For the first time in its history, The Center for Health Design presented its Changemaker award to two recipients: D. Kirk Hamilton and Jaynelle Stichler.

The duo, who’ve spent the last 10 years working together as founding co-editors of the Health Environments Research & Design (HERD) Journal, were honored at a Monday morning keynote presentation at the Healthcare Design Expo & Conference in Houston where they sat down with moderator Don McKahan, principal at McKahan Planning Group, to discuss their careers, the founding of HERD, its influence on the industry, and their hopes for the future of evidence-based design (EBD).

“There’s magic in the intersection of two disciplines and we’ve found the magic,” said Stichler, who has spent her career on both sides of the aisle as a nurse and vice president of women’s services at Sharp HealthCare in San Diego and then as a design consultant on strategic planning and healthcare design before going into academics as professor emerita of nursing at San Diego State University. She’s also a founding member of the Nursing Institute for Healthcare Design.

Hamilton’s 50-plus-year career includes founding healthcare architecture firm WHR Architects (Houston and Dallas) and serving as past president of the AIA’s Academy of Architecture for Health before also turning to academics, where he’s the Julie & Craig Beale endowed professor of health facility design in the department of architecture at Texas A&M University.

While both Changemakers have made an impact in their fields and in advancing EBD in healthcare, neither set out for a career in the sector. Hamilton said his childhood spent moving around the globe with his parents and receiving multiple rounds of immunizations left him with “white coat fear.” However, his career in architecture started with a firm focused on healthcare.

“I was almost late for my first project meeting at a hospital because I was so nervous about walking into the building,” he said. Eventually, his fear turned into “an obligation to be an advocate for others.” Early work by Roger Ulrich on patient-centered care and Robin Orr who pioneered the Planetree model “further changed my life,” said Hamilton.

Stichler says her first experiences in healthcare were as a mother giving birth when it was accepted practice not to allow husbands into C-section surgeries and newborns were taken to admitting nurseries far from their mothers for hours after birth. Following that experience, she talked with her husband Ron, a healthcare architect, about designing an admitting nursery in the PACU.

“We did that,” Stichler added, along with other project highlights throughout her career, including improving privacy in semi-private patient rooms and nurses’ station design. Later on, she focused on advocating for bringing nurses to the leadership table on projects and then training nurses on what to do once they got there.

The two met more than a decade ago at a Healthcare Design Expo & Conference and talked about their ideas for a scholarly journal where researchers could publish their work on healthcare design research. Reflecting on some of HERD’s seminal articles, Hamilton recalled publishing “the old testament” of research that related to environments and outcomes by Roger Ulrich, Craig Zimring, and their teams. “Then, bless them, those same leaders published a ‘new testament’ in 2008 with updated research,” he said. “They established the case we were serious and professionals needed to read us.”

Stichler said an early supplement on healthcare acquired infections (HAIs) and research on room configurations and same-handed room design stand out to her. “What’s exciting is we’ve seen a science emerge,” she said.

They discussed the evolution and growing acceptance of EBD in healthcare (as well as its viability in other industries) as more research related design to patient outcomes. Both speakers agreed that the “rigor is increasing,” illustrated by the fact that the editors now require authors to not only discuss research and findings in their articles but also make the link to what the implications are for design and their practices.

Looking ahead, the Changemakers said it will soon be a standard practice for firms to submit evidence supporting their designs as part of the bidding process and that post-occupancy research will be a requirement on all projects. “We have a social responsibility to measure the outcomes,” Stichler said. “Anything worth doing is worth measuring.”

Hamilton agreed on the value that EBD brings to a design and project. “The practice of using evidence and doing research to answer questions to further design, that’s not commodity architecture,” he said.