ever wonder how interior design comes to life? Explore our curated case study collection of real-life projects to see how we do it. These examples show how we tackle problems, listen to our clients, and add creative touches to our work. Whether it’s fixing space issues, making things look beautiful, or reaching specific design goals, our projects prove that our design methods work.

At Bynn Esmond Designs, we use modern methods to design spaces that fit our clients perfectly. We’re not just designers – we’re active partners in the entire design process, making sure everything looks beautiful and functions well.

We start by getting to know the homeowners and their homes. We figure out what design challenges we need to solve and set clear goals. This hands-on approach helps us create a unique and personalized design for each project, making sure it truly reflects the homeowners’ style. But we don’t stop there. Because surprises can happen during construction. Therefore, we are diligent during this phase and manage the design to ensure your vision becomes a reality.

We invite you to dive deeper into our design journey through our design portfolio .  There, you will find not just our selected projects but also a diverse set of projects that showcase what we can do.  See how Bynn Esmond Designs transforms spaces with care and creativity, bringing ideas to life through a hands-on and client-focused design process.

Tudor style home remodel in San Carlos, CA

Modernizing a dated tudor, bringing it into the 21st century. A full-scale remodel, we added a small extension to the kitchen, revised the floor plan, and raised ceiling

California ranch-style home gets an update

Redwood City, CA contemporary white and gray kitchen with hidden pantry. Full-service “wellness design” included interior architectural remodel, addition, kitchen and bath planning and selections design, interior design,

Art takes center stage in this modern treehouse

Home renovation and interior design in Palomar Park, CA. Services provided include custom kitchen, bathroom and fireplace design and remodel, construction documents, interior design and furniture, lighting design, full service design-build-furnish, renovation management and design oversight.

Hidden corner kitchen opens up to guests

San Carlos, CA modern farmhouse kitchen renovation. Full service design included kitchen planning, materials selection, cabinet layout and design, design oversight and renovation management.

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Let’s Start Creating Your Dream Home Today

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Join us every second Tuesday of the month for a dose of optimism with thought-provoking guests who are revolutionizing their fields. Innovators will lead virtual workshops for an hour of discovery, inspiration, and community. Led by editor in chief, Avinash Rajagopal, these workshops will be guided by our audience, where questions are not only welcome but encouraged.

Metropolis Editors, Natural Habitat, sustainability, sustainable architecture

METROPOLIS Introduces Natural Habitat, a Sustainable Homes Video Series

The series debuts with a tour of a tranquil upstate New York retreat designed with Passive House principles.

December 8, 2021

26 Case Studies in Design for Impact

Metropolis’s new publication, Design for Impact, showcases how innovative architects and interior designers are leading the charge in creating a healthy, just, and sustainable world.

 There is a sustainability revolution underway. At the World Economic Forum’s Davos Agenda 2021 event earlier this year, Bain & Company chairman Orit Gadiesh warned: “With consumers and investors demanding significant change, profit pools shifting away from incumbents to insurgents, and even the most carbon-heavy companies making net-zero pledges, executives ignore this revolution at their peril.”

Real estate is an essential tool in this revolution. The building industry accounts for 40 percent of the world’s carbon emissions, yet it can also have an outsize influence on people’s health and happiness. For any organization or individual interested in making a positive impact in the world, architecture and interior design can show the way forward.

Design for Impact showcases a comprehensive cross section of projects that are driving incredible positive outcomes in energy reduction, carbon reduction, health, economy, and community. Taken together, they offer some vital insights into the state of responsible design and construction:

  Certifications are important, but outcomes are critical. Systems like LEED, the WELL Building Standard, Fitwel, and the Living Building Challenge provide benchmarks and standards for sustainable, efficient, and people-centered facilities and spaces. But the ultimate success of any project lies in its real-world impact.

The “green premium” is a thing of the past. Architects and designers now know how to create spectacular, sust-ainable spaces at low or no additional cost, whether it’s schools, workplaces, hospitals, hotels, community centers, or homes. Moreover, upfront investments in resilient and responsible development and construction generally pay for themselves within a matter of a few months or years—generating savings for the rest of the project’s life.

More from Metropolis

We can make a holistic positive impact with buildings. For many years, executives, developers, and facilities managers remained focused on saving energy through smart design, but now we know that the right real estate decisions can have far-reaching impacts on health, pro-ductivity, and community as well. 

Add those up, and you can see why every building and interior space we create in the future must follow the example set by the 26 case studies in this book. The teams behind the projects that follow are heroes, working tirelessly toward the goal of a healthy, just, and sustainable world.

We hope you find inspiration—and future partners and collaborators—through Design for Impact . 

Would you like to comment on this article? Send your thoughts to: [email protected]

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Interior Design Project Case Study

OUR ROLE FOR QUB DESIGN

• UX/UI Design
• Consulting Services

The Project

We spend most of our time in interior spaces, but not all of us have the skills and knowledge to transform interiors into inspiring places. This is precisely why Qub Design dreamed about giving rise to an awesome team of designers, architects, developers and photographers.

As a result of years devoted to passionate teamwork, they can confidently take up any project, be it residential or large-scale commercial projects.

The Challenge

As an interior design business, image is everything for Qub Design. Needless to say, their website had to reflect this in a way that would attract new clients and inspire the existing ones.

That meant a flawless and rather aesthetic web design with a high focus on images and easy to read content. The main challenge here was to create a fantastic website full of high-quality images, without taking them forever to load. Another business concern was embracing the constant change of interior design trends without consistently redesigning the website.

Our main goal was to showcase a killer portfolio by means of a clean and modern website. We also envisioned a deep architecture with a personalized structure, in a way that allowed anyone to easily update the content.

We kicked off by a short meeting with the dream team behind this project. We wanted to catch a glimpse of the entire creative team, before focusing solely on business needs. From that moment on it was easy to understand who we needed on board for this journey: a back-end developer, a front-end developer, a designer, a marketing specialist, a QA specialist, a product manager.

Discovery & Research

We quickly came to the conclusion that we wanted a clean layout to shift focus towards the content. We also wanted to convey the feeling of stylish furniture and contemporary facades.

However, we needed time and research to realize that dividing the website into different sections would come as a great benefit for the various types of customers.

Prototyping & Testing

Nowadays, customers tend to seek out design services on the go. So the next phase was structuring the website into various pages and enabling each type of customer to access the portfolio according to their interests and needs.

The information architecture became complex in order to accommodate large information systems, but the important part was to make it easy for the client to update the content.

After accomplishing a top-notch experience in terms of usability and responsiveness, we were ready to bring the real artwork into the spotlight.

4 Interviews

+49 Wireframes

4 A/B Tests

2 Prototypes (Desktop / Mobile)

6 Iterations

+60 Detailed UI Screens

We have been extremely inspired by this project and the work of the people we were going to display via this platform.

This meant it was a rather smooth process, even when it came to assessing business needs and tailored solutions for this particular project. Thus, we decided to build the Qub Design website with WordPress and create custom modules for their specific needs.

• The full-screen mode for the exquisite pictures was one of them since we wanted the users to have a compelling experience when admiring the creativity and high-end delivery of each project.
• Another custom feature was providing an outstanding About Us page, where each representative project would be rendered through a visual timeline to reflect the evolution of the business.
• Basically, we ended up with a website that is user-friendly for both our client and the end-customer. However, it still has the looks of a modern-day portfolio, that can easily inspire and lure prospects.

Error Prevention

They say slips happen when you walk on ice and so do errors, especially when the average person has a short attention span. That is why we took every measure to make sure we wow the customers from their first click and help them quickly find their way around.

Website Design

The greatness of Qub Design’s work had to be made visible to art lovers and interior design aficionados at all levels. But in order to create a wow-effect and invoke emotions, we needed to keep the canvas clean. That meant a minimalist approach, with bold typography, little text and lots of visuals.

We designed everything with easy navigation in mind. Therefore we created small navigation links and simple menus in each section to avoid user confusion by saturating the user flow.

Nevertheless, the images were the fundamental ingredients of the website. They are the key feature which, together with functionality, can elicit positive visceral responses from people.

Project Details

Keep the work front and centre

because you don’t want fancy navigation and weird typography on an interior design site. Photography is the key element here.

Stock photography is not an option

This kind of websites are basically portfolios, so it makes perfect sense to highlight the unique features and experience of the company by using their work’s images.

Custom features make the brand stand out

Each company has specific business needs and that is exactly why custom modules can make a huge difference even in WordPress.

Final Thoughts

Building a website for such a passionate design project was both a challenge and an inspiration for us. Nonetheless, we were thrilled to see how the end-result matched their vision and style. The time and creativity we’ve invested in this website massively paid off, as we managed to step up our game and bring precious results for the online business presence of our customer.

Ready to start working on your creative and unique website?

Case Study: Hillside House and Guesthouse by Hoedemaker Pfeiffer Architects

Whatever the topography or scale, a good house celebrates the experience of space inside and out, and these two buildings do that extraordinarily well. On a remote island in Puget Sound, the getaways are as rugged as their setting, but cocoon-like as well. The serene main house and guesthouse demonstrate the restorative potential of architecture by inviting the owner to connect with herself and with nature.

That was important, because she is active in Seattle’s civic culture and depends on this place to decompress. She had been coming to an existing house on this spot for many years and wanted a house that better suited her lifestyle. It was also an opportunity to build a smaller retreat for her grown daughter on the adjacent lot, or “building circle.” In this community, land is shared in common and each resident owns a building circle where a house can be built, says Steve Hoedemaker, AIA, whose firm, Hoedemaker Pfeiffer, was hired to design the project.

The compact 2,500-square-foot main house and 1,975-square-foot guesthouse have shed roofs, Douglas fir windows and doors, hemlock ceilings, and oak floors. Canted slightly toward each other on the steep, rocky site, they both use simple, stacked-stone volumes as an organizing principle. While this concept acknowledges the site’s geology, it was also an emotional touchstone. “The client’s family had a property in Appalachia with an old stone cottage that had a lot of sentimental meaning for them,” says Steve. “It was lost to fire and the property was given to the state to become a park. The property has lived in their memory and imagination, and they wanted to reach back and touch an aspect of what it meant to them.”

Sitting high above the water, the main house is a glass-and-wood structure resting on a plinth of Whistler basalt stone quarried in Canada. “The idea was to create a stone platform on which the house could rest, and then a stone wall to provide privacy from a small road,” Steve says. “On top of the platform is a light wood building that could perch there with much less need for both structure and privacy.”

On the north entry façade, a bar-shaped stone volume contains the master bath, powder room, and mudroom/laundry, its shed roof tilted down against the weather and the road. An east-west hallway axis joins it to the taller and lighter structure behind it housing a kitchen/dining/living room and master bedroom that flow out to a deck overlooking Puget Sound. Stacked stone reappears in this volume as a pair of central fireplaces. They separate the public and private spaces and flank a wide stairway to the lower level, which holds two bedrooms, a bath, and a kayak garage.

“The house sits on the westernmost portion of the island with beautiful sunlight and great views across the water and the islands,” Steve says. Sheltered and controlled, the main living space gets abundant light through a south wall of glass facing the water. This volume also tips up to the north, but its higher roofline allows for a band of operable clerestory windows that backfill the space with continuous northern light and release warm air on the leeward side. Its lower pitch toward the water protects the inside from glare.

One thing the client liked about the old house was that there was a sunny place to sit comfortably outdoors in cool weather, sheltered from the wind, Steve says. Hoedemaker Pfeiffer’s design recreated that version through the roof overhang and the two stone fireplace volumes that puncture the back wall, creating a protected seating nook on the deck. “The design allows them to occupy the main floor outside the building, and that protected space captures warmth from sunlight even when the temperature isn’t quite accommodating,” says project architect Todd Beyerlein.

Indeed, the design sets up a nuanced relationship between house, land, and view. “When you enter the house, there’s a moment where you’re able to see distant views, and you can see that there’s an exterior plinth you can inhabit; it inspires you to move around the building to get there,” says Todd. Adds Steve: “You can see the stone level that the whole first floor sits on and can read the ground dropping away. It’s an introduction to the concept, but you have to go looking for it.”

The solid, enduring interior materials are a further manifestation of the house as a tool for exploring nature. The feel of both cottages came from a basket of objects the client had collected from the site, such as bark, feathers, and rocks. In addition to the stone, honey-colored cedar siding wraps inside to cover the walls. Charcoal-colored basaltina, an Italian stone, adds a calming complement in the kitchen and baths.

A variation on this theme, the guesthouse was conceived as a stone tower with three protrusions. Closer to the water than the main house, “the site is a great deal steeper,” Todd says, “and was encumbered by a community association rule that limited its height to preserve the views of other residents. It also had a smaller building circle than the main house, which to some extent dictated the design. We wanted to build on a small footprint to limit excavation, yet we wanted more square footage, so we came up with what amounted to a stone tower with a program that extends outward.”

Visitors enter through a ground-to-roof glazed opening on the north side. To the left is a bumped-out wall of louvered casement windows that light the switchback staircase leading to the lower-level bedrooms and bath. Ahead on the main floor are the great room’s kitchen, island, and living room—and beyond, a south deck that cantilevers far above grade. The third protrusion is a glass-enclosed, 12-foot-by-15-foot dining room, held dramatically aloft on two 36-foot steel beams that anchor 24 feet into the building structure.

“It’s great to be up there among the trees, but we had to work hard to keep them there,” Steve says. Footings for a retaining wall under the dining room were tapered to steer clear of the roots of an important tree.

