Reflecting on this year’s Healthcare Design Showcase, jurors noted that among the discussions about Lean approaches and wayfinding and operational efficiencies, there was a considerable amount of attention—positive attention—paid to projects’ overall design statements.

“The quality of submissions seems to suggest project sponsors are invested in the architecture of their buildings more than ever before,” says juror Peter Lambur, a principal at Peter Lambur Architect Inc. (Vancouver, British Columbia). “Most projects did something more than right and even extraordinary in some instances.”

In reviewing the program’s 55 submissions (all of which were approved for publication, an unusual occurrence), the jurors noted the use of authentic materials, both inside and out, and thoughtful details that were carried through into patient rooms and treatment spaces. Many projects also illustrated an effort not to just plop a building down within a community or on a site but to add or renovate one that’s designed to reflect the community, embrace its cultural nuances, and set the stage for a welcoming and stress-free experience.

 

More specialized projects

While acknowledging several large new-build projects among this year’s submissions, jurors weren’t surprised to see the majority of projects reflect the ongoing shift to ambulatory care models, with noticeably more specialty-based projects this year. A large number of submissions were cancer centers, which jurors attribute to the increasing prevalence of diagnoses and focus on earlier intervention as well as the potential revenue stream for these complex treatment regimens attracting more providers.

“We’ve been hearing of reports on the decline of family practice and general medicine for years and that seems to be bearing fruit,” says Toni Gocke Wyre, senior associate at Polk Stanley Wilcox Architects (Little Rock, Ark.). “On a positive note, the healthcare industry is recognizing that cancer treatment facilities need to promote healing and prioritize the patient experience.”

This year’s two Award of Merit winners illustrate that effort with striking façades and some fresh approaches to bringing daylight into treatment spaces and improving a patient’s sense of control within the environment. “Some projects created such wonderful infusion bays that it becomes difficult to accept bays where patients are lined up in chairs around the perimeter in a room and given a curtain divider to separate them,” Wyre says. “Just because this has been the standard for the last decade or so doesn’t mean that we can’t do better.”

 

Evolving aesthetics

This year’s crop of Showcase projects illustrated a shift toward predominantly white interiors with touches of color delivered through furnishings, artwork, and connections to nature. However, jurors were divided on whether these approaches reflected a more refined approach to healthcare interiors or were simply a backlash to the hospitality-driven look of year’s past.

Sheila Bosch, assistant professor, department of interior design, at the University of Florida, College of Design, Construction and Planning, appreciated the use of neutral colors and white walls on many of the submissions. “They were used beautifully in a way that didn’t feel cold or institutional.”

Janet Kobylka, lead interior designer and transition planner at Workplace Solutions Inc. (Virginia Beach, Va.), says the move toward a lighter color palette could be a reaction to statistics on healthcare-associated infections and the desire to create safer environments. “The focus is moving toward a clean, germ-free environment,” she says. “The use of white in healthcare design solutions is a reflection of this trend.”

However, Steve Blye, senior design director and associate director of healthcare at Legat Architects (Chicago), doesn’t welcome the shift toward more clinical-looking and white environments with high-tech clinical finishes. “It almost seemed to be a search for a new ‘style,’ away from the warm, home-like hospitality finishes, despite the fact that evidence continues to state that these latter environments infused with nature reduce patient stress and promote healing,” he says.

However, patient comfort is still a top priority, with many projects focusing on patient and family amenities and design features that promote healing. “The indoor/outdoor connections were prevalent in almost all of the entries reviewed and it was refreshing to see,” Wyre says.

Juror Todd Cohen, director of healthcare capital planning and client success at AtSite Inc. (Washington, D.C.), agrees. “You don’t need to have a conversation with an administrator about the value of natural light anymore—they get it,” he says.

And while this year’s Showcase projects illustrate some new approaches to bringing light and nature into patient, staff, and even treatment spaces, Wyre would like to see these efforts pushed even further, not just through artwork and windows but through the addition of outdoor spaces. “We’ve seen this on a small scale in notable projects, but it seems to be a concept reserved for high-end projects,” she says. “I’d challenge any facility to consider affordable ways to integrate outdoor terraces, gardens, and walking paths into their design, not only on ground floors but for upper floors as well.”

 

Building connections

Jurors agree that the best designs are authentic and distinctive to the healthcare providers’ brand, the community served, and the physical context, such as the graphics and artwork inside the Honorable Mention-winning University Medical Center New Orleans (UMC; New Orleans, La.) that pay homage to its French Quarter neighborhood and the city’s history. “Healthcare facility designs should be as varied as the communities served,” says Jon Buggy, principal and studio leader healthcare and life at RSP Architects (Minneapolis).

These efforts could also be seen in exterior designs, where designers maximized material choice and architecture to create a synergy between the site and the building. For example, the University of Arizona Cancer Center (Award of Merit) utilized a dramatic layered building envelope and locally derived materials and colors to reflect its desert climate, while the Josie Robertson Surgery Center Memorial Sloan Kettering Cancer Center (Honorable Mention) resolved its tight urban site in New York with a vertical layout and a veiled glass façade to offer varying degrees of privacy while still preserving views to the city.

Lambur notes that some of the bigger hospital projects also showed efforts to scale their buildings to complement residential settings, such as UMC’s new hospital, which opted for a multi-building approach, rather than the traditional large podium and bed tower set-up. “It fits with the neighborhood scale and character [of New Orleans] without sacrificing operational efficiency,” he says.

 

Future investments

One area where jurors were underwhelmed was in the design of staff spaces, especially considering the pressur
e organizations face to retain skilled employees. Mitch Goplen, vice president of facility services at Billings Clinic (Billings, Mont.), wondered where were the natural light, respite spaces, and sleep rooms for employees. “The design has to incorporate more to support staff,” he says.

Scot Latimer, president of Latimer Health Strategies (Evergreen, Colo.), says staff amenities still fall below patient solutions for most clients in this era of consumer-driven healthcare. “I suspect some were value-engineered out, while others never made it to the program,” he says. “Sadly, it doesn’t require much (if any) money to improve environments for staff.”

Juror Cohen says he’d also like to see more focus on private areas where families and care teams can collaborate on treatment planning and where patients can ask questions, process the complexity of a diagnosis, and even grieve. “The diagnosis in the corridor, outside of the waiting room, or within ear-shot of a stranger or friend can’t work for privacy and protected health information reasons,” he says. “But we must not tolerate it as families and patients hear lasting and damaging information with so many outside distractions.”

As healthcare designers and architects seek to address these challenges, Wyre says the investment in patient- and staff-centered spaces, refined materials, and iconic structures can pay off. “In this climate of competition, clients want to establish a brand that is well-known to the public,” she says. “Even though iconic structures may cost more, they become their own marketing machines as they draw patients to a different type of experience and level of care.”

Anne DiNardo is senior editor of Healthcare Design. She can be reached at anne.dinardo@emeraldexpo.com.