Take 5 With Jennifer Aliber
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.
Jennifer Aliber is a principal at Shepley Bulfinch (Boston and Phoenix). Here, she shares her thoughts on healthcare-acquired infections, the rise of 3-D printers in medicine, and the convenience of clinic care.
1. Healthcare in the media
In mid-February, Time and Newsweek magazines had a fascinating juxtaposition of covers and articles. The Time’s piece, “The New Age of Much Older Age,” showed an adorable baby and made the point that Americans are living longer, but the hard part will be living well. Newsweek’s “Death Becomes Them” article had an image of a black-veiled woman and a story about the Dutch and euthanasia. The mere appearance of both articles at the same time suggests the possibility that the two trends may be inexorably linked—will we only want to live longer if we know we can end our lives when we are no longer living the way we would like to? Or can afford to?
2. We all triage all the time
My 15-year-old daughter is a “frequent flier” at our local children’s hospital, not because she has any chronic conditions, thankfully, but because she does stupid stuff. I’ve taken her in because she slashed her finger on an ice cube, slashed another finger with a hand-held blender, and broke her leg swinging it into her bedpost (long story). But the last time she hurt her hand while playing soccer goalie, we skipped the hospital and went straight to the local urgent care clinic. Her hand was only bruised and, afterwards, we picked up dinner next door. If her hand had been broken, I probably would have taken her straight to the hospital, but from now on, I’ll play the odds on where we go first.
3. The Ebola shark
I was watching a wonderful TED Talk by Swedish statistician Hans Rosling on how little we can trust our intuition when it comes to major trends. Rolsing says one contributing factor to this problem is the media and he makes the point that the things that scare us the most, such as sharks, are highly unlikely to kill or maim us. So unless you were living in Sierra Leone or Liberia last summer, Ebola is really a shark—scary but not threatening to the great majority of us. That said, the re-emergence of Ebola, like that of MERS and SARS, is a great opportunity to rethink how hospitals should deal with infectious diseases. At the same time, the real danger to most of us is more likely to be antibiotic-resistant bacteria, such as CRE, which has caused recent deaths in Los Angeles via infected endoscopes. According to the Centers for Disease Control and Prevention (CDC), 23,000 Americans die each year due to such healthcare-acquired infections.
4. The 3-D parallels between medicine and architecture
I’ve been struck for years by how many physicians (especially surgeons) will mention that they considered becoming architects before they chose medicine. As more and more medical care has become dependent on imaging and 3-D rendering, the two worlds are aligning in new ways. Now, physicians are using 3-D printers to make physical models of the brains of individual patients and as a method to create implants for specific patients. Boston Children’s Hospital currently has two 3-D printers and they are adding four more. What’s next?
5. Healthcare equity in the developing world
I recently returned from a trip to Uganda to help program and design a new cancer center. As we toured the existing hospital in a small city several hours from Kampala, Uganda, I felt as though I’d stepped into a depiction of a 16th-century hospital. The beds were lined up against windows, there were no sinks or medical gases, the electricity was iffy, and nursing care was primarily a function of doling out medications. It made me wonder what’s the appropriate response to issues of healthcare equity in the developing world?
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