These companion buildings frame the indoor-outdoor conversation in different ways. “In the main house it’s about perching on a piece of earth and allowing the architecture to become light and ephemeral,” Todd says. “In the guesthouse, it’s about what it means to be inside, yet step outside of the architecture and still be indoors. We liked the idea of setting up rules and then finding very specific reasons to violate them.” Adds Steve, “it was almost like the square was too strong and simple until we came up with the exception.”

It took almost two years to build the houses, working on an isolated island without ferry service. With headquarters in Seattle and operations all over the U.S., Schuchart Dow (now Dowbuilt) knew how to organize around difficult terrain and time the arrival of concrete trucks with the tides. Most of the workers commuted by private boat daily, and the materials were barged in and staged at a house rented for the duration. “We would take all of our materials to that location first, prep them, and take them out to the job as needed,” says project manager Josh Williamson. “The 400,000 pounds of basalt stone came as blocks and every stone needed to be cut to a gauged size we could work with. But once we fell into a system, it became routine.”

The steep slope was daunting too, and not just for the construction crew. “We had to put up a perimeter safety fence around the whole site so that people and tools and materials didn’t fall into the water,” Steve says. Or sheep, it turns out. The island is home to a native population of free-ranging sheep brought here more than 100 years ago. During construction, a newborn fell down the hill and would have hit the water had it not been for the fence. “Our laborer who was living on the island took it home and nursed it back to health,” Josh says.

The project was a collective effort of more than 100 workers, he adds. The result is two well-crafted compositions that achieve the best of retreat architecture by letting nature shape and define it.

Plans and Drawings

Project Credits

Hillside Sanctuary and Hillside Retreat

San Juan Islands, Washington

ARCHITECT: Steve Hoedemaker, AIA, principal in charge; Todd Beyerlein, project architect, Hoedemaker Pfeiffer, Seattle

BUILDER: Josh Williamson, project manager, Schuchart/Dow (now Dowbuilt), Seattle

LANDSCAPE ARCHITECT: Randy Allworth, Allworth Design, Seattle

STRUCTURAL ENGINEER: Malsam Tsang, Seattle

CIVIL ENGINEER: LPD Engineering, Seattle

GEOTECHNICAL ENGINEER: Nelson Geotechnical Associates, Woodinville, Washington

ARBORIST: Island Tree Doctor, Eastsound, Washington

PROJECT SIZE: 2,500 square feet (main house), 1,975 square feet (guesthouse)

SITE SIZE: .07 acres each

CONSTRUCTION COST: Withheld

PHOTOGRAPHER: Kevin Scott

Key Products

COOKTOP/RANGE: Wolf

DISHWASHER: Miele

DOOR HARDWARE: Baldwin

ENTRY DOORS: Northstar Woodworks

EXTERIOR LIGHTING: B-K Lighting, Lucifer Lighting

FAUCETS: PHYLRICH

INTERIOR LIGHTING: Philips Lightolier, Hafele, Tech Lighting, Casella, Currey & Company, Modern Fan Company

REFRIGERATOR: Sub-Zero

SINKS: Blanco, Duravit, PHYLRICH

THERMAL AND MOISTURE BARRIER: PROSOCO

TOILETS: TOTO

TUB: Lacava

WASHER/DRYER: Electrolux

WINDOWS: Woodcraft Windows

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Interior Design Case Study

By HOME & DESIGN

Interior Design Case Study Celia Welch subscribes to the notion that less is more when it comes to interior design. “My style is grounded in simplicity,” she explains. “Ultimately, I believe that simple home design leads to ease of living.”

This philosophy underlies all of her projects, and it’s what attracted a couple building a custom home in the Middleburg area. They brought Welch in at the start of the process, asking her to work closely with their builder, Visnic Homes, to create an elegant yet comfortable abode that capitalizes on its bucolic surroundings; the kitchen and adjacent family room exemplify the team’s success.

The house is located on a golf course, so retaining unimpeded views was a high priority. The two-story family room and adjacent kitchen are flanked by windows and French doors; solar shades can be tucked away and draperies frame the window and door openings.

To delineate the kitchen and sitting area, Welch designed a granite-topped, walnut display shelf. The kitchen boasts custom Shaker-style cabinetry and Carrara marble counters and backsplash. The kitchen opens to a breakfast nook where a rustic roundtable is artfully paired with bright red Windsor chairs from Maine Cottage. Welch designed a cabinet that beautifully displays the couple’s pottery collection along one wall.

Most of the furniture is new to the house. An existing Baker sofa was reupholstered for the sitting area and Welch selected a metal coffee table and wood-framed chairs, both from Four Hands in California, to create “simple, soft lines with a touch of modern,” she says. A restful landscape by John Brandon Sills adorns the mantel.

Builder: Ted Visnic, Visnic Homes , Rockville, Maryland. Interior Design: Celia Welch, Celia Welch Interiors , Bethesda, Maryland. Photography: Angie Seckinger .

Celia Welch’s Trade Secrets:

• Remember that keeping things simple, without too much clutter, allows the details to show. We used the same color metal for hardware, light fixtures, and drapery rods—and they are more noticeable because space is not cluttered.
• Stay close to your main concept.
• Look for different ways to add interest. Here, the interior doors are painted a different color from the trim and walls.
• With tall ceilings, there are tricks to imparting more human scale to space. Hanging sconces and low pendants bring the eye down. In this room, a raised hearth made the fireplace taller.
• Use one flooring material throughout the house to keep things flowing. It will open up space.
• Display shelves are a great way to introduce what is important to you.

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Write great high-end Interior Design case studies

The most effective and convincing high-end interior design case studies have 4 key attributes when being promoted online

Bath Kitchen Company website Fun Loving Kitchen – Example case study

1. they are usually 500+ words of indexable content with an editorial focus on the impact of your studio’s work, 2. they have a client testimonial, 3. they include easily scannable list of related services. we don’t want to relate other case studies here, though the temptation is there. we want our prospects to transition from research mode to understanding how our business works, not get caught in a content cul de sac., 4. they have a buyer-friendly call to action to set up a meeting, get in touch about a project, etc..

David Harber website Big Spaces – Example case study

Featured projects.

This is very different from, write-ups of projects, which in the main we all have on our websites, as we name drop the client (where appropriate) and show off the finished work. This isn’t hitting the mark as a case study and certainly isn’t making for a great study. It worth pointing out having a portfolio is very valid, but that is not the focus of this article.

We have to remember why we should be investing in writing the case study in the first place. Its about generating opportunities with the next prospect, and its role is to prove the impact of the work that we have just had beautifully shot. You should look beyond simply writing about what you made to articulate the impact of the outcome. If we can prove the worth of our project that has just been undertaken with facts and figures. If you have created impact with your work, then this can be no better communicated than through the happy words of the client, after all no matter how good you are at selling yourself, you’ll never be as good a salesperson as the client for whom you have had the greatest impact.

The Myers Touch website Bronze Appeal – Example case study

Generating leads.

The purpose of your well-written impactful, process-framed case study is to generate leads; (just the be clear, process is important in framing your approach to a project, but at the end of the day people don’t buy processes, processes offers reassurance, people buy promises). A case study is a sales tool.

We all like a story, and we understand the story composition: a beginning a middle and an end. And like a story your case study should follow this format. Having a back-story, setting the context of the situation and the problem your were able to overcome, the middle— the ideas, process and solution you arrived at, and finally the impact of the outcome, the results of your work.

If you cover off all four elements outlined in the opening, you will not need thousands of words and you will be on the way to creating great case studies.

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Boost Your Design Biz with Great Case-Studies and Reviews

As you are well aware, having a great portfolio can go a long way to winning over clients. Being able to see your past projects can really help them determine if your unique style is a match for theirs.

But portfolio photographs don’t tell potential clients what it’s like to work with you one-on-one. What sort of service do you provide? Will you help them hone in on their signature style? Will you proactively manage the project? 

For potential clients to feel comfortable moving forward with you, they want to hear the experience others have had when working with you.

Depending on the type of design services you offer, potential clients will be hunting for different things in your testimonials and case studies. Some might be looking for a speedy turnaround, while others will be looking for end-to-end project management. 

Whatever your clients want, your goal is to make sure it’s reflected in the testimonials on your website. 

In this guide, we give you important steps for collecting great reviews from your clients and adding them to your site. 

Table of Contents

Clarify project expectations upfront

You’ll get better reviews and testimonials when your onboarding process is on point. 

When clients pay you to do something, they want clear expectations just as much as you do. When things are clear, there’s a sense of ease throughout the whole project and less awkward moments. 

Whether you choose to do this in your proposal, an email, or over the phone, make sure you share the project details and expectations.

Here are some things you might include:

• The project phases and what they include
• How long each project phase lasts
• When they need to give feedback by
• The estimated price range of suggested items for each room
• Purchasing procedures (setting expectations for lead time)
• Clarify how you bill design work and project management (and what the difference is)
• Potential hiccups that could happen and what to expect if they occur

Surprise and delight your clients during the project

In order to get great reviews, you have to impress your clients. There’s a phrase that marketers like to use: “surprise and delight.”

This refers to the practice of going above and beyond client expectations. This can be something simple like including a treasured heirloom in your design or giving your client an awesome bottle of champagne or including fresh cut flowers to the space on the day of the installation. 

Let your clients know you’re hoping for their public feedback

Tell your clients you’ll be asking for a case study, testimonial, or public review.

• Case study – A case study is a problem/solution story (typically 500 – 900 words long) published on your site that covers why the client hired you, what problem they were facing, how you solved that problem, and the final result. You should only ask your most enthusiastic, gushing clients to participate in a case study.
• Testimonial – A testimonial means a written or video account of what it was like to work with you and whether or not they would recommend you. Most designers prefer to ask for written testimonials, but you can also ask for video testimonials if you feel that’s a fit for your brand. You could add video testimonials to your website or post them on social media. 
• Review – This refers to a written review on your Google business listing, Facebook page, or other site. The benefit of these is that reviews are good for SEO. Google ranks business listings high up in Map results when they have a high amount of positive reviews.

Here’s how a DesignFiles member approaches the ask:

“Provide some sort of written summary of your process. Within that, mention that your goal is to provide 5-star service and that if you ever fall short, you want the client to tell you and you will fix it. During the process, ask the client how things are going and if there is any way you could improve the process for them. If they give accolades, save those. If they offer ways to improve, obviously acknowledge those and implement them as you can or if you cannot, tell them what you can do. Always offer something! Then make sure your offering is sufficient for them. Once the project is finished, ask for the review. You can tell them that to make the process easier, you have saved some kind words they have expressed. Make sure you reply and acknowledge the review.” – Clare Re of CDR Design

Create a process for asking for a testimonial or review after the project

You should create a repeatable process for requesting testimonials or reviews. 

Here are some useful tips:

• Time it right . Timing is everything. It’s important to ask your client to participate in a case study interview or write you a review pretty quickly after the successful project is complete. As long as the project went well, ask them right when you’re celebrating the completion and explain to them any final things they need to know. 
• Make it easy on the client by giving them some ideas for what they might include in the review. As Clare mentioned in the quote above, you can outline some kind words they said about you during the project.
• Create your own email template for requesting these reviews and save that template in a tool like Yesware (which plugs into Gmail for easy template access) or store it in Google docs.
• Add “request review” or “request testimonial” into your project management system for every project so you never forget to ask.  

Write case studies like a pro

If you want to publish case studies, you’ll need to interview the client on a 15-minute call. 

Questions you should ask

Make sure to ask them how they found out about you, why they hired you, what they were struggling with, what it was like to work with you, and whether or not they would recommend you. 

Here are the best questions to ask (modify them to fit the type of service you provide):

• What challenges were you facing with the current design of your home?
• What hesitation did you have about working with me?
• What made you decide to work with me?
• Once we started working together, what was your initial reaction about the process?
• How do you feel about the completed design?
• How has this impacted your life?
• Would you recommend me to others? If so, what would you say?

How to structure your case studies

Work the information into a written case study with the following sub-sections:

• Before – In this section, include how they found out about you, why they hired you, and what their needs were. For a brand new AirBnb, for example, you might write about the experience the client wanted to create for visitors. For a residential project, you might write about what the client didn’t like about their current living room. 
• The project experience – In this section, include any challenges that you faced during the project and how you overcame them. Also include your design process and how this benefitted the project. 
• The finished result – In this section, include raving testimonials from your client about how much they love the result, how they can’t wait to work with you again, and why they would recommend you to others. 

While this is the standard case study format, you don’t have to use it. You can write your case studies in a way that matches your design process. Just make sure you hit on those important points within your own unique structure.

In this example , the subsections are Site Survey & Program, Schematic Design, Design Development, Construction Documents, Construction Oversight, and Success.

Display case studies and testimonials on your website

You can create a dedicated website page for your case studies, and link to the individual case studies that you have. 

Here’s an example case study page with four case studies:

If you have testimonials, feel free to add them at the bottom of the web page. If you don’t have case studies for now, you can just create a testimonials page instead.

Don’t forget, that you might also want to sprinkle testimonials throughout your website. 

Make sure to link to case studies from strategic places on your site. For example, on a services page, you might link to your favorite case study in one section. 

In this example, designer Allison Jaffe has put press mentions and testimonials on her Praise page , which also includes her PR features .

Use testimonials to win over clients who are on the fence

Testimonials, case studies, and reviews are all great for winning over clients. You hope that potential clients and leads will check out the social proof on your site and decide to hire you, right?

