When the term “Pebble” was coined to describe The Center for Health Design’s field study research project, it was intended to be a metaphor for the reaction a small stone creates when tossed in a pond. That reaction is a ripple that radiates slowly but deliberately from its epicenter, adjusting to interferences but making changes in the landscape that has influences well beyond the visual effect.

In this world of instant gratification one expects a pebble to create a tsunami almost immediately. Truth be known, little of good effect happens that quickly. It is rather the well thought out plan carefully and methodically carried through that is constantly tweaked and adjusted for varying influences that makes the most meaningful changes in our landscape.

At its Board Meeting in February 2008, The Center for Health Design accepted the resignation for retirement from one of its Founding Board Members, Derek Parker, FAIA. In struggling with how to honor a man with a strong vision for an institution but more importantly for an industry, we bestowed Derek with the newly established title of Board Member Emeritus. The title is a special honor but in no way fully represents the contribution Derek Parker has made to how healthcare is thought about when it comes to the design of the built environment.

The ripple that is Derek’s as a founding member of The Center for Health Design started in 1988. A small group of healthcare architects and designers knew more than what was stirring in their bellies; they knew that there was proof that the reaction to a design intervention would impact human behavior and improve outcomes. It has taken 20 years to build an infrastructure that can accumulate and disseminate the knowledge gained from the studies that capture the results of those reactions. Half of those 20 years was bringing a design community on board; the last eight or so have engaged 50+ institutions, our Pebble Partners, to use their great projects as a laboratory to prove or disprove age-old assumptions. On the shoulders of those proven interventions, new innovative concepts have been launched that are revolutionizing healthcare delivery. It is that ripple that has been long and slow, but has now captured many beyond the early adoption stage. It has piqued the curiosity of all who build and their questions are found in most every request for proposal to build a new healthcare facility. That is the effect of a slow and deliberate ripple.

What I have learned from Derek Parker—who served as Chair of the Board before me—is to never forget The Center for Health Design’s mission is linked to informed design interventions that improve health outcomes, organizational delivery models, and the economics that link the capital and operational financial columns. He has taught me that this change must be gradual, as it cannot be just a fad. It is about a shift in methodologies that are steeped in the delivery of significant projects, so we must accept the responsibility to steer interdisciplinary teams carefully and expertly. There is much concern about the process of design that is evidence-based and how it will stay true to its intent. The evidence-based design process is in fact a pebble that has a slow and deliberate ripple that continues to move from its epicenter started in the late 1980s.

So I ask that you question the rate of velocity of ripple that you are causing through a specific project or in your career. Derek has left his professional charge in our hands.

I know we will see him sailing more on San Francisco Bay. Derek is an expert captain of his craft who understands the way of the wind and waves; maybe that is why he so expertly led us to the metaphor known as the “Ripple.”

Derek, we thank you for your guidance and wisdom and wish you full sails ahead!

Please feel free to send your well wishes on The Center for Health Design’s blog at http://www.healthdesign.org/blog. HD

The Center for Health Design is located in Concord, California. For more information, visit http://www.healthdesign.org.

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