Many feel that the healthcare building and design industry was born in 1988, when The Center for Health Design's (CHD) founders convened the First Symposium on Health Care Interior Design at the La Costa Spa & Resort in Carlsbad, California. It was the first time that healthcare executives, design and construction professionals, product manufacturers, and related professionals (about 500 total) came together to explore how the design of the built environment affects the quality of healthcare. It also represented a fundamental shift in thinking about healthcare facilities and opened the door for more design creativity and innovation.
Planetree, founded about 10 years earlier, had begun to introduce the concept of patient-centered care and healing environments, but on a very small scale. At the time, less than $10 billion a year was being spent on new construction or renovated facilities in the United States. “In the 80s, healthcare was not considered a desirable market segment in the field of interior design, thought to be institutional and restrictive, with little room for creativity,” says Louise Nicholson Carter, AAHID, IIDA, EDAC, RID, principal and director of Healthcare Interiors for Morris Architects. “Healthcare product options were extremely limited and poor. There were few healthcare specialty manufacturers, and those that were in existence were driven by functional needs, with little emphasis on aesthetics.”
Jocelyn M. Stroupe, AAHID, IIDA, principal, director of Healthcare Interior Design for OWP&P, agrees: “One of the primary changes has been a shift from a focus on high-tech and facility design based solely around function to one where the experience of those who use the spaces-caregivers, family members, and patients-are considered more equally and that the experience is expressed as an important design consideration,” she says. “The expectation that healthcare buildings could be beautiful did not always exist. This is changing dramatically, as hospitals look to respond to their competition but also value the impact of design on outcomes, such as staff retention and recruitment, patient and family satisfaction, increased market share, and philanthropy.”
Last year, about 3,500 professionals attended HEALTHCARE DESIGN.08 (the conference CHD is now associated with), while spending on new and renovated healthcare facilities topped $47 billion. Approximately 150 hospitals and 300 outpatient centers, nursing homes, pharmacies, and home care agencies are now using the Planetree model. It is hard to accurately estimate the number of professionals in the United States who are part of the industry (see sidebar), but it includes architects and interior designers who specialize in healthcare, facility managers working in healthcare facilities, healthcare product manufacturers, academic institutions that offer healthcare design degree programs, and a variety of associations and nonprofit organizations, as well as public and private healthcare systems, hospitals, long-term care/senior-living owners/operators.
“Healthcare interior design has gone from focusing on decorative materials and furniture 20 years ago to a hybrid role between interior design and medical planning,” says Linda Gabel, AAHID, IIDA, senior associate, NBBJ. “With evidence-based design, we are focusing on patient/staff safety first, wayfinding, room function and detail, daylighting and artificial lighting design, framed views, fine details, forms, and visual textures. The integration of our role has grown rapidly, and this is supported by the LEED process for design, BIM [Building Information Modeling], and integrated project delivery (IPD) models of business.”
“The most significant change in healthcare over the past 30 years has been moving the focus of just providing healthcare services to providing healthcare as a business,” says Rick Abbott, healthcare principal/vice-president, HDR, the nation's largest healthcare design firm. “This has brought on the interest in operational issues, evidence-based design, and cost-effectiveness.”
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