In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject.

Don Thomas, is a principal and director of interior design at BWBR (St. Paul, Minn.). Here, he shares his thoughts on human commissioning, multipurpose healthcare spaces, and the impact of behavioral health within the ED, recovery centers, and more.

1. Designing beyond big data

Healthcare providers have been sending out a clear call to the design community to be better listeners.  They’re asking us to not only create safe, functional, and sustainable healing environments based on data—that’s now a given baseline—but also to be keenly focused on helping create an experience that enables an authentic and meaningful patient and care-team partnership. This call means we need to dispel our certainties of solutions and work hard at being excellent listeners to what’s important to patients—to really hear their stories and design with compassion, empathy, and, yes, love. We also need to honor the passion, vision, and professional struggles and celebrations of those directly responsible for patient care and express it through creative, innovative, and thoughtful design solutions.

2. Behavioral health’s impact

For a sector so long forgotten, behavioral health is having a big impact on healthcare design today. Creative design solutions in behavioral health facilities are now being applied to collaborative care, such as including behavioral health services in primary care, innovative ED models, and addiction/recovery centers. Connections are also being explored between wellness centers/integrative medicine, genetics/research, special education/autism, brain disorders/trauma, and secure environments. What started as a quiet revolution in behavioral health has grown tremendously, and it’s fascinating to understand that we’re beginning to comprehend the significant impact mental health has on just about every aspect of healthcare and related industries.

3. Human commissioning is key

As our built environments become more complex, we utilize building commissioning to verify that all the systems work optimally and efficiently together. Seldom, however, do we consider commissioning end-users on how to actually use their new environments and immerse staff with their new spaces. More than a quick walk-through for key leaders, human commissioning is a planned series of events for all staff to showcase process change, new work-flow, orientation to integrated technology, and unique design. This phase is key to more effectively integrate teams with new ways of working and new technology and to reinforce any process and cultural changes.

4. Thinking outside the silo

As reimbursement structures continue to be unpredictable, the built environment is one of the things that could be the easiest element to control. Imagine an inpatient room that becomes an ED exam room or overflow post-recovery room—all within a 24-hour period. Dedicated spaces that are used only two hours per day might be a thing of the past. Hospitals can’t afford to have expensive spaces, technology, and trained personnel sit idle. We need to think of spaces as multipurpose, high utilization, and extremely flexible. It challenges us to program differently, not incrementally department by department, and to think of the facility as a whole.

5. Is our desire for evidence risking innovation?

Evidence-based design skillfully mirrors the medical community at gathering and understanding the implications of our design actions and making informed decisions. But at some point in the design process, we need to ask the big “What if?” questions to help us look at problems differently. In such a dynamic and ever-changing industry as healthcare, the only areas of innovation open to design seem to be in operations, Lean, or processing.  If that’s true, we’re in danger of “tweaking” our way to mediocre solutions. We absolutely need to use the evidence and research data of the built environment on healthcare and the healthcare experience, but we also need more intentional balance early in the process to find innovation through design.

Want to share your Take 5? Contact executive editor Anne DiNardo at for submission instructions.