In my last post, I talked with colleague Steve Christoff about his experience as a patient in a hospital he designed—an experience that gave him a fresh perspective on how he might approach future healthcare planning.

But when Steve left the hospital and had to spend the following month in a wheelchair, he had another opportunity to re-evaluate the design and planning process, but this time from an accessibility perspective.

The Americans with Disability Act (ADA) of 1990 mandates equal access to public accommodations, employment, transportation, state and local government services, and telecommunications for people with physical or mental impairment.

As architects and designers, we design to the ADA standards with every project. And we usually think we’re getting it right—until we experience architecture from the first-hand perspective of a mobility-impaired user.

Steve acknowledged that spending a month in a wheelchair is different from spending a lifetime in one, yet the ADA is written equally for those with permanent or temporary impairments.

“We’re aware of how to default to the ADA in our design process,” Steve said. “But once you actually sit in a wheelchair and experience mobility challenges, you soon realize these are minimum standards that address minimum functional requirements. The ADA does a great job of establishing those minimums, but there are still personal challenges along the way.”

Most designers readily reference the top-line requirements—curb cuts, counter and desk heights, ramp incline, grab bars—but Steve discovered a few things that were missing from his checklist.

For instance, he noticed that a wheelchair gliding across a carpet surface can build up static electricity, often leading to a sudden electric shock when reaching for a metal door handle. He eventually learned, after a few jolts, that touching his elbow to a metal surface first will transfer the static less painfully.

He also discovered, unsurprisingly, that outdoor ramps are best used in dry weather. Wheeling up a wet or snow-covered ramp is challenging at best and impossible at worst. Even the most diligent building owner has a tough job keeping sidewalks and ramps clear when the snow is coming down at an inch per hour.

On other points, Steve noted that conference room size and configuration can offer their own challenges to the mobility impaired. Wheeling around a conference room table can be a tight squeeze, especially if chairs are randomly pushed in or out from the table. After a few business meetings, he learned to arrive early to claim a free spot near the door, avoiding getting stuck in the back of the room as people pushed their chairs out to leave.

As with his experience in the hospital, Steve became more convinced that full immersion is the best approach to take when planning a healthcare facility.

“Every architect should spend time in a wheelchair doing a Gemba walk,” he said. “This will help increase awareness of the minimum ADA standards and opportunities to go beyond the minimum. By placing a nonmobility-impaired designer in a wheelchair, you suddenly become aware of challenges that are not necessarily covered in the ADA guidebook. This exercise helps make us more conscientious of all user groups.”


Read Christine Guzzo Vickery's previous blog in this series: "Full Immersion: Learning The Impact Of Design Firsthand."