But you don’t have to only rely on a passive approach!

You can also follow up with leads and send them links to your various testimonials and case studies. 

For example, if you haven’t heard from a client after a paid consultation, you might send them an email linking to a case study that really shows off your project management skills and ability to get a project done efficiently. 

Collecting case studies is an important part of doing business. The best tip of all might just be Nike’s slogan: just do it. DesignFiles offers the tools, content, and community that interior designers need to succeed! Sign up for DesignFiles.

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Case studies.

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• Evaluate Sources
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A case study is a research strategy that uses "an empirical inquiry that investigates a phenomenon or setting" in its real life context. (Adapted from Groat, Architectural Research Methods , 346).

Check out these books from the library for further guidance on case studies:

• Flyvbjerg, Bent. "Five Misunderstandings About Case Study Research." Qualitative Inquiry, 12, no. 2 (April 2006): 219-245.

• Last Updated: Sep 9, 2024 3:19 PM
• URL: https://guides.lib.utexas.edu/interior_design

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Ten interior design projects from Ryerson University students

Students at Ryerson University's School of Interior Design present spaces for Muslim humanitarian support, LGBTQ2+ community celebration and more in our latest school show .

Ryerson School of Interior Design in Toronto has selected 10 student projects from its annual Year End Show, this year titled Re-vision, that aim to "revise, reform, and renew the shifting paradigms in the current social, cultural, and political reality". For 2021, the show will take the form of a virtual platform for the first time. This Digital Design Festival is taking place 5-9 May.

Ryerson University School of Interior Design

University: Ryerson University School of Interior Design Exhibition title: Re-vision Course: Bachelor of Interior Design Tutors: Jonathon Anderson, Taymoore Balbaa, Jyhling Lee, Lorella Di Cintio, Cindy Rendely, and David Grant Rubash

School statement:

"Our school takes a humanistic view on interior design. Utilising the user experience and basing our design and placemaking on the subject, we create meaningful space that supports human activity. Sustainability, global relevance, economic exigencies, and emerging technologies all work to shape our approach to interior design. Careful understanding of human context, cultural practices, and research our projects engage students to investigate human values and needs at all levels of this program." – Ryerson School of Interior Design

Case Study – Vertical Glass House by Jinyu Ma

This design was a case study for the Vertical Glass House, Shanghai. The main purpose of the house is to demonstrate privateness by using thick concrete walls to establish a sense of heaviness, and therefore the overall perception of the house is unbreakable and impenetrable. Due to the material and glass floor, the house looks cold and desolate. To eliminate the negative feeling and without changing any construction component, I used a relatively brighter colour to illuminate the space, physically and psychologically to establish an "emotion" space where occupants would feel cherished instead of the cold feeling of mechanism.

Student: Jinyu Ma Professor: Jonathon Anderson LinkedIn: linkedin.com/in/jinyu-ma-2b9935a4

Verge Hotel by Minseo (Joanna) Ji

This design functions as a pod system where the workplace and rest space is collaborated into one unified ecosystem. Derived from the ancient symbol: a labyrinth, is a place to stay when one finds themselves feeling lost. It combines the circle and the spiral into a purposeful path of finding one's self. This particular space is meant for people to rest, stay and rediscover themselves.

Student: Minseo (Joanna) Ji Professor: David Grant Rubash LinkedIn: linkedin.com/in/minseo-joanna-ji-979b41156 Website: minseoji.wixsite.com/mysite

Freedom in the Feeling by Miranda Graff

When I am creating a project, I try to add my own bold style whenever possible. For this project, I wanted to entice the viewer by creating a distinctive scene where one would want to be immersed in the space and escape reality. The Atrium House was designed by Tham & Videgård Arkitekter in the secluded country side of Gotland, Sweden. With the house being quite hidden, I was inspired to create a colourful and graphically intriguing image that evokes a sense of excitement while being alone. The feeling of freedom and ability to do whatever while having complete privacy.

Student: Miranda Graff Professor: Jonathon Anderson LinkedIn: linkedin.com/in/miranda-graff-77b7411a4

Al Nasir (The Helper) by Nora Alkeyat

Al Nasir (The Helper) is a Muslim humanitarian supportive and spiritual community centre that represents a respect towards creating a space of guidance and education for newcomers, immigrants, and refugees among other underprivileged people. The world faces a series of mounting crises and growing refugee populations and there is an overwhelming Muslim refugee population in Toronto. The common struggle that they face is this lack of accessibility and inclusivity in our individualistic societal systems. Therefore, Al Nasir creates a unity between a communal spiritually practicing purpose while also being a social and economic bridge for these communities.

Student: Nora Alkeyat Professor: Taymoore Balbaa LinkedIn: linkedin.com/in/nora-alkeyat-aa58b718a Website: noraalkeyat.com

Arquives by Daniella Muraca

A place where one can interact with the past, present, and future. The relocation of The Arquives means a living community where LGBTQ2+ can come together to celebrate their identity. By the use of different exhibition methods, visitors can immerse themselves in the stories and works of Canada's LGBTQ2+ communities. The stairs, a nod to growth and change, are a hotspot for visitors to leave their own mark in the space and participate in history. Representation is essential for the space to welcome all who enter. The walls, featuring colours of the rainbow flag, give visitors the opportunity to communicate with others who visit, present or not. The Arquives will be an experiential space for visitors, timeless and ever changing.

Student: Daniella Muraca Professor: Jyhling Lee LinkedIn: linkedin.com/in/daniellamuraca

Paralyze by Elham Morshedi

Paralyze is a maze installation that emphasises the surrounded and trapping feature of our boundaries and shows the audience how they can stock in them without awareness. A characteristic way of thinking, feeling, judging, and action defines our culture. Sometimes the boundaries that society, religion, and family assigned for us work as a maze. As much as we dig into them and limit ourselves, we get trapped more. They assign limits not only for our behaviours but also for our thoughts. We cannot grow our thinking and expand them. At this moment, we feel trapped in them and can sense their sharpness which causes us mental pain.

Student: Elham Morshedi Professor: Lorella Di Cintio LinkedIn: linkedin.com/in/elhammorshedi Website: elhammorshedi.com

INFN by Dayan Afshari

INFN is an immersive illusionary infinite room. This space is intended to distort our understanding of the literal approach we have towards the concept of self reflection. Why must introspection be viewed throughout a verbatim lease? INFN allows us to look into the metaphoric state by creating a warped infinite illusion.

Student: Dayan Afshari Professor: Cindy Rendely LinkedIn: linkedin.com/in/dayan-afshari-115138186

Wood You Touch? by Lauren Chan

Using wood shavings, a byproduct that is often discarded, I wanted to create a model that highlighted what is commonly considered waste as well as use it to provide multiple functions. The first and most apparent purpose is a sensory experience. Be it touch, sight, or even smell, the unique texture of the wood shavings creates intrigue and invites interaction. Another function the wood shavings provide is a natural form of insulation. The renewable resource offers many benefits when using it for building. It's time to rethink what we throw away and consider to be "garbage".

Student: Lauren Chan Professor: Lorella Di Cintio LinkedIn: linkedin.com/in/llaurenchan

A Refuge Within a Refuge by Charissa Leung

Imagine you are in a pavilion deep within a forest. An enclosed structure that still allows the sounds, sights, and sensations of the forest to seep through as you relish the tranquility of the trees that surround you.

This design concept provides a sanctuary to revitalise one's personal health and well-being. The structure uses Corten steel rods. At the beginning of its life, the material juxtaposes against the natural landscape. As a natural weathering material, it rusts over time, camouflaging within its surroundings. Hidden and enveloped within the landscape, it is a refuge for those who seek it.

Student: Charissa Leung Professor: Cindy Rendely LinkedIn: linkedin.com/in/charissa-leung Website: ctleung2018.wixsite.com

Stimulus by Nehaa Rahman

Stimulus derives its concept from the element and qualities of water to metaphorically describe the idea behind this corporate concept design for Grip Ltd. The overall concept of Stimulus was to create a design where two different energies, stillness and movement, join together to create a transformable environment suitable for everyone's individual needs. As these two energies are vastly different, similar to the Yin & Yang philosophy, they rely on each other to exist for balance.

Each individual has a specific working style and this design tries its hardest to accommodate these variants of styles by making its space interchangeable in accordance to its user. Similar to water and how its qualities are able to be manipulated for our own purposes and uses, Stimulus is a design that strives to achieve similar qualities to further accentuate the importance of mental health in a workspace.

Student: Nehaa Rahman Professor: Jhyling Lee LinkedIn: linkedin.com/in/nehaarahman Email: [email protected]

Partnership content

This school show is a partnership between Dezeen and Ryerson University. Find out more about Dezeen partnership content here .

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Case Study Residence / Arkifex Studios

• Curated by Paula Pintos
• Architects: Arkifex Studios
• Area Area of this architecture project Area:  6200 ft²
• Year Completion year of this architecture project Year:  2017
• Photographs Photographs: Aaron Kimberlin
• Manufacturers Brands with products used in this architecture project Manufacturers:   Lutron , Miele , AutoCAD , Bulthaup , Dorken Delta , HE Williams , Lumen Pulse , Manko Window Systems , Mitsubishi Electric , Trimble Navigation , Unreal Engine
• Lead Architects: Michael Hampton
• Landscape : Grant Williams
• Design Team:  Arkifex Studios
• Clients:  Anonymous Architects
• Engineering Mep:  Interpres Building Solutions/ Structural: J&M Engineering
• City:  Springfield
• Country:  United States
• Did you collaborate on this project?

Text description provided by the architects. A case study on Ozark Modernism. The Case Study Residence harkens back to the post-WWII Case Study Houses project sponsored by Arts and Architecture magazine. Just as the original project was experimentation in modern American residential architecture, the Case Study Residence seeks to define and embody “Ozark Modernism” is an example of single-family residential architecture. For the firm, Case Study Residence is an opportunity to test a hypothesis, develop a specific regional vocabulary within our practice, and to reaffirm our mission statement.

Principal features of the project include: • biophilic design • context sensitive design • an underlying geometric formal logic

• Miesian horizontal symmetry • an emphasis on the haptic modality and visceral experience • a simplified and naturalistic materiality

• passive solar considerations to siting • minimal removal of trees on site • Use of reclaimed walnut, sustainably harvested siding, and locally quarried stone • consideration of archaeoastronomy in the design

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How to Craft the Perfect Interior Design: A Case Study

Interior design can be a complex undertaking, especially for a large villa. Many people often wonder, "How do I make an apartment decorating plan?" or "How can I make my apartment look better?"

Mr. Sachin, a resident of Buldana, faced a similar situation when he desired to enhance the interior design of his villa. Instead of going with a local designer, he chose Ongrid's online home design services, a decision that marked the beginning of his home's transformation.

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Creator : OnGrid Design

Copyright : OnGrid Design

Credit : OnGrid Design

Starting Off with a Plan

Starting off with an apartment decorating plan is essential, and this is where Ongrid's expertise comes in. They focused on the 7 principles of interior design , creating a comprehensive strategy that respects the Rule of Three in interior design.

This rule emphasizes that objects arranged or grouped in odd numbers are more appealing, memorable, and effective than even-numbered groupings. With this rule in mind, the Ongrid team went ahead to work on Mr. Sachin's villa.

The Kitchen

Among the first areas to receive a makeover was the kitchen. The use of creative kitchen tile designs added a modern aesthetic to the room. It's surprising how a well-designed kitchen can significantly impact the overall feel of an apartment, and Mr. Sachin's villa was no exception.

The Living Area

In the living area, the central piece was a beautifully crafted center table . The table was positioned to complement other elements of the room, including geometric shapes and patterns which have become popular in Indian interior home design .

A Focus on Small Spaces

Ongrid's services are not limited to spacious homes. They have expertise in crafting home design plans for small spaces . In Mr. Sachin's villa, they optimized every inch of space without compromising style or functionality.

Online Design vs. Local Designer

Choosing between a local designer and online home design can be tough. In Mr. Sachin's case, the advantages of online design became evident in the efficient and professional work of the Ongrid team.

In Conclusion

To answer "How can I make my apartment look better?" or "How to create a luxury apartment?", it's crucial to understand the importance of good interior design. Using Mr. Sachin's villa as a case study, we've seen how the principles of design, from the Rule of Three to an understanding of the client's needs, come into play to create a beautiful home.

The Bedroom: A Sanctuary of Peace

When it comes to answering "How to decorate a small flat?" or "How to design a small bachelor apartment?", the bedroom is often one of the most challenging areas. With limited space and a need for comfort and functionality, designing this room takes skill and understanding.

Drawing inspiration from the concept of mindfulness at home , Ongrid created a calm, serene space where Mr. Sachin could rest and rejuvenate. The use of minimalist design elements, inspired by minimalist living principles, contributed to an uncluttered and peaceful ambiance.

The Study: Mixing Old and New

One of the trending styles in interior design is the intermingling of traditional and modern elements. In Mr. Sachin's study, Ongrid opted for a style that mixes old and new to striking effect. The result was a space that exudes a sense of nostalgia while still being practical and up-to-date.

Incorporating Open Floor Plans

The idea of open floor plans and multi-functional spaces is gradually gaining traction, especially in small apartments. By breaking down walls and allowing rooms to flow into one another, Ongrid created an illusion of space and fluidity in Mr. Sachin's villa, further enhancing its appeal.

