Apair of interesting new books made their way to my mailbox in the last month, each highlighting a different side to the healthcare design industry and thus drawing some intriguing questions to mind as to how the subjects work together and, more significantly, what the differences say about it.

The first book, Evidence-Based Design for Healthcare Facilities (edited by Cynthia McCullough, RN, MSN, senior healthcare consultant at HDR Architecture), is a primer on what many see as the most significant movement in healthcare design in the last 50 years. The book provides readers with the basics on tools, strategies, design concepts, and more, all of which are important to planning a modern healthcare project where the trend of creating healing environments is paramount in the minds of many involved-including the ultimate end-users, the patients.

Contrast this with the new second edition of Change Design: Conversations about Architecture as the Ultimate Business Tool, published by global Architecture firm NBBJ. While not exclusively focused on healthcare by any stretch, the collection of interviews, essays, and case studies shows that there are connections to be made, including a section on Banner Health's Estrella Medical Center. Across all the examples, good design helps drive and transform businesses, operation tactics, and cultures both social and corporate.

The difference in the books-as well as the similarities-raises a question well worth pondering: what is the real bottom line on healthcare building projects? Is it about realizing high performance so as to make the most profit? Or is it about healing people at the end of the day? Why can't it be about both? The issue may not be as cut and dried as we once thought, especially in these financially difficult times.

But perhaps the most important lesson here-one that it took these books to remind me of though I don't think I ever really forgot it-is that the aesthetic and the financial both work hand in hand these days as they never have before, and you can't expect to be successful in one without the other also working at optimum level. HD

Todd Hutlock, Editor-in-Chief Healthcare Design 2009 November;9(11):10