The Big Picture: Framing Healthcare Design Today
HEALTHCARE DESIGN’s annual Architectural and Interior Design Showcase has always been one of the most exciting projects the editorial team works on each year. Not only does it result in a concise portrait in print of healthcare design and construction in any given 12-month period, but the assembled panel of experts called upon each spring to judge the competition represents some serious brainpower, all together in one room.
The roundtable discussions that take place at the end of the judging period result in very robust and revealing conversations. The assembled jury is composed of experts from every walk of the industry, from architects to interior designers to owners, and everyone in between, their insights and observations, both in person and via follow-up questions from our editorial team, place this year’s Showcase in context regarding the competition and the “big picture” healthcare design landscape.
Timing is everything
Many of the projects reviewed for this year’s Showcase were in the planning stages just as the U.S. recession was rearing its ugly head; in fact, 2008-2009 saw the largest decline in healthcare construction activity in 50 years. This timing led to tangible results in the eyes of many jurors.
“We’re at the tail end of a building boom where many larger-scale projects are repeating what we’ve all seen in the past,” says juror Randall Bacidore, AIA, of Matthei & Colin Associates. “Consumer expectations are leveling the playing field, and we’re starting to see, as a result, fewer innovations.”
To some jurors, however, these constraints led to more creative ideas, although on a smaller scale. “Restricting floor space and amenities due to the down economy or value engineering led quite a few firms to approach their design in a different manner and utilize space in a way that they had not intended to previously,” says juror Laurie Placinski, IIDA, LEED AP, EDAC, interior project designer with Progressive AE. “Perhaps the obstacle created a better solution in the end.”
Still, compared to design work done in the early 2000s—the peak of the recent healthcare building boom and the beginning of the evidence-based design movement—certain practices that were once looked at as innovative have become the new status quo.
“Evidence-based design has become the new norm,” summarizes juror Steven M. Raasch, AIA, LEED AP, EDAC, vice president and director of healthcare planning at Zimmerman Architectural Studios.
Kimberly Ritter, LEED AP, associate at GBJ Architecture, further notes that, “designs grounded in research about healthcare delivery, patient outcomes, staff, patient and family satisfaction, and solutions that leveraged the unique opportunities of site and project context were the most inspiring to me.”
Evidence-based design isn’t the only industry practice that would have been new when many of these projects were being planned, however. “BIM and sustainability are pretty much normative to excellent healthcare design in 2012,” Ritter says. Other trends the jury noted in this year’s projects: standardized room sizing, same-handed patient rooms, the onstage/offstage concept of staff and patient flow, and patient- and family-centered care models.
The evidence is in
So if the old innovations are now expected, how does the healthcare design community keep from settling into the same cookie-cutter designs that evidence-based design and the movement toward healing environments has done so much to combat? Most jurors don’t see it as a problem, instead choosing to see the development as a sign that things are moving in the right direction.
“Many of these projects set a really high bar in that beauty was more than skin deep,” Ritter says. “Engaging, elegant healthcare environments were also organizationally and conceptually very strong. I came away from the review of this year’s projects with a renewed commitment to ground our healthcare design work ever more firmly in research and outcomes. It’s increasingly apparent that this implies new standards of collaboration between healthcare designers and healthcare providers.”
While there weren’t many explicit themes that the jury spotted as being common among projects, two closely related tenets of evidence-based design stood out: daylighting and views to nature. “A lot of the projects seemed to incorporate natural daylighting quite well. Those projects that approached the process from both sides, inside and out, were the most successful. A hospital is an extremely animated building, and allowing a glimpse of the movement helps break down a lot of the visual barriers,” says Bacidore.
An eye toward the future
While any deep look at completed projects naturally leads to commentary about the recent past, it also provides the opportunity to speculate on how things might change moving forward, especially in the wake of healthcare reform. Many experts feel that the design world will have to adapt to a new care model soon to provide a leaner, more efficient space in which better, faster care will be delivered.
Juror Todd M. Cohen, MHSA, EDAC, director, special projects, at MedStar Montgomery Medical Center, sees themes in this year’s projects such as “consideration for consumer-driven amenities and outpatient focus from a business perspective.” Both are sure to be key concerns moving forward, as the baby boom generation makes demands on the healthcare system that have never been louder or clearer.
So what will next year’s Showcase projects look like? “A handful of the projects were starting to stretch beyond the new standard and look for opportunities of true innovation. The future is in innovation,” says juror Robert J. Smedberg, PE, healthcare sector leader at VHB, Inc. Given that yesterday’s innovation has become today’s best practice, it would seem that genuine innovation might be hard to come by.
But that doesn’t mean the healthcare design community will stop trying; the new U.S. healthcare reality—whatever that might wind up being—will all but demand it.
Todd Hutlock can be reached at firstname.lastname@example.org.