When President Bill Clinton presented Michael Graves with the National Medal of Arts in 1999, he suggested that an architect's challenge is more daunting than a physician's, quoting master architect Frank Lloyd Wright: “After all, the doctor can bury his mistake, but the architect can only advise his client to plant vines.” Any architect or design professional who has experienced the complexity and high stakes involved in designing healthcare settings might take issue with that “either-or” assertion. Today's healthcare design professionals and healthcare leaders understand the role the built environment can play in impacting clinical and financial outcomes.

The definition of what constitutes a healthcare facility is changing, and it's changing rapidly. Architects and designers must be willing to continually push the boundaries of design to help achieve the outcomes their clients are looking for. Every year, the HEALTHCARE DESIGN conference provides an opportunity to interact with and learn from innovative, leading thinkers in the healthcare design community in a collegial setting. This year presents an exciting opportunity to hear directly from someone who has been has been credited with broadening the role of the architect in society and raising public interest in good design as essential to the quality of everyday life; someone every student of architecture has studied-architect and designer Michael Graves, FAIA, who will deliver the conference's opening keynote address.

While many of his colleagues in the healthcare design industry could be called building specialists, Graves considers himself a “general practitioner.” The traditional concept of “architect” is almost too narrow a classification to describe his appetite for design. A native of Indianapolis, Graves received his architectural training at the University of Cincinnati and Harvard University. His practice has evolved into two firms: Michael Graves & Associates, which provides architecture, master planning, and interior design services; and Michael Graves Design Group, which specializes in product and graphic design, as well as branding services. He is most commonly recognized through his designs for domestic products that are sold at Target stores throughout the United States. The architectural practice has designed more than 350 buildings worldwide encompassing many building types, including healthcare facilities. The product design practice has designed more than 2,000 consumer products, which include a wide variety of consumer products for home, office, and personal use, as well as building components such as lighting, hardware, bath, and kitchen products.

In 2003, a sudden illness left him paralyzed from the chest down. Confined to a wheelchair, Graves' healthcare sector designs are now informed with his deeper understanding of the importance of accessibility and patient-centered design. Six years after the illness that changed him forever, Graves and his team are working on several healthcare design projects, including a line of home healthcare products that fuse one-dimensional medical utility with style, multifunctional elegance, and beauty.

Graves believes that hospitals and other healthcare facilities can fail humanistically on two levels: first, by not functioning well for those who work in them, and second, by not creating aesthetic environments that patients can interact with in calming ways to facilitate healing. In thinking about healthcare design, his aim is to encourage the impressions of familiarity, by focusing on buildings and products that make caregiving easier, while allowing the objects and environments to be seen in a slightly different way. Given that the ultimate goal for Graves is to combine simple utility, functional innovation, and formal beauty, he feels that there is no reason why objects in healthcare environments cannot have a symbolic function, as well as a pragmatic one.

In anticipation of what promises to be an engaging, deeply personal and inspirational address, Graves was asked to share some of his design philosophy and approach to healthcare projects.

Most people who design for healthcare decide to focus on this field because of some personal experience, either with himself/herself or a loved one. How has your experience with healthcare shaped your focus?

Michael Graves: My story is somewhat the same. My interest in healthcare design has been completely shaped by my personal experience with the healthcare system. When I became paralyzed, I spent a lot of time in hospitals, rehab centers, and other healthcare faculties. Let's say that I saw the good and the bad. I remember asking my surgeon to sit in a wheelchair and to try to brush his teeth in the bathroom of my rehab facility. He immediately gained a new perspective, just as I had. And since I continued to work with my partners throughout my rehabilitation, together we gained new expertise and insight into how people live and work, whether mobility-challenged or not. We're applying these new insights and principles to a broad range of design challenges-from the complexities of community planning and the design of visionary healthcare facilities to the aesthetics and functionality of medical equipment and other aids for daily living and well-being. We hope that our passion for design will be an inspiration and help to others, solving problems and improving the quality of life for everyone.

Describe your design process-how would you typically start a healthcare project?

Graves: As with all projects, we start with research. We spend time in healthcare facilities watching how all stakeholders use their environments, from the patients and their families to the clinicians, orderlies, and environmental services staff. We strive to design straightforward solutions that combine simple utility, functional innovation, and formal beauty for environments and objects.

How have you used design research or even market research as part of your work and how does that translate into your healthcare work?

Graves: Research is key. We find that research is not going to provide the solutions, but it will provide an insight into the problems faced in healthcare environments. By identifying these problems, and understanding how all users interact within the built environment, we develop hypotheses to improve not only the aesthetics but also the function of the space. We then design and test our solutions. This includes returning to the research sites to re-engage all stakeholders to determine if our designs provide solutions for the problems they face.

In your experience, what are the key design differences for healthcare versus other industries?

Graves: Every project and industry is unique. In all of our projects, we focus on function and efficiency, as ensuring that our designs work well is very important to us. There is no industry where this is more critical than the healthcare industry. There are also specific safety and hygiene requirements that are imperative for healthcare environments. We treat them as part of the design program much the same way as we treat security concerns when designing an embassy or a branch of the Federal Reserve Bank.

How do you design healthcare spaces for those with special needs, such as children, the elderly, and people with disabilities?

Graves: Being that I am someone with “special needs,” I know the importance of designing spaces and products that are accessible. I also know that just because someone has special needs doesn't mean all other considerations such as aesthetics are irrelevant. In our practice, in both architecture and product design, we have conducted an ongoing investigation of a language of for
ms that communicate function and help people connect with the built environment.

For example, we recently designed a new building for St. Coletta School of Greater Washington, a charter school that serves children and adults with cognitive disabilities. Our goal was to design an environment that actually improves the lives of everyone who enters the building-the teachers, clinicians, and students. By using colors and shapes in the architecture, the building communicates function to the students and they inherently understand their environment. We are told they are comforted and that teaching has actually been made easier. The building actually creates a calming feeling, which allows all students to reach their full potential. Everyone in the St. Coletta community has felt the benefits.

Do you feel that there are any design features or considerations in healthcare that can universally meet the needs of all groups?

Graves: Universal design is a wonderful objective. However, the world is completely diverse and that diversity prevents any one design feature from universally meeting the needs of all groups. With this in mind, we focus on creating design solutions that satisfy the most challenging users, which generally will also solve the problems of the wider audience, as well. We do believe that people make natural associations with forms, as well as with materials and colors. Forms that are familiar and accessible can universally convey meaning, because we identify with them.

By way of example, we are currently studying the patient room environment, including new designs for patient and guest seating. A few problems unveiled during our research are addressed in our designs. While the design solutions are mostly intended to help the patient, our chairs actually improve the experience of the guests, clinicians, and even environmental services. HD