Articles emphasizing the importance of good design in healthcare environments are becoming commonplace. Research studies have long suggested a relationship between natural elements—whether an image of a pastoral landscape or a view to an exterior garden—and their positive effect on patient length of stay. Accordingly, hospitals have carefully considered building sites and exterior views, finishes and fabrics in patient rooms, and the use of art programs. Clearly, the concept of the “healing environment” is well known and accepted today, and the trend toward evidence-based design is now entering the mainstream.

But what about the needs of the healthcare office worker? Sadly, healthcare institutions are considerably behind the times in their office workplace solutions. Corporate America, though, has addressed and successfully resolved many of these workplace needs. By reviewing the existing corporate models, healthcare administrators can better respond to and address the changing demographics of their workforce, the needs of the knowledge worker, and the necessary marriage of technology and furniture.

Taking each of these factors one by one:

Changing Demographics of the Workforce

This century will see increasing numbers of better-educated women entering the workforce. Women will continue to surpass men in the percentage of conferred bachelor's degrees (up from 43.4% in 1971 to 55.4% in 1998) and master's degrees (40.1% in 1971 to 55% in 1998). It is estimated that by the year 2007, women will outnumber men enrolled in college three to two (9.2 million women to 6.9 million men.) In the workplace, the female majority will have a significant impact on design and furniture selections—in fact, a recent survey found that 65% of women polled “felt strongly that a nice work space is one of the key things that helps people feel better about their jobs and enjoy their jobs more.” Whether one attributes it to the influence of Martha Stewart or to the popularity of home design programs on cable TV, design has become a pop culture phenomenon, with today's women finely attuned to its impact in their homes and workplaces.

Ethnic and racial diversity is also increasing in America. According to the 2000 Census, 72% of the U. S. population is classified white, 12% African-American, 11% Hispanic, and 4% Asian; projections for the year 2020 show the white population at 64%, African-American at 13%, Hispanic at 16%, and Asian at 6%; and projections for the year 2050 show the white population at 53%, African-American at 14%, Hispanic more than doubling to 25%, and Asian doubling to 8% (figure 1).

Not only is the workforce becoming more racially and ethnically diverse, it also is becoming increasing multigenerational. As life spans continue to increase, workers are delaying retirement. It is projected that 80% of baby boomers plan to work during “retirement.” In 2000, 86% of American workers aged 50 to 59 were white; of working teens, 66% were white, 15% African-American, and 14% Hispanic (figure 2). In other words, the percentages of African-American and Hispanic working teens are higher than percentages of their ethnic groups in the population as a whole.

These charts show the changing trend in the ethnicity of the U.S. population. Reprinted with permission from “The 21st Century Workplace,” a study conducted for Knoll, Inc., by DYG, Inc.

Americans about to enter the workforce are a much more diverse group than in years past. Reprinted with permission from “The 21st Century Workplace,” a study conducted for Knoll, Inc., by DYG, Inc.

Generally speaking, these younger workers have vastly different work styles and workplace needs than the semiretiring baby boomers. Any parent of a teenager can testify to differences in kids’ toleration of volume levels for music, instant mastery of complex technology and mass communication media for events/news, and highly honed multitasking skills. These skills will not diminish or change as the Gen Y-ers permanently enter the workplace. But what about the needs of the 60-year-old in the cubicle next door?

The Emergence of the Knowledge Worker

Recognition of knowledge workers and an understanding of their impact and needs in the work environment is another issue corporate America has studied and addressed. Knowledge workers have literally changed the way work is done: They constantly create, analyze, collaborate, and act on received information. They multitask and work with multiple layers of information. In today's workplace, teamwork is the norm, with fewer than 25% of all workers occupying private offices.

Hospitals are, of course, filled with knowledge workers. However, these physicians, nurses, support staff, administrators, business developers, facility managers, and others are usually housed in private offices or cubicles (figure 3) with minimal furniture options, hard-to-reconfigure furniture or workstations, and a one-size-fits-all task chair.