Other Elements: Industrial Chic and Art Deco

Finally, to make the villa look even better, Ongrid incorporated elements from other styles of interior design such as Industrial Chic and Art Deco . These elements added a unique touch, contributing to the luxurious and stylish feel of the villa.

The Final Verdict

Ongrid's transformation of Mr. Sachin's villa into a luxury apartment was a combination of several design principles and concepts, all creatively executed to result in a home that is not only aesthetically pleasing but also comfortable and functional. It serves as an inspiring case study for anyone asking, "How can I make my apartment look better?" or "How to create a luxury apartment?"

In conclusion, remember that a great design is the sum of its parts. It's about understanding and employing the 5 concepts of interior design , be it balance, rhythm, harmony, emphasis, or proportion. By embracing these concepts, anyone can create a beautiful and inviting space that truly feels like home.

🏠 Dreaming of your own luxury apartment? Feel free to get in touch with Ongrid today! 🏠

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Success Stories of Ongrid's Most Innovative Clients

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Mr Pansaree from Nashik truely upgrades the home interiors with specail workstaions and master suite

A Brand Image Upgrade

A renowed regional retail store from Odisha brings a fresh new look for its customers with Ongrid, Pune.

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Interior Design Case Study

Our transformational interior design is an immersion into a new way of thinking about interior design and personal empowerment. Learn about our unique set of design strategies by clicking a link. Each case study shows a different approach based on the personal needs and sensibility of our clients.

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An office space design called Acutely Bare located in Bengaluru, India Designed by Collage Architecture Studio , India

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Featuring the RP-Sanjiv Goenka Group – Corporate Office & Rooftop , located in Kolkata, India. Designed by Abin Design Studio

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Featuring Timber Rhyme , located in Chandigarh, India. Designed by Studio Ardete

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Featuring The Canvas located along Marine Drive, Mumbai, India. Designed by Studio PKA

Societal culture in Architectural design

Featuring ‘Veranda on a Roof located in Pune, India. Designed by Studio Course

Entranced by jazz along the Queen’s necklace

Featuring the Eau Bar, the Oberoi Hotel , Mumbai, India. Designed by sP+a Architects , Mumbai

Limited Time Offer! Save up to 50% Off annual plans.* View Plans

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How To Write A Case Study For Your Design Portfolio

Case studies are an important part of any designer’s portfolio. Read this article to learn everything you need to know to start writing the perfect case study.

When you’re putting together your online design portfolio , design case studies are a great way to showcase your experience and skills. They also give potential clients a window into how you work.

By showing off what you can do and your design process, case studies can help you land more clients and freelance design jobs —so it can be smart to dedicate an entire section of your online portfolio website to case studies.

Getting Started

So—what is a design case study and how do they fit in your portfolio.

Let’s get some definitions out of the way first, shall we? A design case study is an example of a successful project you’ve completed. The exact case study format can vary greatly depending on your style and preferences, but typically it should outline the problem or assignment, show off your solution, and explain your approach.

One of the best ways to do that is to use a case study design that’s similar to a magazine article or long-form web article with lots of images throughout. When building your case study portfolio, create a new page for each case study. Then create a listing of all your case studies with an image and link to each of them. Now, let’s get into the nitty-gritty of creating these case studies.

Choose Your Best Projects

To make your online portfolio the best it can be , it’s good to be picky when choosing projects for case studies. Since your portfolio will often act as your first impression with potential clients, you only want it to showcase your best work.

If you have a large collection of completed projects, you may have an urge to do a ton of case studies. There’s an argument to be made in favor of that, since it’s a way to show off your extensive experience. In addition, by including a wide variety of case studies, it’s more likely that potential clients will be able to find one that closely relates to their business or upcoming project.

But don’t let your desire to have many case studies on your portfolio lead you to include projects you’re not as proud of. Keep in mind that your potential clients are probably busy people, so you shouldn’t expect them to wade through a massive list of case studies. If you include too many, you can never be sure which ones potential clients will take a look at. As a result, they may miss out on seeing some of your best work.

There’s no hard-and-fast rule for how many case studies to include. It’ll depend on the amount of experience you have, and how many of your completed projects you consider to be among your best work.

Use Your Design Expertise

When creating the case study section of your portfolio, use your designer’s eye to make everything attractive and easily digestible. One important guideline is to choose a layout that will enable you to include copy and image captions throughout.

Don’t have your portfolio up and running yet and not sure which portfolio platform is best for you? Try one that offers a free trial and a variety of cool templates that you can play around with to best showcase your design case studies.

If you don’t provide context for every image you include, it can end up looking like just a (somewhat confusing) image gallery. Case studies are more than that—they should explain everything that went into what you see in the images.

Check Out Other Case Study Examples for Inspiration

Looking at case study examples from successful designers is a great way to get ideas for making your case study portfolio more effective. Pay special attention to the case study design elements, including the layout, the number of images, and amount of copy. This will give you a better idea of how the designer keeps visitors interested in the story behind their projects.

To see some great case study examples, check out these UX designer portfolios .

Try a Case Study Template

There are plenty of resources online that offer free case study templates . These templates can be helpful, as they include questions that’ll help you ensure you’ve included all the important information.

However, most of them are not tailored to designers. These general case study templates don’t have the formatting you’ll want (i.e. the ability to include lots of images). Even the ones that are aimed at designers aren’t as effective as creating your own design. That’s why case study templates are best used as a starting point to get you thinking, or as a checklist to ensure you’ve included everything.

How to Write Case Studies

Maintain your usual tone.

You should write your case studies in the same personal, authentic (yet still professional!) tone of voice as you would when creating the About Me section of your portfolio . Don’t get bogged down in too much technical detail and jargon—that will make your case studies harder to read.

Since your case studies are part of your online portfolio, changing your usual tone can be jarring to the reader.

Instead, everything on your portfolio should have a consistent style. This will help you with creating brand identity . The result will be potential clients will be more connected to your writing and get the feeling that they’re learning what makes you unique.

Provide Some Context

Case studies are more effective when you include some information at the beginning to set the stage. This can include things like the date of the project, name of the client, and what the client does. Providing some context will make the case study more relatable to potential clients.

Also, by including the date of the project, you can highlight how your work has progressed over time. However, you don’t want to bog down this part of the case study with too much information. So it only really needs to be a sentence or two.

Explain the Client’s Expectations

Another important piece of information to include near the beginning of your case study is what the client wanted to accomplish with the project. Consider the guidelines the client provided, and what they would consider a successful outcome.

Did this project involve unique requirements? Did you tailor the design to suit the client’s brand or target audience? Did you have to balance some conflicting requirements?

Establishing the client’s expectations early on in the case study will help you later when you want to explain how you made the project a success.

Document Your Design Process

As you write your case study, you should take a look at your process from an outsider’s point of view. You already know why you made the decisions you did, so it may feel like you’re explaining the obvious. But by explaining your thought process, the case study will highlight all the consideration you put into the design project.

This can include everything from your initial plan to your inspiration, and the changes you made along the way. Basically, you should think about why you took the approach you did, and then explain it.

At this point, consider mentioning any tricks you use to make your design process more efficient . That can include how you managed your time, how you communicated with clients, and how you kept things on track.

Don’t Be Afraid to Mention Challenges

When writing a case study, it can be tempting to only explain the parts that went flawlessly. But you should consider mentioning any challenges that popped up along the way.

Was this project assigned with an extremely tight deadline? Did you have to ask the client to clarify their desired outcome? Were there revisions requested?

If you have any early drafts or drawings from the project saved, it can be a good idea to include them in the case study as well—even if they show that you initially had a very different design in mind than you ended up with. This can show your flexibility and willingness to go in new directions in order to achieve the best results.

Mentioning these challenges is another opportunity to highlight your value as a designer to potential clients. It will give you a chance to explain how you overcame those challenges and made the project a success.

Show How the Project’s Success Was Measured

Case studies are most engaging when they’re written like stories. If you followed the guidelines in this article, you started by explaining the assignment. Next, you described the process you went through when working on it. Now, conclude by going over how you know the project was a success.

This can include mentioning that all of the client’s guidelines were met, and explaining how the design ended up being used.

Check if you still have any emails or communications with the client about their satisfaction with the completed project. This can help put you in the right mindset for hyping up the results. You may even want to include a quote from the client praising your work.

Start Writing Your Case Studies ASAP

Since case studies involve explaining your process, it’s best to do them while the project is still fresh in your mind. That may sound like a pain; once you put a project to bed, you’re probably not looking forward to doing more work on it. But if you get started on your case study right away, it’s easier to remember everything that went into the design project, and why you made the choices you did.

If you’re just starting writing your case studies for projects you’ve completed in the past, don’t worry. It will just require a couple more steps, as you may need to refresh your memory a bit.

Start by taking a look at any emails or assignment documents that show what the client requested. Reviewing those guidelines will make it easier to know what to include in your case study about how you met all of the client’s expectations.

Another helpful resource is preliminary drafts, drawings, or notes you may have saved. Next, go through the completed project and remind yourself of all the work that went into achieving that final design.

Draw Potential Clients to See Your Case Studies

Having a great portfolio is the key to getting hired . By adding some case studies to your design portfolio, you’ll give potential clients insight into how you work, and the value you can offer them.

But it won’t do you any good if they don’t visit your portfolio in the first place! Luckily, there are many ways you can increase your chances. One way is to add a blog to your portfolio , as that will improve your site’s SEO and draw in visitors from search results. Another is to promote your design business using social media . If you’re looking to extend your reach further, consider investing in a Facebook ad campaign , as its likely easier and less expensive than you think.

Once clients lay eyes on all your well-written, beautifully designed case studies, the work will come roaring in!

Want to learn more about creating the perfect design portfolio? 5 Designers Reveal How to Get Clients With Your Portfolio 20 Design Portfolios You Need to See for Inspiration Study: How Does the Quality of Your Portfolio Site Influence Getting Hired?

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From space planning, to furniture selection, window treatments and more, our talented interior designers will guide you through the interior design process from the beginning until the final piece is perfectly in place. View our portfolio and discover how we create customized, commercial and residential interior design solutions.

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Using Colour: A Case Study

Colour surrounds us; it is so embedded in who we are as human beings that sometimes we forget how powerful it can be in defining situations, memories, places, feelings or even time.

We take colour for granted and because we move constantly from one point to another we do not realise the continuum or the fragmented effect colour has in our experience of the world.

Colour is extremely complex: relating to culture, climate, fashion, emotions, our sigh, our psychological state etc.

Because colour can generate, recreate or transmit a huge variety of emotions and perceptions it is an invaluable and always useful tool in developing concepts for interiors.

This is why choosing the right colours can be a challenging task.

In this sense, I would like to share with you an example of how I chose the colour scheme for the loft of a house in West London and what elements helped me to create that scheme. Hopefully this  will give you some ideas on how to approach the project.

Firstly the context:

Key points for the most important floor in the house

_For the ground floor the space is open plan; the client wants a modern look even though some of the pieces to be kept are period ones.

_It is important to keep the balance between elegance and informality.

My understanding of the client

Having worked with the client three times before I know how important it is for them to have spaces that can be easily associated with elements of British tradition or taste.

These aspects were, primarily, the genesis when thinking of the colour scheme for the loft; this was the sequence of thoughts and decisions:

_The loft is a small area composed of a bedroom and an en suite bathroom

_It will be one of the guest bedrooms

_Being small and at the top of the house the client wanted to make the most of natural light.

_Knowing the feel and look of the main floor was going to be modern with elements of British traditional, I proposed to invert this approach in the loft: A traditional look with just a touch of modernity in the bedroom.

_The element that embraced the traditional look was the wallpaper (wallpaper with a pattern of birds came to my mind). This wallpaper I chose carefully, so as to maintain the brightness of the room and a neutral gender appeal). The colour scheme was developed thanks to the wallpaper: Greys and blues.

The traditional feel of the room was accentuated by choosing period furniture in wood and lights.

The architectural elements: architrave and skirting are modern in look and design, the same applies to the built in furniture. Those were painted in white for reinforcing the bright interiors.

The use of colour for the built in furniture (reproducing one of the blues on the wallpaper) acted as a transition between the traditional and modern look. So fulfilling the design’s concept.

The carpet in light grey added lightness to the perception of the space.

For the en suite bathroom it was decided to replicate, as much as possible, the grey colours on the wallpaper so as to have visual continuity with the bedroom but with a completely modern feel consistent with the use and character of bathrooms nowadays.

The wood look-like tiles matches that of the oak furniture in the bedroom.

The ambition above all these considerations was to create a mood of lightness; freshness and a sweet but very light romanticism reminiscent of British period rooms.

The photographs will give you an idea of how the works are developing though the furnishing is still in process.

Above all, the ideas, intentions and hopefully, achievements for these rooms were developed by thinking of colour and the power of its creative presence.

