If you are about to embark on a new building project or maybe even just a small renovation project, during the development of the project guidelines, ask yourself how innovative you would like the project to be. If you are inclined to seek the excitement of discovering new solutions, then there is a systematic way to approach innovation in a relatively safe manner.

Here are a few thoughts to help discover the scope of your innovative spirit.
Map your innovative prowess
According to the Rogers Adoption Innovation Curve (noted below), 2.5% of newly released design interventions and/or operational or clinical practices qualify as innovations and 13.5% as early-adopted practices. What is your project’s tolerance for innovation?

Innovator is a status to aspire to, and not a place to begin your journey into the world of healthcare design. Being an early adopter is sometimes adventurous enough given the complexity of most facility-related decisions.

There are two scales to consider for achieving the appropriate balance before you forge new roads—or even follow the trailblazers in the field. One scale is related to what drives decision-making on your project, and the other is relative to the level of innovation you will tolerate.

Where you decide to be on each of these scales will drive a unique set of decision-making practices. Remember, these scales provide an interesting exercise to create the litmus for decision-making throughout the course of your project's lifecycle.

The first scale is about how to base your decisions in order to achieve a certain set of outcomes. Will the approval of design interventions known to improve outcomes merit a primary decision based upon financial value or institutional values? Too many projects start with values-based desires and then engineer out good design interventions, because of a later misdirected value-driven or price-based decision.

These two opposing factors can be easily reconciled with solid evidence-based design knowledge.

The greater the alignment between the design decision and your values, the more meaningful the financial value discussion will be. If aligned with your values, then the decision where to spend money sets your coordinates on this scale early in the planning process and will likely show a return so great that the costs are recouped in the first few years of operation.

The second scale deals directly to the degree of innovation your project will drive. You have a choice as to whether to just engage in baseline knowledge or to innovate. Innovation can be one small detail or a major shift in the industry's mindset on how to deliver medical care.

Often, a project team is surprised at how much industry advancement has been made since their last project, and it all seems innovative.

It is important to understand the current state of baseline data so you can provide clear direction to the project team. Providing baseline knowledge so that healthcare facilities change rather than stay static—or worse, regress—is central to The Center for Health Design’s work. Often, a project just needs to hover at the baseline knowledge level, while others need a higher level of innovation.

If you can be honest on each of these scales, then you will begin to profile a design program that your design team can follow with certainty and accurate delivery.


Converse about industry drivers
Most design conversations start with a driver that determines which outcomes need addressing. In 1999, when the Institute of Medicine came out with a report on safety, it drove all healthcare design conversations around outcomes related to safety. It was because of those conversations that the single-bedded room was born.

A new set of questions also arose that created innovative concepts, like the variable-acuity room to reduce the risks associated with transfers and the bathroom's placement on the headwall to avoid the risk of patient falls.

With health reform as the driver, we are all currently seeking outcomes related to efficient and effective models that deliver more care while using fewer resources. Design interventions are currently supporting Lean work processes, like decentralized personnel and supply distribution, resulting in community-based healthcare delivery.

As we move into a more accountable-care model, we will need to find a way to keep our most vulnerable population in a state of good health. Innovative health-related design interventions will move from the acute care facility into the community, and maybe even into the home.

These shifts are occurring faster and faster, and the need for innovation to be inspired, vetted, proven or disproven, and then adopted into baseline data is greater now than ever. We no longer have the typical 10-to-15-year cycle where one team innovates and then waits for the rest of the industry to follow before we consider what comes after what comes next.

The Center has opened that conversation up across all platforms with the most likely innovators—our Pebble Project partners, as well as others testing new concepts in the field, like our Affiliates and those in the Built Environment Network. Consider finding your community of interest and avoid falling into the laggard’s position.
Use the EBD process
Most meaningful innovation has its seed planted long before the design project begins. A crucial step in the evidence-based design process is to have the foresight to align corporate strategy with facility planning. Mapping your strategy across your physical assets is fortuitous if you have the luxury of time and a team in place that understands the current baseline knowledge—a target that is continually on the move.

Is your facility and design team really using an evidence-based design process or is it just a marketing buzzword? The implication for falling behind in this fast-moving industry is too great to not know the answer to this question.

Add an evidence-based design expert to your team long before there is a project, so when the time comes to develop a meaningful program, you will have a resource who can guide the process more effectively.
Call to arms
I have a prediction in mind for where we are headed after what comes next, so catch up and, please, do not hang back in the laggard's position. If you are reading this publication or my blog post, then you are looking for the “what's next” on the healthcare industry's blurry horizon.

Use the group brain at The Center and those who are participating in the conversations to move this industry, and all who use it, into a state of wellbeing.


Rosalyn Cama, FASID, EDAC, is President and Principal Interior Designer of CAMA, Inc., in New Haven, Connecticut. Her blog post on this topic can be found at www.blog.healthdesign.org. For more information on The Center for Health Design, please visit www.healthdesign.org.