The Center for Health Design has been working with organizations for years to advance the practice of healthcare design. But lately, I’ve been hearing more and more about how the process is broken: There’s no time. Everything has to be done faster, cheaper.

I don’t think it’s just the economy or healthcare reform. As our use of technology has progressed, we now live in an instant world. We expect immediate responses to content that’s 140 characters or less.

And then there’s reality TV. Not just the Housewives or the Kardashians, but design reality TV. The shows where they go in for a one-day makeover, sometimes called a “daykover,” or flip a property after a facelift. As an architect, when I see these shows, it’s like a traffic accident—you just can’t stop yourself from slowing down to stare.

It’s always the outdated kitchen (just a few years old) or the open plan that’s needed for the extensive entertaining (really?). And I’m always left wondering what’s left after the production team leaves? Not just the staging of flowers and books, but the underlying structure. Is that drywall going to stay up more than one month? Isn’t that running tile backsplash going to look just as outdated next season?

It’s almost like reality TV has deadened our senses to the real work of design, especially in something as complex as healthcare. We’re pressured into easy answers, black and white, and there are fewer opportunities to understand where the real solution might be.

The Center recently had the opportunity to pilot test its forthcoming safety risk assessment tool at three organizations: Barnes Jewish Hospital in St. Louis, University of California Irvine Medical Center in Irvine, Calif., and Memorial Sloan Kettering in New York.

Universally, the organizations faced the challenge of understanding the implications for participation. How many people needed to be there? What was the internal and external cost of such a meeting? But once done, they were amazed at what they found: a synergy and focus that didn’t exist in other meetings, solutions that may never have been discussed, and a realization that traditional user groups create a game of telephone where you’re repeating what you thought you heard last further down the line.

Healthcare design involves systems thinking. What we do has upstream and downstream implications, and it’s not just about departmental needs, space allocations, or operating hours. It’s about how we interact with the space around us and how design facilitates to support what we do in our jobs.

But it takes time. And commitment. And a recognition that what you invest in time or resources now will pay dividends down the road. Everyone agreed that even though it was an investment, it was well worth it, and that they got more out of it than they expected.

I guess that’s hard to pitch these days. We don’t seem to have time to think, only time to get things done and move on to the next task. Yes, it’s an overstatement, but let’s make time. Let’s be committed. And let’s avoid the traffic accident delay created by some Hollywood version of what we are all really trying to achieve—meaningful change that has a lasting impact.

Ellen Taylor, AIA, MBA, EDAC, is director of research at The Center for Health Design (Concord, Calif.). She can be reached at