How many healthcare clients have you worked with that have run the numbers, looked at the demographics, understood the prevalence of chronic disease in the community, and developed a community assessment to define the appropriate approach and services for those patients?

Yes, every single one. But how many clients do you know who have gone beyond the numbers to truly know their community, their definition of health, and what the community’s actual need is toward achieving wellness?

I remember the day when a client first told me that he wanted to really know what his community needed. This CEO of a safety net hospital had already started spending time within the community to understand its culture and access to health.

Through research, we learned that this community’s definition of wellness was much different than many of ours. Theirs was about opportunity for overall life improvement through access to education, fresh food, daycare, and safe places to play. So the shape of the project changed and instead became a community center focused on wellness—a center truly focused on the needs of the community.

In order to really understand those we serve, we must dig deep into their everyday lives. We have to look at both the quantitative and qualitative aspects—and most importantly, the human aspects—to truly understand their need.

A combination of the following can be used to start to uncover what’s important to a specific community, and fully inform the care delivery model and the spaces that will support it.

  • Focus groups allow the researcher to ask questions in an interactive group setting where participants are free to talk with other group members about their perceptions, opinions, and beliefs.
  • Interviews are used to understand the experiences of others in a one-on-one setting without the potential conflict of a larger group and its influences.
  • Ethnographic studies are used to systematically observe people and their behavior to capture the deeper meanings of ordinary activities, allowing the researcher to potentially discover unmet needs or unrealized gaps.
  • Shadowing involves observing everything that a subject does that’s related to the work that is expected to be accomplished, and outlining areas of success and other areas in need of improvement.
  • Adaptive analytics is a process that inspects, transforms, and models data to help clients understand the current market condition, physician landscape, and future population and healthcare utilization projections—all critical components to developing comprehensive operational, growth, and profitability strategies.
  • Precedent studies allow the researcher to find qualitative or quantitative information from subjects or projects that reflect the characteristics of the subject being studied, building a stronger foundation based on lessons learned of similar projects.

Health and wellness are very personal, and culture, age, socioeconomic conditions, environment, and access can all change its definition. We as architects and our clients should understand these subtleties as part of the design process, developing approaches to projects that reflect the communities they serve and provide opportunities for residents to achieve their personal definition of wellness.

As Churchill once said, "We shape our buildings; thereafter they shape us." It’s time for us to listen and explore more deeply for a truly responsive approach to each community our clients serve.

Abbie Clary directs HDR’s Central Region healthcare business development efforts. Her passion at work is community health, which led her to launching HDR’s Community Health Initiative in 2011, a program focused on building healthier communities through facility design. She’s also involved with HDR’s Translational Health Science Initiative and the firm’s new innovation consulting group, in addition to leading numerous successful project pursuits for the Rehabilitation Institute of Chicago Research Hospital, Cincinnati Children’s Hospital Medical Center, and the Focal Point Community Campus. She can be reached at Follow her on Twitter at @AbigailClary.