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This opulent Mumbai apartment is a case study in functional design

Showcasing exemplary modular contemporary design, DIG Architects transformed a run-down 530-square-feet Mumbai apartment into a luminous luxury suite. Copper Cube Haus, which is located in an unlikely old building in the bylanes of Andheri, is a case study in creative problem solving, and an example of how good design is always ripe for the challenge. “The brief was pretty out of the box,” admits DIG Architects co-founder, Amit Khanolkar. The client is originally from Goa, but travels frequently, and has to transit through Mumbai very often. “He got tired of staying in hotels each time, and decided to get something of his own.” He acquired a small apartment in a nondescript building close to the airport, and was looking to convert it into a secondary transit home. “His idea was to create a kind of studio or lounge, where he could even conduct meetings from home,” says Khanolkar. The challenge, however, lay in making the most of the cramped, poorly-designed floor plan. “The apartment itself was a 1BHK, with a very linear layout,” explains Khanolkar. “The challenge was to open up the entire space, while making a bold statement at the same time.” Copper is the basis of the design palette, which is otherwise a wash of black and vitrified cementitious tiling. The copper cube, from which the project gets its name, is a copper sheet-clad kitchen unit that systematically partitions the living space and master bedroom. “We wanted to be somewhere in the vicinity of contemporary, dark, and a little industrial,” says Khanolkar. “The copper gets its importance because most of the materials around it are very muted.”

Copper is the basis of the design palette

In that vein, all architectural lighting was kept under 3000K colour temperature, which is yellow or golden, to give the copper its due. The result is a home that has the ambience of a plush hotel suite. “We try to be consistent in our design,” explains Khanolkar, “We know that with one or two materials, you can make a strong statement. It’s about designing responsibly.”

Living Room

The living room is furnished sparingly with a TV console, a sofa and a side table. In the centre, a table and arrangement of chairs doubles as a dining table or work-from-home table. A movable fabric screen, framed in aluminium, slides across the window—it functions as a curtain while allowing the overall volume of the space to appear seamless. A custom rug from Weavers Knot underlines the space, while a pendant light completes the arrangement. A large artwork, customised to compliment the volum etric theme of the house, provides a soft backdrop to the scene.

The focal point of the house is the kitchen, from which the project gets its name. The eponymous “copper cube” is a modular kitchen unit clad in copper sheets. The cube appears to be detached from the ceiling, thereby raising the visual height of the space and also making room for a ceiling-mounted air conditioner. All cabinets and shelves within the unit are also clad in copper sheets, and a copper inlay extends along the floor, thereby defining the cubic structure within the visual space. The front portion of the kitchen, which shares space with the living room, has been fitted with bar stools to provide additional seating. A slit in the middle offers visual connectivity between the kitchen and living room, making the unit appear more spacious. The walls around the cube are clad in black tiles that extend all the way to the master bedroom at the far end of the house. The top of the kitchen unit is wrapped in Barrisol, a fabric that distributes the light evenly across the copper surfaces. “It completely washes the copper and makes it more opulent,” explains Khanolkar, “The mood of the space is quite dark, so by using this Barrisol, we’re highlighting the primary theme, which is the copper cube.”

Master Bedroom

A sliding door, cleverly concealed within the kitchen cube, can be pulled forward to create a private master bedroom that includes the master bath. “The doors don’t take up circulation space,” explains Khanolkar, “They disappear into the walls, so there is no visual interruption.” The master bedroom appears almost like a framed tableau, a birch ply-clad cube that is set within a thick wrap clad in black. The wrap makes room for concealed storage, both around and within the cube of the master bedroom. A full length mirror, a ceiling-height shelving unit and drawers within the base plinth make up what will function as the dressing area. The birch ply cube is the sleeping unit, fitted with a modular bed and a built-in side table, the base of which can be opened for additional storage. As in the living room, the only window in the master bedroom can be accessed by sliding back a framed work of wall art. The TV wall opposite the master bed is a fluted surface that also opens out to reveal additional storage compartments. “Smaller houses require this kind of utility,” insists Khanolkar, “and every square inch of the space that is available for storage and utility has to be made use of.”

The master bedroom appears almost like a framed tableau

The birch ply cube is the sleeping unit, fitted with a modular bed  

The theme of black is fully realised in the master bathroom, which is entirely clad in a mosaic of black ceramic tiles. White grouting offers a stern contrast, and gives the space “a digital look,” as Khanolkar describes it. “We were very minimalistic in our design for this space,” he adds, “The mosaic itself, which is busy, does the job.” Black granite shelves and a black ceramic basin enhance the palette. Copper accents appear as towel rods and racks, and the countertop which is entirely clad in copper sheets.

The theme of black is fully realised in the master bathroom

STUDY WITH NYC’s TOP-RANKED COLLEGE FOR INTERIOR DESIGN .

The New York School of Interior Design (NYSID) offers on-campus and online programs that’ll put you on the path to becoming a sought-after interior designer.

Learn more about NYSID’s undergraduate programs.

“One of the best interior design schools.” Architectural Digest

“One of the top schools for interior design.” Houzz

“One of the best schools for an interior design education.” House Beautiful

Are you a visually creative person who likes the idea of impacting how people live? Make NYSID your next step after high school. Through our CIDA-accredited interior design programs—a certificate, associate, and BFA—you’ll explore how texture, light, color, and other design elements can make life better for people and the planet. After graduation, you’ll be prepared to work for top boutique residential firms, as well as all the major players in interior design and architecture. You could be designing homes, hospitals, hotels, and so much more.

Why Choose NYSID?

A sole focus.

Our sole focus on interior design means you’ll get a true deep dive into every single aspect of the industry and the multiplicity of careers and related jobs. It also makes our alumni network an invaluable resource throughout your entire career.

A CLOSE COMMUNITY OF CREATIVES

Here, you’ll find a diverse group of aspiring designers, hailing from more than 30 countries, enjoying student life that involves everything from trips to famous landmarks to movie nights on campus.

TRAVEL OPPORTUNITIES

When they’re not on campus in the design epicenter that is NYC, our students are in places like Nantucket, Los Angeles, Palm Springs, Chicago, and Florence — studying everything from contemporary design to interior gardens.

Learn from the best

Our faculty are principals of their own firms and practicing designers at places like Gensler, HOK, Perkins&Will, and Rockwell Group. Something else they have in common: the belief that interior design has the power to improve human welfare.

NYSID Grads Design For:

Sample Courses

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“My interior design education has opened me up to a whole world of possibilities that I never dreamed of.” ROSE DARLINE DARBOUZE, BFA ’15

“The faculty is amazing. Most are working designers and architects. They taught us what it was like to actually design for clients.” ALLISON RUSSELL DAVIS, BFA ’08

“My experience at NYSID was amazing. I loved my professors; they were so passionate, personable, and dedicated. I never felt like I was just a number.” JODI COHAN, BFA ’08

“As a student, I visited designer showrooms and construction sites in and around the city, and I always had the chance to attend networking events with industry professionals.” GARRETT CARTER, BFA ’17

What’s the difference between interior design and decorating?

Interior designers are professionals who craft spaces that anticipate our needs and appeal to our emotions while pulling from a broad set of skills and technical knowledge. They work on every kind of project from restaurants to law offices to hotels to people’s homes. As a NYSID student, you’ll master color, textiles, materials, software applications for computer-aided design, health and safety issues, and so much more. Decorators are often self-taught and usually, but not always, work on residences. Think of it this way: design is a big bucket that includes decorating. At NYSID, you’ll learn it all… and more.

What’s the difference between interior design an decorating?

Think you want to study interior design in college?

We’d love for you to get to know us better—and vice versa. Request information now about the New York School of Interior Design.

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F186 ST9 Light Grey Chicago Concrete

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Colour and character

The decor F186 Light Grey Chicago Concrete is reminiscent of a cool-looking concrete surface that is often used in interior and furniture design. On large surfaces, it has a very authentic effect, as fewer repetitions are visible due to the XL repeat. The ST9 Smoothtouch Matt surface texture creates the matching cool matt feel. In the EGGER Interior Match, this decor is the same as the EPL166 laminate flooring from the EGGER PRO Flooring Collection 2021+.

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Trade Fair Light and Building in Frankfurt, exhibition stand of K’Electric

Several EGGER decors were used for an elegant, high-quality realisation of the K'Electric exhibition stand.

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Cocooning atmosphere with Scandinavian vibes

The fire - a primordial element around which lots of legends and myths developed becomes the central point of this design story

U114 ST9 Brilliant Yellow has been used as a bright accent in the kitchen

Interior Match: Created for harmonious designs

With the Interior Match, you benefit from coordinated combination options for furniture and flooring. The decor package includes same-decor and colour-coordinated flooring as well as furniture and interior design products. This allows you to create coordinated modern designs.

A complete overview is available in the flyer.

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Decor and combination recommendations

Our recommendations for matching decors

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Thanks to the Decorative Collection app, the entire EGGER decor selection is always at your fingertips, no matter where you are. Be inspired and create individual decor collections and mood boards.With the enhanced scan function, you can access the full view of the decors and detailed information on availability even faster. Order the desired samples for your projects even faster and easier.

A comparison with an actual sample is recommended. The stars indicate the quality of the colour match. *: close colour match, ** and ***: good colour match, **** and *****: very good colour match.

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Nt1310 Unit 3 Network Case Study: a Comprehensive Analysis

How it works

In the world of information technology, network design and setup are super important for keeping everything running smoothly in a company. The Nt1310 Unit 3 Network Case Study gives us a detailed situation where we need to look closely at different network parts, design ideas, and how everything works together. This essay dives into the details of the case study, looking at the theories and practical steps needed for a good network setup.

• 1 Checking Out the Current Network Setup
• 2 Building a Better Network
• 3 Putting the Network in Place and Testing It
• 4 Wrapping It Up

Checking Out the Current Network Setup

The first thing we gotta do with the Nt1310 Unit 3 Network Case Study is to take a good look at the current network setup.

The case study talks about a medium-sized company with an old system that has outdated hardware, a complicated network layout, and not enough bandwidth. They’re using mostly old Ethernet connections, with a mix of Cat5 and Cat6 cables. This setup works, but it’s not great. The data transfer speeds aren’t the best, and it’s not protected well against electrical interference.

Also, the current network doesn’t have good security features, making it easy for hackers to attack. The firewalls and Intrusion Detection Systems (IDS) are old or missing, which means there could be data breaches and losses. Plus, the network can’t grow easily because of its stiff structure, making it hard to add new tech or expand in the future.

Building a Better Network

Given the problems with the current setup, we need a complete redesign to make things better. The new plan focuses on three main things: upgrading the hardware, adding better security, and making the network easy to expand.

First off, upgrading hardware means switching from Cat5 to Cat6a or Cat7 cables. These newer cables can move data faster and are less likely to have interference problems. Also, using Gigabit Ethernet switches will make connections quicker and more reliable. For wireless, moving to Wi-Fi 6 will boost speed and capacity, which is great for new apps and devices.

Security needs to be top-notch and layered. Using next-gen firewalls (NGFW) will help catch and stop threats better. Adding Intrusion Prevention Systems (IPS) and Network Access Control (NAC) will make the network’s defenses stronger. Regular security checks and tests should be done to find weak spots and meet industry standards.

To make the network easy to expand, the design should use modular parts and virtualization tech. Software-Defined Networking (SDN) can help manage the network dynamically and allocate resources better, making it easy to add new devices and services. Using cloud solutions for data storage and processing will also make things more efficient and flexible.

Putting the Network in Place and Testing It

Once we have the design ready, the next step is to put the new solutions in place without causing too many disruptions. It’s best to do this in stages, starting with the most important parts and then gradually upgrading other systems. This way, we can keep things running smoothly and make changes as needed.

Testing is super important during this phase. We need to set up thorough testing plans to check the network’s performance, security, and reliability. Stress tests will show if the network can handle heavy loads, while vulnerability assessments will find security gaps. User acceptance testing (UAT) will make sure the new network meets what the company needs.

After everything’s set up, ongoing monitoring and maintenance are crucial to keep the network running well and secure. Using Network Performance Monitoring (NPM) tools will give real-time info on network health, helping to spot and fix issues quickly. Regular software updates and security patches are also important to protect against new threats.

Wrapping It Up

The Nt1310 Unit 3 Network Case Study highlights how important it is to have a thorough approach to network design and implementation. By upgrading hardware, boosting security, and making the network scalable, companies can create strong networks that meet their needs now and in the future. The proposed solutions tackle the problems with the current setup and set the stage for a resilient and adaptable network. As technology changes, staying updated on new trends and best practices will be key to keeping a network efficient and secure.

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Solution-Focused Brief Approach for Caregiver of a Person Living with Schizophrenia: A Case Study

• Case discussion
• Published: 17 September 2024

Cite this article

• Amit Kumar 1 ,
• Janaki Raman Kalyanasundaram   ORCID: orcid.org/0000-0002-9614-5858 1 ,
• John P. John 2 &
• Binukumar Bhaskarapillai 3  

In Asian countries, about 70% of people with Schizophrenia live with their families or friends. Caregivers are the persons who have significant responsibility for the well-being of a person diagnosed with Schizophrenia. In developing countries, the joint family system and the sense of collectivism resist paid caregivers for a person with Schizophrenia. As a result, caregivers may experience psychological and emotional distress and have poor mental health. Aim of the Study: To assess the caregiver's burden, Quality of life and coping patterns of caregiver's of persons living with Schizophrenia. The researcher had used single case AB design pre- and postassessment methods. The researcher administered Pai and Kapoor's Family Burden Interview Schedule, Brief Cope by Carver et al., and WHO Quality of Life-BREF. The scaling technique was used to assess the change in the post-assessment. The therapist took 10 sessions, each lasting for 45–60 minutes. The therapist organized the sessions into initial sessions, which included 2 sessions for building rapport, providing psychoeducation, developing a case conceptualization, and discussing the techniques that would be used. Additionally, there were 6 middle sessions focused on implementing core therapeutic techniques. After conducting psychoeducation sessions, utilizing the miracle questions, discussing preferred future outcomes, exploring exception questions, and implementing coping techniques with the mother, behavior management was taught to address the client's demanding behavior and emotional outbursts. Two sessions were dedicated to gathering feedback on the therapy process, preparing the mother for potential setbacks, and developing relapse prevention strategies. At post-assessment, the caregiver reported amelioration in burden, coping pattern, and Quality of life. The mother learnt the management of the illness and was quite confident in handling the PLWS. The scaling question at the time of preassessment was 1, and at post-assessment was 7.

