I recently sat in a hospital project team meeting where a colleague asked what the Pebble program was giving to the design effort. In the architect's eyes, the design interventions being proven right now are the intuitive no-brainers that many design professionals have been proposing for years. Without missing a beat, another team player at the table said, “Take the JFK approach to your question and ‘Ask not what Pebble can do for you, ask what you can do for Pebble.’”

Not a week later, at the table of another healthcare design team, in another city, another architect remarked that there was just not enough evidence to push this team to another plateau of thinking about design solutions.

I believe this debate resides at the fringes of a discussion about evidence-based design. Clearly there are many enlightened design professionals paying attention to the advances being made in their profession and the healthcare industry, but they do not see the effort they make to be informed as part of the first step towards an evidence-based approach. In a subliminal way they are in fact doing research. They are using this state of being informed to come to innovative conclusions, hence hypothesizing an improved outcome. With enough enlightened teams in the field right now, the best are in fact keeping pace with the advances. What they are missing is the “Ask what you can do…” follow-through with their assumptions, measuring their new innovation's outcome and then sharing with their colleagues to then push and launch the next innovation that much faster.

I have long been of the belief that the innovation cycle in healthcare design is nine years. From the time it takes a design team (and I include the informed client with a strong vision in this mix) to incubate an “aha!” moment and go through the motion of developing and documenting the idea, and then build the project, many years pass. If we are lucky, the team has a good marketing effort and some years later when the facility opens, a third generation of design teams comes to tour it as a best practice and begins to dream of an improved iteration of that nine-year-old “aha!”

The industry has suffered from moving at this pace. It takes an enlightened team to innovate and often only half of that exists on most project teams. A crackerjack design team is only as good as an informed client with a clear vision. I know that because it has been the difference between a “good” project and a “great” project throughout my 30-year career. A great design team with a fearful client can only produce good results and vice versa. What puts lift under the wings of a fearful team member is substantial evidence. It is in the evidence-based process that many innovative designs are now being launched, not just from a hunch, but also from proven outcomes.

Have you noticed how many more projects are advancing the delivery models to a new form on the heels of evidence-based outcomes? I am seeing a foreshortening of the nine-year cycle because the process of sharing is occurring long before the final project opens, and the interim studies are fueling earlier opportunities to improve the last best “aha!”

So I ask you to consider the question: Is there enough out there right now to fuel innovation in your studio or healthcare design project? Share with us through the CHD blog at http://www.healthdesign.org/blog or the comments section at http://www.healthcaredesignmagazine.com to help us understand where your skepticism lies and/or where you see a deficiency in a body of knowledge. We are constantly filling in gaps, but clearly we are not reaching you all. I welcome an open debate.

Look for me, and my Center for Health Design and HEALTHCARE DESIGN magazine colleagues, at HEALTHCARE DESIGN.07 and let us know your feelings about the “Ask Not” debate. I look forward to your contributing to “…what you can do for the industry!” HD

Rosalyn Cama, FASID, is Board Chair, The Center for Health Design, and President of CAMA, Incorporated in New Haven, Connecticut. The Center for Health Design is located in Concord, California.

To comment on this article, visit http://www.healthcaredesignmagazine.com.