Knowledge workers require flexibility in their office environment, and furniture is integral to this. It must be easily reconfigured, moved, adjusted for height variances, and personalized (figure 4). For knowledge workers in healthcare institutions, national furniture-purchasing agreements and standards programs can be stumbling blocks in this regard. Often the most innovative products used in the corporate world are not an option in healthcare environments. Rather, standards programs implemented to facilitate purchasing typically minimize options and personalization for the knowledge worker.

Furniture and Technology

Corporate America has long recognized the need to integrate furniture selection into the early stages of the design process. Unfortunately, though, because of the complexity of most healthcare projects, furniture selection is usually relegated to the project's final phases. Twenty-five years ago, whenever a furniture layout failed to match the user's needs, the worst-case scenario called for the relocation of an electrical or phone outlet. Today, the presence of multiple technologies in a standard office demands that furniture and its layout be considered much earlier in the design process.

The issue is further complicated by the traditional office image evident in most healthcare settings. For example, most physicians and executives still want an “image” desk and a credenza made of high-quality wood. However, moving these large pieces of furniture to access power and data outlets is cumbersome and time-consuming, and risks damaging the furniture, thus voiding manufacturers’ warranties. Some facility managers attempt to resolve the power/data access problem by specifying custom cutouts or doors in desk panels. This solves the problem for a particular installation but minimizes flexibility and increases costs through customization.

Conventional panel workstations are not conducive to collaboration and worker flexibility.

In this design, knowledge workers can multitask, collaborate, or work alone. The system is easily reconfigured.


Professional interior designers working in healthcare environments can offer solutions to these issues. Their depth of understanding of hospital systems—the variety of workers housed there, and their needs and roles, and the ever-present budget constraints—reinforces their traditional knowledge base of space planning, interior design, finish selections, and introductions of new furniture products.

Introducing an interior designer into a healthcare project during the early phase of planning saves money. These designers are trained to visualize the completed space with finishes and furniture, not just an empty volume or box. Ceiling treatments, specialty lighting, door locations, and equipment and furniture placement are considered within one unified space with all technology requirements accounted for.

For example, to address the needs of design-sensitive women in the workforce, interior designers would consider options for office fabrics on guest chairs, task chairs, and tackboards. They might, in fact, recommend the use of several interchangeable fabrics. The needs of multigenerational workers can be addressed during space planning. Quiet areas or small work booths for concentrated work can be designed into large, open office areas. Furniture can be specified with acoustic options in open workstations, with privacy screens that easily reconfigure. The requirements of the knowledge worker demand personalization, therefore interior designers can work with the hospital staff to design standards programs that offer individual options but still maintain the intent of a standards program.

Perhaps the strongest argument for the early inclusion of interior designers in the planning process is to facilitate the marriage of technology and furniture. Many construction dollars are spent on installation, renovation, or reinstallation of office space and office furniture. Today, however, movable wall systems, quick-disconnect light fixtures, flex-hose sprinkler systems, and modular casework allow corporations to move employees in a few hours instead of weeks, minimizing employee downtime and maximizing productivity. Moreover, the technology of raised access flooring allows power, data, and HVAC to be introduced into the space and easily reconfigured, saving time. These products, developed by or in coordination with furniture manufacturers, are all well known to interior designers and used commonly in corporate environments.


Awareness of good design and its impact on our daily lives will continue to grow in importance throughout society. Their significance in American healthcare environments and the healing process will not diminish. Now is the time to consider the needs of our healthcare office staffs and the skills interior designers offer to meet those needs. HD

Linda Porter Bishop, ASID, IIDA, is Vice-President and Director of Interior Design with Houston-based FKP Architects. She has 14 years’ experience as an interior designer, specializing in healthcare, research, and education projects and is a nationally recognized leader in furniture product development.