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Kumar, A., Kalyanasundaram, J.R., John, J.P. et al. Solution-Focused Brief Approach for Caregiver of a Person Living with Schizophrenia: A Case Study. J. Psychosoc. Rehabil. Ment. Health (2024). https://doi.org/10.1007/s40737-024-00434-y

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Transformation of modern urban park based on user’s spatial perceived preferences: a case study of kowloon walled city park in hong kong.

1. Introduction

1.1. research background, 1.2. a literature review, 2. materials and methods, 2.1. study area, 2.2. investigation methods, 2.3. statistical research methods, 2.4. statistical methods, 3.1. descriptive statistical analysis, 3.2. semantic differential analysis, 3.3. perceived preference analysis, 3.4. analysis of influential factors, 4. discussion, 5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest, appendix a. questionnaire on user’s spatial perceived preferences of kowloon walled city park.

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Di, S.; Chen, Z.; Ren, Z.; Ding, T.; Zhao, Z.; Hou, Y.; Chen, Z. Transformation of Modern Urban Park Based on User’s Spatial Perceived Preferences: A Case Study of Kowloon Walled City Park in Hong Kong. Forests 2024 , 15 , 1637. https://doi.org/10.3390/f15091637

Di S, Chen Z, Ren Z, Ding T, Zhao Z, Hou Y, Chen Z. Transformation of Modern Urban Park Based on User’s Spatial Perceived Preferences: A Case Study of Kowloon Walled City Park in Hong Kong. Forests . 2024; 15(9):1637. https://doi.org/10.3390/f15091637

Di, Shuyi, Zimeng Chen, Zhipeng Ren, Tianyi Ding, Zheng Zhao, Yilei Hou, and Zejin Chen. 2024. "Transformation of Modern Urban Park Based on User’s Spatial Perceived Preferences: A Case Study of Kowloon Walled City Park in Hong Kong" Forests 15, no. 9: 1637. https://doi.org/10.3390/f15091637

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• Published: 16 September 2024

Hybrid emergency care at the home for patients – A multiple case study

• Åsa Falchenberg   ORCID: orcid.org/0000-0001-8956-8011 1 , 2 ,
• Ulf Andersson   ORCID: orcid.org/0000-0002-1789-8158 1 , 3 ,
• Gabriella Norberg Boysen   ORCID: orcid.org/0000-0003-3203-3838 1 ,
• Henrik Andersson   ORCID: orcid.org/0000-0002-3308-7304 1 , 2 , 4 &
• Anders Sterner   ORCID: orcid.org/0000-0002-2430-5285 1 , 2  

BMC Emergency Medicine volume  24 , Article number:  169 ( 2024 ) Cite this article

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Introduction

Healthcare systems worldwide are facing numerous challenges, such as an aging population, reduced availability of hospital beds, staff reductions and closure of emergency departments (ED). These issues can exacerbate crowding and boarding problems in the ED, negatively impacting patient safety and the work environment. In Sweden a hybrid of prehospital and intrahospital emergency care has been established, referred to in this article as Medical Emergency Team (MET), to meet the increasing demand for emergency care. MET, consisting of physicians and nurses, moving emergency care from EDs to patients’ home. Physicians and nurses may encounter challenges in their healthcare work, such as limited resources for example medical equipment, sampling and examination, in unfamiliar varying home environments. There is a lack of knowledge about how these challenges can influence patient care. Therefore, the aim of this study was to explore the healthcare work of the METs when addressing patients’ emergency care needs in their homes, with a focus on the METs reasoning and actions.

Using a qualitative multiple case study design, two METs in southwestern Sweden were explored. Data were collected from September 2023 – January 2024 and consist of field notes from participant observations, short interviews and written reflections. A qualitative manifest content analysis with an inductive approach was used as the analysis method.

The result of this study indicates that physicians and nurses face several challenges in their daily work, such as recurring interruptions, miscommunication and faltering teamwork. Some of these problems may arise because physicians and nurses are not accustomed to working together as a team in a different care context. These challenges can lead to stress, which ultimately can expose patients to unnecessary risks.

When launching a new service like METs, which is a hybrid of prehospital and intrahospital emergency care, it is essential to plan and prepare thoroughly to effectively address the challenges and obstacles that may arise. One way to prepare is through team training. Team training can help reduce hierarchical structures by enabling physicians and nurses to feel that they can contribute, collaborate, and take responsibility, leading to a more dynamic and efficient work environment.

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According to the World Health Organization (WHO), healthcare is facing several challenges, including an aging population [ 1 ] rising rates of chronic diseases, often characterized by exacerbation [ 2 ], which place greater demands on healthcare services. Simultaneously, the number of available hospital beds is decreasing, and due to staff cuts, there will be fewer ambulances and emergency departments (EDs) are closing [ 3 ]. In EDs, this leads to issues such as crowding and boarding, and which have a negative impact on the work environment such as workload that is too high, which may cause stress and risk of burnout [ 4 ]. Furthermore, crowding and boarding and have negative impacts on patient safety since of delays in medical treatment and inadequate monitoring, which can lead to increased mortality [ 5 ].

One way to meet patients’ needs for emergency care is to shift the care provided from the hospital to patients’ homes [ 6 , 7 ]. Offering home-based care (HBC) has been shown to be cost-effective [ 8 ] and safe for patients [ 9 ]. However, it may entail longer treatment times than hospital care, especially for certain chronic conditions [ 10 ]. Studies indicate that exacerbations of chronic conditions such as heart failure and chronic obstructive pulmonary disease, as well as pneumonias [ 11 ], symptoms such as fever, dyspnea [ 12 ], nonspecific symptoms in frail elderly patients, patients with cognitive impairment [ 13 ], and pain or injury to the skeletal or muscular system [ 14 ] can be effectively managed at patients homes. Currently, there is no consensus on what HBC entails or how it can be termed [ 15 ]. Terms such as “Hospital At Home” [ 9 , 16 ], “Same Day Emergency" [ 17 ], “Hospital In The Home” [ 18 ] or “Residential In Reach” [ 19 ] are used internationally, while in Sweden, general terms such as “Mobile teams”, “Mobile emergency teams”, or “Mobile home care teams” are used [ 20 ].

The Swedish healthcare system is divided into three levels of governance: state, region, and municipality. These levels are responsible for different parts of healthcare, specialized hospital care, primary care, and municipal care [ 21 ]. Currently, all levels are undergoing a transformation process called “good and integrative care” [ 22 ]. This initiative resembles the Integrated Care System in England [ 23 ] and aims to make healthcare more accessible and closer to the patient, focusing on their unique care needs [ 24 , 25 ]. As part of the Swedish transformation process to meet the increased need for emergency care, a hybrid of pre- and intrahospital emergency care has been established [ 25 ]. This hybrid version of emergency care will, in this article be referred to as the Medical Emergency Team (MET). The MET, consisting of two organizations, ambulance services (AS), and EDs, has merged and operates outside the hospital setting. MET is not the same as care provided by ambulance, primary or municipal care, MET is rather a combination of these services. The MET is staffed with ED physicians and nurses from the ED or AS and provide emergency care to patients who have suffered from sudden illness or injury [ 26 ] and operates wholly or partially from hospital-affiliated EDs.

When emergency care is provided in patients’ homes, a holistic approach is required to ensure that all aspects of patients’ care needs, including medical, caring, physical, psychological, social, and existential needs, are addressed [ 27 ]. This means that METs must be prepared to handle a wide range of care-related issues with limited resources, in an unfamiliar environment to ensure that the care provided in patients’ homes meets their needs [ 28 ]. This requires the MET to collaborate across boundaries both within the MET, and outside the team with other care providers such as AS, primary care or municipal care [ 25 , 29 ]. If the expectations of the MET’s care work, i.e., what they can do, are unclear, difficulties may arise [ 28 ]. In this study, healthcare work refers to performing various tasks which not only including technical skills such as collecting blood samples and managing medical equipment but also through understanding and responding to patients’ needs, both expressed and unexpressed. Furthermore, healthcare work includes communication within the MET, with patients and their relatives, as well as other healthcare actors. By examining how physicians and nurses reason and act when encountering patients’ care needs at home through the MET, obstacles and opportunities can be identified when hybrid emergency care is shifted to patients’ homes. The aim of this study was to explore the healthcare work of the METs when addressing patients’ emergency care needs in their homes, with a focus on the METs reasoning and actions.

Employing a qualitative multiple case study design [ 30 ], this study explored the MET as a contextually and socially bounded system [ 31 ]. The data were collected through participant observations, which enabled participation in daily activities, interactions, and events [ 32 ].

The research settings were two METs in the southwestern part of Sweden: MET A, which operated from a hospital-affiliated ED, and MET B, which operated from the AS. The possible assignments providers for MET A and MET Bs were similar. However, MET B could have paced assignments identified by the ED and AS when the MET was not operational. MET B could also be assigned to time-critical medical conditions to make initial assessments/treatments while waiting for AS. Primarily, the nurses were responsible for checking the equipment and restocking supplies in the vehicle. When the MET had no assignments, the physicians in the MET A supported their colleagues in the ED, carried out administrative tasks, and answered incoming calls to the MET. The physicians in MET B had administrative tasks and handled incoming calls to the MET when the team had no assignments. The two METs had varying conditions and staffing, and the equipment was slightly different between MET A and MET B, consisting of up to 13 different units. For more information see Table  1 .

Study participants and recruitment

The study received ethical approval from the Swedish Ethical Review Authority in Stockholm (NO: 2023-02186-01) and access to the research field was granted and formally approved by the managers of the participating facilities. All physicians and nurses who staffed the MET were invited to participate in the study. MET A was informed by the first author through a staff meeting and email, while MET B received the information verbally from the medical chief of the department. Each participant received both oral and written information about the study from the first author and signed a consent form. Other ethical considerations regarding data protection and data security were followed in accordance with the Swedish Data Protection Act [ 33 ]. All data are presented at the group level for the purpose of ensuring and maintaining the participants’ integrity and confidentiality, and the study aligns with accepted ethical principles for research [ 34 ]. The studies included five physicians and five nurses from MET A and five physicians and five nurses from MET B, see Table  2 for further information.

Data collection

The data were collected during the period from September 2023 to January 2024 and consisted of participant observations with field notes [ 32 ], interview notes [ 35 ] and written reflections [ 32 ].

Observations

The first author conducted all observations by following both METs for full work-shifts, and each patient visit was defined as one observation. The duration of the observations varied between the METs, se Table  3 . Physicians and nurses were encouraged to work as usual and to ignore the researcher, who aimed to maintain a low profile throughout. When arriving at the patient, the researcher was briefly introduced as a person who was there to observe how they worked.

All observations began when the MET received the assignment and ended when the door to the patients’ home closed. During the observation field notes were written containing what physicians and nurses said and how they reasoned when the assignment was received, during the assignment, and when it was completed. In total, 25 observation days were completed, comprising 73 observation instances. The observations lasted an average of 41 to 44 min and generated two to three pages of transcribed text, see Table  3 for further details.

To obtain a deeper understanding of METs reasoning about their actions when patients’ care needs were met, the following questions were asked; What are your thoughts about the assignment and what are your thoughts on the teamwork? Follow-up questions were posed in response to the answers given. To gain a deeper understanding, questions such as “Can you tell me more?” were used frequently. The interviews took place after the observations were completed, conducted in the car while leaving the patient.

After the completion of the observation and interviews, the first author wrote down reflections in a reflective text. The purpose of the reflection was to gain additional understanding of the research questions. These reflections were utilized in the discussion of the results.

Data Analysis

The collected data consisted of field notes, interview texts, and reflection texts were transcribed by the first author. During transcription, the text became more descriptive than the original because several fieldnotes were written with incomplete sentences when trying to write down as much as possible. The data were sorted into three phases of the MET assignment- preparatory, during the patient visit, and the reflection phase - which is a way to structure the data chronologically and provide organization [ 30 ]. To ensure that the analysis was as free as possible from interpretations, the author group discussed och reflected during the process. The qualitative manifest content analysis was conducted using an inductive apporach [ 36 ] and began with the first author reading the fieldnotes and interview texts multiple times to understand the content and obtain an overall sense of the data. In the second step, units from the text were extracted that addressed the aim of the study, to capture and describe METs healthcare work such as communication, physical actions, understanding and responding to patients’ care needs. These units were condensed without losing the content and coded based on their content. The codes were then sorted into categories and subcategories describing different aspects, similarities, or differences, ultimately forming four categories: Assignment reception and preparation phase, patient interaction and examination phase, decision-making and treatment phase and reflection and evaluation phase.

The results will be presented in chronological order, from when the METs receive the assignment until the assignment is completed, concluding with reflections from the METs. The results will include situational descriptions and quotes to present general patterns for MET A and MET B; unless otherwise specified, the aspects were the same. Each phase begins with a generic vignette that encompasses of several observation sessions. Individual observations are presented with the unique observations number.

