D. Kirk Hamilton, FAIA, FACHA, EDAC

Professor of Architecture, Center for Health Systems and Design, Texas A&M University

D. Kirk Hamilton is a renowned thinker and innovator, a longtime leader in the healthcare design community who continues to restlessly investigate, analyze, and discuss forthcoming trends and best practices via the multiple roles he plays.

As co-founder and editor of the HERD Journal, Hamilton has brought true healthcare design research to the public via long-form research pieces that dive deep into the subject at hand to a level seldom found in other publications.

As a professor at Texas A&M University, Hamilton has a significant role in the future of healthcare design through his work with the next generation of healthcare architects.

Hamilton also conducts his own ongoing research, with a primary interest in the study of the relationship between evidence-based design of healthcare facilities and measurable organizational performance.

In addition, Hamilton was a founding principal at Watkins Hamilton Ross Architects, Inc. (originally Watkins Carter Hamilton Architects, Inc., and currently known as WHR Architects, Inc.), in Houston, Texas, working there from 1983 to 2004. As the firm’s healthcare practice leader for national and international hospital clients, Hamilton was responsible for healthcare business development, visioning, strategy, master planning, schematic design, and medical planning.

Many in the healthcare design field would be proud to have the above represent their entire career; Hamilton shows no signs of resting on his laurels.

Hutlock: You’ve been involved in healthcare design for many years, predating in many ways the establishment of the current healthcare design “community” – from your perspective, are there specific events that have led to the establishment of this community?

Hamilton: As an architect working in the highly specialized and narrow world of hospital design, I was powerfully influenced by early mentors, including Allen McCree, Bill Caudill, and Barry Bruce. I became involved with the AIA Academy of Architecture for Health early in my career, and it provided me with wonderful supportive relationships with leaders in the field, like Tib Tusler, Mo Stein, and Don McKahan, and it taught me something important at each turn.

The most memorable event was the 1984 publication of Roger Ulrich’s now famous paper on the ‘View Through a Window’ in Science magazine. It gave us the first scientific study to validate what many of us had believed about the environment’s influence on illness and recovery. I had read William H. Whyte, Edward T. Hall, Ian McHarg, Christopher Alexander, and Robert Somer as a student, so had been prepared for the rationale of evidence-based design, and Ulrich taught us that there were connections to clinical evidence.

My next biggest influence was Planetree, to which I was introduced by presentations made by Robin Orr. She gave me a new way of thinking about healthcare, and later became a colleague who taught me so much about the work we do in this field, and those for whom we do it. The idea of patient and family-centered design inspired me to my best work, and fits perfectly with my understanding of design based on findings from research. Planetree, Robin Orr and Roger Ulrich were central to Wayne Ruga’s founding of The Center for Health Design, on whose board I ultimately served for more than two decades. CHD went on to become the strongest, most widely visible proponent of evidence-based design, and a central point around which many who were believers could gather annually.

At a conference held jointly by Georgia Tech and Emory University, Craig Zimring suggested a field needed a purpose, meetings, and a magazine, so its members could connect. We had those, including HEALTHCARE DESIGN, as an important voice and the well-attended annual HCD conference. Craig also said we needed a scholarly journal so young scholars could publish and advance at universities where their study of the field could be legitimized, and we needed programs at the universities where these things could be studied and taught. I had wanted a journal for some time, and when Jan Stichler proposed we collaborate on starting an interdisciplinary peer-reviewed journal, I knew it was time. So the HERD Journal became a big influence, and I left practice to join the Texas A&M faculty. Programs like David Allison’s at Clemson and Texas A&M’s, with faculty like George Mann and Mardelle Shepley, have led the way in our specialty, and we are now seeing promising new programs in Kansas, Nebraska, Texas Tech, and elsewhere.

The field’s trajectory has been positive and relentless. The state-of-the-art hospital or health facility is demonstrably better that it was when I entered the field in 1970. New relevant evidence is appearing daily, and the idea of evidence-based and sustainable design for health facilities is spreading around the world. I will be in China, Europe, and Australia this summer, in each case carrying the message of evidence-based design to interested audiences. These are exciting times.

Hutlock: You’ve been an influential figure in the field for a number of years now – who do you think are going to be tomorrow’s most influential people in healthcare design?

Hamilton: The young folks I see at conferences, and new folks whose projects are being published are likely candidates for future leadership. You must be visible to be influential, and that means writing, speaking, and playing roles in events or organizations that are part of the field. I am certain many of the students I see every day will become leaders as they are bright, enthusiastic, and committed.

An interesting future group to watch is that small group of skilled designers who are also trained in serious research. It is currently a very small number, but those skilled in both domains will have an advantage over researchers unfamiliar with the realities of design, and designers who are not conversant with rigorous research methods. Cross-discipline education is a great advantage in our area.

Hutlock: Is there a single career accomplishment that you absolutely will not rest until you see achieved?

Hamilton: I have achieved more than I could have imagined, and am blessed in many ways, esp
ecially by those I have met along the way. I suppose I won’t be allowed to rest until I complete the doctoral program in which I am currently enrolled at Arizona State. I am pursuing a degree in Nursing & Healthcare Innovation, and plan to launch my dissertation research and writing next year. With degrees in architecture and organization development, I am a poster child for cross-discipline education. My progression from architecture to the social sciences, and now the clinical sciences, has been an exercise in increased rigor at each step. This has been good for me, and highly instructive.

Hutlock: If you could only have chosen one career path, would you have sided toward architectural design work or research?

Hamilton: Although I am focused on research today, and hope to eventually become fairly skilled at it, my heart and soul lie with the sacred work of designing healthcare facilities for those privileged to work in the healing professions, and those unfortunate enough to need their help. I practiced healthcare architecture for 30 years, and have left it with no regrets, but my current work is to contribute to ever better design decisions through the development of relevant evidence, and by teaching the next generation of healthcare design leaders.

Hutlock: Obviously you influence and inspire many people in the healthcare design field. Who influences and inspires you in your work?

Hamilton: In addition to Roger Ulrich and Robin Orr, I have been profoundly influenced by the extraordinary leadership and vision of IHI’s Don Berwick. Peter Block has powerfully influenced my understanding of organization theory and human interaction. And on a daily basis, I am inspired by my students! They are incredibly bright and energetic, and have chosen to commit themselves to healthcare design at an early point in their career. I am especially proud of the Tradewell Fellows with whom I work. The current generation is far better prepared for this difficult and rewarding work, and I am convinced that they will produce a legacy far richer than what I will leave behind.