This is HEALTHCARE DESIGN magazine's annual Architectural Showcase issue. Each year Vendome, along with The Center for Health Design, hosts a peer-reviewed selection of the best of the most current healthcare projects. Those of you who have had the opportunity to jury an architectural design competition know that the quality of the photography influences the lens through which a juror judges the submitted projects. Most competitions require a written synopsis of a project's scope and guidelines, but rarely do they ask for the evidence-based knowledge used to set a baseline for design standards and/or innovation, and even fewer ask for measurable results.

This issue, which features the best of the most recent design work in our healthcare specialty, is critical because it is important to many who are involved in the planning and design of the next generation of healthcare building projects. In fact they covet it. This issue offers a glimpse at what was on the minds of others who passed through the design process, depending on the size of the project, four to nine years earlier; hardly new ideas! I find that project teams scrutinize design details and products used in recently published projects. Those design ideas, if deemed award-winning, influence a future generation of projects. Some not so successful outcome-driven solutions tend to perpetuate themselves simply because they were designed to look good, or worse, just photographed well. I am sensing a shift in some design teams' sensibility about what is important because I am being asked more frequently to help identify projects that have recently opened with proven results from their hypothesized outcomes.
Rosalyn Cama, FASID, EDAC

Rosalyn Cama, FASID, EDAC

This means that award-winning attractiveness of the architectural/interior design of a project will shift from a glossy page in a magazine toward quantifiable evidence that improves an outcome. Good design is still important; it just needs to be measured. As this demand grows, so will the requirements for our design competitions. A shift in the way we share our work will be more meaningful to new project teams and to the industry as a whole.

I also believe that project teams should not wait until a project is completed to share the insight gained. Projects in progress have as much information to share with developing projects as completed ones. As teams do more interim studies, we can foreshorten the perpetuation of bad design concepts and create a faster link to those interventions that return a positive health, organizational, or economic outcome. I have been known to say that rapid access to proven as well as failed design interventions will spark more innovation in healthcare design and create a stronger case for the role that design will play in the healthcare reform this country yearns for.

Marketing departments take note: at the request for proposal of a project, you should incorporate an evidence-based design approach. During the design process, report a research agenda and the results of the interim studies taken from mock-ups. At the opening of a project, share photographs and the results of hypothesized design interventions.

Jurors of competitions will then take on the same role as academic peer reviewers. They will need a lens that measures good design aesthetics as well as quantifiable returns on investments.

I asked Michael Roughan, AIA, HDR, Boston, how evidence-based design influenced his ability to judge submissions for this year's competition. He says, “Judging a healthcare design competition is a delicate balance of interpretation of what the sponsor submits for design rationale and what a juror can interpolate from the submission graphics. Evidence-based design often manifests itself in recognizable patterns. Whether it is the relationship of the patient headwall to the patient toilet or the patient room to the caregiver stations, rigorously measured healthcare typology is not the antithesis of creativity but rather the objective application of knowledge based design. As a juror, recognition of these evidence-based design elements provides for a level of confidence that the designer's work will be utilized as intended”

My most important message here is that we need to do research on our projects. Then, when our peers judge them, they are judged equally for their performance measures as well as for their design aesthetic qualities.

I'd love to hear your thoughts on this shift in evaluating design competition entries. HD

The Center for Health Design is located in Concord, California. For more information, visit

Healthcare Design 2009 September;9(9):10