Assignment reception and preparation phase

The METs are on their way to a patient , the physician reads loud from the patient’s medical record , the phone rings repeatedly , regarding new assignments and questions from AS , municipality care, etc. After each call , the physician gives a summary to the nurse. The nurse asks “inquisitively”… which patient are you referring to? The one we’re heading to , or is it another? Transportation time is then spent with the physician dictating notes in the patient’s medical records where recommendations to seek other levels of care or stay at home are given. When the nurse parks the vehicle outside the patient’s address , the METs discuss which equipment to bring.

Patient assignments could be provided at any time during the shift via phone or radio, and the information was sometimes vague or incomplete. The time for preparation varied depending on when the assignment was received, where the METs were geographically located in relation to the patient’s address, whether in an apartment in the same building or several kilometers away. Physicians received the most calls; occasionally, the speakerphone function was used so that the nurse could take part in the conversation and ask questions. On occasions when nurses answered the phone, a brief report was taken, and the nurse was asked to call back after consulting with the physician, or the phone was handed directly to the physician. Unlike MET A, MET B could receive assignments from the ED and AS when the MET was not operational. Messages were then written on notes handed over in person during shift changes at the ambulance station or at the ED. MET B could also be assigned to a critically ill patient, resulting in all delays for all other accepted assignments. On some days, assignments could pile up, causing patients to wait for several hours or for the METs to decline assignments. When assignments were received, the METs discussed the pros and cons to determine if it was a suitable patient; the physician had the authority to accept the assignment.

Nurses drove the vehicle, and transportation time could occur in silence, with the phone ringing incessantly, or with the METs discussing private matters. Physicians read and documented in the patient’s journal for upcoming and completed patient assignments. The METs could have difficulties finding the correct address; the functionality of the navigation system varied, and on several occasions, it did not work at all or provide incorrect directions. Upon arrival at the correct address, the need for additional information, such as a gate code or miscommunication regarding contagious patients, was discovered. When the vehicle was parked outside the patient’s residence, the decision on which equipment to use was made. Physicians were responsible for bringing the laptop bag and ultrasound equipment, while nurses were responsible for carrying other equipment. In instances where physicians were in an ongoing call, the nurse entered the patient’s home alone, but usually, the METs entered together.

Patient interaction and examination phase

When the METs entered the patient’s home , the physician approached first , either standing or squatting in front of the patient and said: Hello , my name is xxx and I am a physician , how are you? The nurse stands quietly behind , not wanting to interrupt the patient’s conversation with the physician and beginning to retrieve and set up the lab equipment. The physician examines the patient , is interrupted several times by phone calls , and then prescribes which tests to take. The nurse , who has been in another room , is not prepared for which tests to take and does not understand why.

When the METs arrived at the patient, they introduced themselves by name and title, and that they were from the MET. The physician was often the first to reach the patient. In instances where the MET had been assigned a critically ill patient, which was a part of MET B’s mission, there were usually already one or two ambulances on site. The physician then first contacted the ambulance nurse. When MET B was the first unit on site, the physician took the medication unit and went in alone to see the patient while the nurse parked the vehicle and brought in the rest of the equipment.

After the introduction, physicians usually immediately began gathering information about what had happened and how the patient was feeling. This meant that the nurse did not have a natural opportunity to greet, which could result in the nurse’s introduction occurring later during the visit or being completely omitted. Physicians often choose to sit down beside the patient or squat down. Before the examination, lights were sometimes turned on, blinds were pulled up, and the bed was raised. This was sometimes initiated by the patient, other individuals present, or the METs themselves. Examinations could also be conducted by leaning over the patient, in dim light where mobile flashlights were used to read vital signs. Depending on how many other people were in the room, information about the sequence of events could come from multiple sources. Nurses sometimes chose to listen as physicians gathered information, sometimes asked questions, or assisted when communication between the patient and physician did not work. When several people were present, it could sometimes become noisy in the room, resulting in the patient not hearing or understanding what the physician was asking, and the patient’s voice not being heard. The METs could be interrupted several times by phone calls with requests for new assignments, pending assignments, and advisory calls from AS.

The examinations were conducted based on the ABCDE principle (airway, breathing, circulation, disability, and exposure) and were carried out by a physician, while the nurse performed the examination, when agreed upon during the preparation phase. Physicians always listen to patients’ lungs. The nurse sometimes participated in the initial examination by handing equipment such as a stethoscope to the physician or standing quietly by the side and listening. Unlike in the MET A group physicians in the MET B group were interested in improving nurses’ examination techniques, such as listening to the lungs and interpreting electrocardiograms (ECG). Physicians encouraged the nurses to listen and report what they heard or allowed the nurses to make the initial assessment of the ECG. Different examination findings were discussed openly, which could lead to various expressions of curiosity and questions among those present. Most often, the nurse chose to begin measuring vital parameters (respiratory rate, saturation, blood pressure, pulse, and temperature) or to prepare the laboratory equipment during the ongoing examination. The cold blood pressure cuff was warmed on rare occasions. The clothing of patients could be partially or fully removed during the examination and was not routinely returned after the examination. Once vital parameters had already been taken, the nurse waited to take new until the physician indicated a desire for them. Nurses could express concerns about patients’ well-being, such as affected vital parameters during the ongoing examination, which the physician did not confirm or did not consider noteworthy.

The nurse measures the patient’s saturation… looks at the meter… furrows brow in concern , asks the patient to take a few deep breaths. Says to the physician: …are you noting the value? Yes , says the physician , who continues to sanitize the equipment [Observation 45].

Problems that could arise when vital parameters were taken included that they were often said out loudly in the room, which colleagues did not always hear. The values could be noted on journal sheets, pieces of paper, on gloves, or not at all. This resulted in uncertainties about which parameters had been taken and what they showed. The mission of MET B, unlike that of MET As, was to care for elderly patients. They could be interrupted during ongoing examinations to care for another patient, residing in the same assisted living facility, who had suddenly deteriorated. In those instances, the nurse stayed with the patient and continued the examination.

Sampling, which occurred after a physician’s order, was performed by nurses. Sometimes, the nurse could interrupt the ongoing examination to obtain blood samples without a physician’s order; other times, the nurse stood by and waited, ready with the sampling materials. When the nurse took the samples, the physician usually chose to sit down in another room to read the patient’s journal and plan for potential treatment. Nurses were responsible for retrieving the laboratory equipment and placing it where there was sufficient space, usually in an adjacent room; patients were then left alone while blood samples were analyzed. The results from sampling were crucial in some cases, such as when patients could not participate in the visit due to a disability. Blood samples could be taken via arterial, venous, or capillary methods, with the choice of method varying. In MET A, it was the patient’s symptoms and signs determine the choice of sampling method, while in MET B, arterial or capillary blood samples are usually taken. The reason for choosing the sampling technique was unfamiliarity with the venous sampling technique and the nurses’ interest in learning to collect arterial samples. This resulted in patients being punctured multiple times, and the decision regarding sampling could suddenly be re-evaluated when the sampling failed when there was a lack of available analysis material.

The issues that could arise with laboratory equipment included its sensitivity to cold temperatures and the shortage of the special cards. Attempts to warm the laboratory equipment were made by placing it near warm sources in the patient’s home, warming it against the body, and re-evaluating the need for sampling. MET A chose to place the sensitive equipment in another location in the vehicle, which MET B did not have the opportunity to do. The lab equipment was space-consuming, which challenged the METs in homes with many personal belongings and dirty surfaces. MET A, which had more lab equipment than MET B, forgot part of the equipment at the patients’ homes. METs can carry up to seven units into the patient, depending on the patient’s condition. Space constraints combined with large jackets during cold weather caused patients personal belongings to fall to the floor and break.

Decision-making and treatment phase

Physicians made decisions regarding treatment , which could involve medication , palliative care orders , expanded sampling , and continued hospital care. Physicians discussed treatment options with patients , when possible , as well as other healthcare personnel present. The nurse , who often remained in another room to manage patient sampling and pack equipment , did not hear the discussions and thus was unprepared for potential treatment and lacked knowledge of prescribed medications. When the decision for hospital transport was made , the nurse arranged it while the physician documented.

Decisions about treatment were typically made by physicians during the examination or sampling phase and could involve medication, expanded sampling, continued hospital care, palliative care orders, or observation. During this phase, METs could be interrupted repeatedly, resulting in incomplete perceptions of orders and important decisions made. Nurses repeated the current medication orders and awaited confirmation from the physician before administering the medication. Nurses could ask patients and relatives several questions but did not wait for or expect a response. Physicians usually provide medical self-care advice, while nurses ask if they have sufficient support from other healthcare providers. Nurses could also take initiative and suggest treatments to patients who had not communicated with the physician, which could sometimes lead to misunderstandings regarding patients’ degree of illness.

Patient with diarrhea , vomiting , high fever , and dizziness for five days. The patient said , “I find it hard to drink”. Nurses responded “ … it is a shame to go to the hospital , better to stay at home. You should take paracetamol and ibuprofen regularly throughout the day for the fever , and then you must drink properly , preferably soup or oral rehydration solution”. Meanwhile , the physician stands a short distance away , looks worried , makes a few attempts to intervene in the conversation but fails and eventually gives up [Observation 45].

Physicians typically proposed treatment options to patients, and in cases where patients had conditions such as impaired cognitive abilities or were in the end-of-life stage, they were not involved in decision-making. Decisions were discussed with other healthcare personnel if they were present. Relatives were involved when possible, and some decisions required physicians to try to help the patient understand, such as patients with mental health issues. The mission of MET B included, for example patients who experienced cardiac arrest and patients who died. During these missions, the MET took the time to talk about and support the relatives present and reassured them that the patient had not suffered.

The familiarity with handling the medications that METs carry varies. Nurses in the MET A were accustomed to administering the medications typically used in the ED, such as antibiotics, unlike those in the MET B. When questions and uncertainties arose regarding medications, which could concern how antibiotics should be diluted and administered, nurses consulted physicians, but they lacked practical knowledge. They then searched for information together on the internet or called the hospital’s ED for advice. On occasion, prescribed medication was not given because both the physician and the nurse lacked knowledge of how the medication should be administered.

Patient with suspected sepsis… the MET has called an ambulance… Physicians have ordered intravenous antibiotics. The nurse asks;… should we skip giving the antibiotics… the ambulance will be here soon? [Observation 42].

When multiple tasks needed to be performed, physicians could offer to administer medications. Since physicians were not familiar with the units containing medications and equipment, nurses had to interrupt their ongoing tasks to show the physician which unit the equipment was in and how it worked.

Patients who expressed insecurity about staying at home or being too ill were offered hospital care. The nurse arranged transportation to the hospital, assisted in moving the patient from, for example, the bed to the ambulance stretcher, and was responsible for filling out the journal sheet accompanying the patient to the hospital. The physician was responsible for documentation and contact with the receiving unit. When the physician had a probable working diagnosis and when there were available beds in the hospital wards, patients could be admitted directly. However, when there was a shortage of beds, which was common in MET A, or when the diagnosis was unclear, patients were transported to the hospital’s emergency department for further evaluation, treatment, and waiting for an available bed. The physicians were always documented in patients’ journals, while the extent of nurses’ routine documentation varied. The differences included nurses in the MET A documenting the reason for the visit, nursing status, entering test results, updating interventions from community care, and phone numbers for the patient and relatives in the patient’s hospital journal. MET B’s nurses documented by creating a case log in an ambulance journal, with reference to the physician’s notes in patients’ hospital journal.

The other healthcare providers with whom the METs collaborated with varied depending on the differences in the mission descriptions. Cooperation with municipal care was common, and physicians were responsible for handovers. MET visits often include takeovers, which could consist of newly prescribed medications, administration of antibiotics and intravenous fluids, as well as vital sign monitoring. There were regulations at certain special accommodations in MET B’s catchment area that governed, for example, the use of IV stands inside patients’ rooms. This resulted in the application rule being broken at the MET initiative when a patient needed intravenous fluids. The extent to which the prescribed medications were left varied. MET A left newly prescribed medications, either for the entire treatment period, which last up to 10 days, or for the first two to three days. Intravenous antibiotics were always left for the first day, then a follow-up visit was usually scheduled for the next day, or the patient could transition to oral treatment. In MET B, the first dose of antibiotics was given intravenously, and possibly the first tablet dose, with the remaining doses prescribed by the physician.

When the mission was considered completed, it was usually the nurse who sanitized the equipment and packed it. The MET usually said goodbye together and tried to restore the patient’s home to how it was when they arrived. Nevertheless, on occasion bright lights were forgotten to be turned off, the patient’s bed was not turned down, and that the patient would not become cold was not ensured. Usually, the nurses carried the equipment to the car, while the physician was responsible for the computer and printer and possibly the ultrasound on occasion.

Reflection and evaluation phase

The METs reflected on whether the mission had involved an ‘appropriate patient’ and considered whether additional examinations that the METs did not perform, such as X-rays, could have affected or improved the quality of care. Patient benefit was viewed as crucial, where the METs considered patients’ preferences alongside potential risks of staying at home, such as an increased risk of falling. The assigned missions often concerned patients who could be effectively treated at home, where a visit to the ED would not have added value.

The assignment involved a patient with addiction problems. The apartment was filled with cigarette smoke , with stacks of newspapers along the walls and personal belongings scattered everywhere. The MET had been contacted by home healthcare. The patient was not very responsive during the examination [Observation 9]. The doctor said; “The patient would have been sent to the ED if the MET had not assessed and treated the patient at home. However , an ED visit would not have made any difference to the patient’s outcome”. The nurse added: “I noticed he was so tired and lethargic… he seemed affected.” The physician responded , “…I had no thoughts of that at all” [Interview 9].

However, the METs also acknowledged that some missions required skills they did not possess, particularly in psychiatry. They expressed uncertainty about their role in certain missions and believed some were better suited for ambulance care, such as patients needing oxygen therapy. For patients requiring oxygen, the METs felt hospital care was necessary and that their involvement could delay treatment. Missions solely based on telephone assessments of patients’ needs were often considered less reliable compared to those assessed by licensed personnel on site. Patients’ emergency care needs varied, from requiring rapid hospital transport to care within primary care settings. The METs noted that some missions were not about providing home care but rather about optimizing ambulance resources, using methods like stretcher transport or a single-nurse ambulance. The METs agreed that in some cases, patients had waited too long for an ambulance and needed quicker intervention.

The METs expressed that within the team, there was an enabling and safe climate where they complemented each other and worked beyond professional boundaries, which they considered a strength. However, nurses sometimes felt that their skills were underutilized in missions that solely involved transporting physicians to patients. Nurses in the MET B group perceived ambiguity in their professional roles, while those in the MET A group experienced inequalities in task distribution. They expressed feeling responsible for multiple tasks, which could be time-consuming and challenging, such as checking vital signs, conducting tests, and addressing patients’ care needs, where they believed physicians could offer more support. The METs highlighted several strengths in teamwork, such as having one team member communicate with the patient to establish a strong connection and contribute different perspectives, with doctors focusing on the medical aspect and nurses on the care perspective. While the METs felt confident in the medical aspect, physicians found nursing tasks challenging, including assessing patients’ nutrition, elimination, personal hygiene, and fall risk assessment.

The mission involves an elderly patient in a nursing home with deteriorated general condition , diagnosed with dehydration by the time the MET leaves the patient [Observation 14]. On the way back , the nurse says; ”The patient resides in a facility , and it is not our responsibility to take over the facility’s duties. Since the patient did not express a desire for anything to drink , nursing interventions can be deprioritized in favor of other patients who are waiting [Interview 14].

The METs reflected on whether the decisions made were right or if they could have done things differently. Physicians in MET B viewed receiving many questions as positive because it prompted deeper thought. There was a clear need for confirmation among physicians during missions involving difficult-to-assess patients or making challenging decisions, such as end-of-life discussions and initiating palliative care orders. However, this need for confirmation was not always recognized by colleagues. Instead, nurses expressed concern about the lack of written information detailing the actions taken and the treatment plan implemented.

The results of the multiple case study indicate that physicians and nurses face several challenges in their daily work such as recurring interruptions, miscommunication and faltering teamwork. This can lead to stress, which not only exposes patients to unnecessary risks but also negatively affects physicians and nurses [ 37 ]. One way to attempt to understand and interpret the work systems within which physicians and nurses operate within is to investigate what happens within and outside the MET and how it can affect caregiving [ 29 ].

The results indicate that the MET could be interrupted multiple times during a patient visit by incoming calls regarding potential new patient assignments, ongoing consultations, or advisory calls from, for example, the AS. Additionally, as described in the assignment reception and preparation phase , MET B could be assigned to a critically ill patient. These interruptions could cause ongoing examinations to be disrupted and force physicians to start over, resulting in inefficient work. Constant interruptions can create feelings of losing control, leading to dissatisfaction and stress, which can result in burnout over time [ 38 ]. Emergency physicians and nurses are more frequently affected by burnout and emotional exhaustion [ 39 ]. Interruptions can negatively impact their ability to concentrate, potentially leading to inadequate or incorrect decisions regarding the care and treatment required for the patient’s condition [ 40 ]. In addition, the MET did not have necessary information such as access codes, and lacked knowledge about whether patients were carrying infectious diseases such as COVID-19 or gastroenteritis. Sometimes, the physician had received this information but had not shared it with the team. The failure to have such information exposed the MET to unnecessary risks of either contracting infections themselves or spreading them further. Previous research indicates, for example, that staff in AS are at greater risk of acquiring infections due to the uncontrolled environment in which they work [ 41 ].

Physicians were often the first to acknowledge the patient and would begin taking the medical history when MET arrived unless it involved a critically ill patient, which could be the case in MET B. On those occasions, as described in the patient interaction and examination phase , the physician took on a more withdrawn role. It was evident during the observations that the AS were accustomed to handling these situations and that the METs medical contribution was limited. Many patients who received care and treatment from the MET, especially MET B were elderly residents living in nursing homes. On several occasions, the MET expressed that these elderly patients were ideal candidates for emergency care at home, but also perceived that many of the visits would have been more appropriately managed by primary care. This is supported by previous research, which shows that emergency physicians and nurses perceived a lack of competence and insufficient involvement in patient care as contributing factors to AS being called out and the patient being transported to the ED [ 42 ].

During the examination, physicians might ask the nurse to measure vital signs, hand over a stethoscope, or remove the patient’s clothing to facilitate a more thorough examination This approach could be due by the fact that physicians working in EDs are accustomed to having limited time for gathering necessary information for making treatment and diagnosis decisions [ 43 ]. Medical history and examination results sometimes occurred simultaneously but could also occur separately. The questions asked were often open-ended, such as ”How are you feeling?” and ”Can you tell me why we are here today?”. Nurses often choose not to participate during the physician’s examination, as described in the patient interaction and examination phase . Instead, they prepared the lab equipment and carried out the physicians’ orders, acting as assistants. MET A, had more lab equipment to prepare than MET B, which could be time-consuming to unpack and set up. This withdrawn role that nurses sometimes adopted could lead to care becoming primarily medically focused, potentially overlooking patients’ comprehensive care needs. It is not surprising and not a new phenomenon that emergency care primarily has a medical focus [ 44 ]. Previous research shows that in EDs, there are deficiencies in both identifying and responding to patients’ fundamental care needs, such as nutrition, elimination, and fall prevention, which can lead to adverse events [ 45 ]. MET A was more likely to follow the ED’s routines and guidelines, such as documenting provided care and collecting blood cultures before administering intravenous antibiotics—a practice that was not followed at all in MET B. By adhering to these guidelines, MET A not only ensured compliance with established protocols but also enhanced patient safety. Guidelines are an essential tool for providing updated information and increasing the standard of [ 46 ]. In conclusion, while the medical focus in emergency care is undeniably important, integrating a comprehensive approach that includes adherence to guidelines is crucial, especially since this type of mobile care is primarily provided for frail elderly patients [ 25 ].

One way to increase patient safety and quality of care could be to work in teams [ 47 ] where collaboration is highly emphasized [ 25 ]. Collaborating is important in all care context, but is especially crucial in emergency care, where decision need to be made rapidly with limited information [ 48 ]. When emergency care is delivered in patients’ homes, MET face several challenges, including weighing the benefits and risks of providing care at home while also considering the patient’s wishes and autonomy [ 49 ]. The results of this multiple case study indicate that teamwork in the MET could be insufficient. Physicians and nurses had differing perceptions of the goal of the patient visit. A possible explanation for this could be a lack of sufficient communication between physicians and nurses. Nurses were not always involved when assignments were accepted, resulting in them having little or inadequate information when they arrived at the patients’ homes. During patient visits, physicians and nurses often worked separately, indicating a sequential working method, as described in the patient interaction and examination phase . A work system consists of several interdependent parts with various characteristics that rely on each other, making caregiving complex [ 29 ]. A sequential working method can thus contribute to unsynchronized, inefficient care, with risks for patient harm, such as missed nursing interventions or the failure to treat time-critical conditions according to standard protocols, such as early administration of antibiotics in suspected sepsis patients [ 50 ]. Another possible explanation for physicians and nurses working separately could be hierarchical structures within the MET. These hierarchical structures might have included ambiguities regarding professional roles and who was expected to be responsible for and carry out different parts of the healthcare work when identifying and meeting patients’ care needs [ 50 ]. In addition, previous research has highlighted the necessity of shared responsibility for patient care, which develops over time [ 51 ]. Another explanation could be that both METs were relatively new, involving a completely new way of working for which physicians’ and nurses were not trained for.

However, this study reveals that the phases described in the results can happen at any time and affect each other, underscoring the complexity the MET encounters when managing patients’ care at home. These factors, when combined, can negatively impact both care and patient safety [ 50 ] especially if the skills within the MET are not fully utilized. To address this, it is suggested that interprofessional simulation be implemented. This approach brings together different disciplines, allowing them to practice collaborative care in a controlled setting, which could enhance patient safety [ 52 ].

Strengths and limitations

A strength of this study is that it was conducted as a multiple case study, which is more compelling and robust than single case study [ 30 ]. Data also describe current phenomena in their real-world context, which is advantageous when the boundaries between the phenomenon and the context are unclear [ 30 , 32 ]. Another strength is that several approaches were used to gather data such as participant observations, short interviews and reflections. This enabled triangulation, which is a method used to explore complex phenomena that cannot be fully understood, with a single method or data source [ 53 ], can provide a broader and deeper understanding of physicians’ and nurses’ healthcare work in this hybrid form.

However, there are also some limitations to acknowledge. When the study was conducted, the METs were relatively new, which may have led to certain issues related to their ongoing development. To gain access to the research environments, gatekeepers were used. This can be seen as a weakness since gatekeepers are often key individuals within the organization with certain power, which may have influenced the participants to take part in the study to appease the chief. There were also differences in the number of observations between the METs. A reason for this was METs differed in missions and geographic catchment areas. The size of the area they served may have affected the number of completed observations due to the time they spent traveling between patients’ homes. Technical differences regarding the vehicles between the METs, as well as the inability to control incoming phone calls, may have resulted in important information being overlooked.

Finally, a limitation may be the professional role of the observer as a licensed nurse, which complicated maintaining the researcher role. On a few occasions, the first author had to abandon the observer role to assist with equipment and medication, which may have led to some data not being recorded. However, patient safety was a priority.

Conclusion & implications

This study highlighted the challenges physicians and nurses meet when a new service is launched in emergency care. The challenges include the expectation for physicians and nurses to collaborate in teams, ambiguity in job descriptions leads to inefficiencies and uncertainty. Moreover, physicians and nurses are not accustomed to working together, and team compositions change almost every shift. As a result, established work routines are difficult to maintain, requiring team members to constantly adapt to new colleagues and workflows.

It is also important to note that these challenges can contribute to increased stress levels among staff, which can negatively impact patient care. When there are deficiencies in communication and collaboration within the team, this can lead to mistakes or delays in care, exposing patients to unnecessary risks. To counteract these problems, it is crucial to invest in team training and to develop clear job descriptions and routines that support effective and coordinated teamwork. Team training can help reduce hierarchical structures by enabling physicians and nurses to feel that they can contribute, collaborate, and take responsibility, leading to a more dynamic and efficient work environment. By practicing reflection and feedback after completing assignments, a more inclusive and development-oriented environment can be fostered, which in turn can positively impact the care provided by METs.

In summary, the study shows that it is essential to place great emphasis on planning and preparation when introducing new forms of care such as MET. By ensuring that all team members are well-prepared and that there are clear structures and support in place, a more dynamic and efficient work environment that benefits both staff and patients can be created. This hybrid version of prehospital and intrahospital emergency care is a complement to traditional hospital care, ED, AS, primary and municipal care. This requires collaboration between different organizations and staff categories, where patients’ current needs and situations are the focus, without boundaries. Further research is needed to define or explain what MET entails or how it can be termed. Likewise, can physicians and nurses experience to meet patients emergency care needs at their homes provide valuable insights.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

Acknowledgements The authors would like to express their deepest gratitude to the physicians and nurses who participated in this study. It was a privilege to take part in your daily work as well to listening to your thoughts on the research topic.

No funding was received for conducting this study. Open access funding was provided by the University of Borås.

Open access funding provided by University of Boras.

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Åsa Falchenberg, Ulf Andersson, Gabriella Norberg Boysen, Henrik Andersson & Anders Sterner

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Åsa Falchenberg, Henrik Andersson & Anders Sterner

University of Borås, Academy for police work, Borås, Sweden

Ulf Andersson

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Contributions

Authors’ contributions The study design was proposed by ÅF, GNB, HA and AS. The observation and interview guide were designed by ÅF, GNB, HA and AS and the observations and interviews were performed by ÅF. The data analysis and interpretation of data was performed by ÅF and further was discussed with UA and AS. ÅF drafted the manuscript, and AS and UA substantively revised it. All authors read and approved the submitted version of the manuscript.

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Correspondence to Åsa Falchenberg .

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The study was approved by Swedish Ethical Review Authority in Stockholm (Approval Number: 2023-02186-01), and access to the research field was granted and formally approved by the managers of the participating facilities. All methods were carried out in accordance with regulations (e.g. Declaration of Helsinki). Other ethical considerations regarding data protection and data security were followed in accordance with the Swedish Data Protection Act.

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We declare that no economic relationships exist that can be construed as a conflict of interest.

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The participants were involved in the study after obtaining written informed consent.

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Falchenberg, Å., Andersson, U., Boysen, G.N. et al. Hybrid emergency care at the home for patients – A multiple case study. BMC Emerg Med 24 , 169 (2024). https://doi.org/10.1186/s12873-024-01087-7

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Received : 20 June 2024

Accepted : 09 September 2024

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DOI : https://doi.org/10.1186/s12873-024-01087-7

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