3 doctors sharing design that drives healthcare architecture
Public health and the built environment have a long history that came into the limelight during the COVID-19 pandemic. The global crisis has made us all acutely aware of how design, whether for medical buildings or other types of buildings, can affect our ability to respond to health emergencies and our daily well-being. Those most attuned to this connection are a niche group of architecture and design practitioners who also have medical experience.
Metropolis recently sat down with three members of this unique subgroup: an intensive care unit manager who also serves as a senior consultant for GunDesigna geriatric internist who also serves as the head of health care at Jacobsand a surgeon using his medical experience as a senior director and chief medical officer for: HOUSEthe general practice. In addition to impressive resumes, these hybrid professionals bring an unparalleled boots-on-the-ground perspective to healthy design. Here they share their insights, discuss how healthcare design methodologies have evolved in recent years, the ways they collaborate with design teams in the wake of the pandemic, and where they see a heightened interest in health and wellness in the design of non- medical areas. —Lauren Volker
ANDREW M. IBRAHIM, MD, MSC
- Head of medical service, healthcareHOUSE
- Assistant Professor of Surgery, architectureand Urban Planning at the University of Michigan
- Co-Director for healthcare Results and Policy at the University of Michigan
- Surgeon, Ann Arbor, Michigan
The healthcare frontline is one of the most complex and demanding environments of any profession. Medical professionals are constantly looking for ways to clarify purpose and simplify processes to ensure the best patient care. As our building designs become more complex – code requirements, new materials, emerging technology – health professionals can discover their most valuable service is bringing clarity and focus to what really matters.
Since the pandemic, data-driven decisions have been central. While previous design decisions have always allowed for trade-offs, the unprecedented focus on climate and sustainability, as well as hospital efficiency and capacity, has made real-time insight into quantitative data incredibly important. More and more, data-driven econometric modeling strategies drive our big design decisions.
The pandemic has not only given us permission, but also mandated us to be more innovative. Designing healthcare spaces with natural air ventilation and retractable roofs may have seemed far-fetched, but now these key concepts — common in stadium design and airports — can play a meaningful role in healthcare facilities. As such, many teams now have members from multiple disciplines and with experience in diverse building typologies to realize a more innovative design solution.
Health is now more central to almost everything we design. Over the past three years, I’ve seen non-care projects grow to more than half of my portfolio. In short, health is important to everyone, and we can intentionally use design to make all areas of our lives – where we work, eat, rest and play – healthier. So many of the principles I use as a physician to help patients live healthier lives carry over into the way we design the everyday space for health.
DIANA ANDERSON, MD, M.ARCH HEALTHCARE PRINCIPAL AT JACOBS
- Co-founder of Clinicians for Design
- Neurology Instructor at Boston University
- Geriatric Neurology Fellow at VA Boston healthcare System
Healthcare professionals can provide insight into healthcare activities and, most importantly, patients’ needs and experiences. These perspectives offer architects a unique opportunity to experience the world of clinical medicine in a way that is typically hidden. We can walk through the halls; we can talk to doctors and other clinicians; we can shadow individuals as they go about their daily routines. Engaging healthcare providers in projects also promotes a data-driven design process, strengthening the built environment in favor of health outcomes.
While the clinical practice of health care and the fields of architecture, planning and design has traditionally spanned different professional, social and cultural worlds, emerging professionals demand to move beyond these rare intersections and seek a convergence of career models through the domains of research. , education and practice. This movement has accelerated during the pandemic, given the need for fast, innovative and often design-based solutions to many problems.
The pandemic exposed the need for a shift to a data-driven design process and the role buildings play in our physical, mental and social health. A striking example is research that showed that smaller-scale nursing homes had better outcomes – significantly less COVID-19 infections, hospitalizations and deaths. What worries me is the reactive approach to design during the pandemic with infection control as the main driver, which in my view is just one element of health design. Ensuring quality of life and health (including mental, physical and social health) for those using care spaces should still be paramount.
We can certainly create enclosed spaces to keep infections at bay, but often there is a knock-on effect. We have seen the negative health effects of social isolation and loneliness – in medical settings, research has shown that long-term care residents without face-to-face contact with family or friends early in life COVID-19 pandemic. And this concept encompasses all spaces and environments. The harmful effects of forced social isolation can be mitigated by design, even in our own homes. For example, a view of nature at home has been shown to reduce levels of depression, loneliness and anxiety, sometimes more than the actual use of outdoor green space itself. The design of the built environment at all spatial scales – from our homes to our neighborhoods and cities – is a determinant of health.
KAELEE STONE, MHA, BSN, RN
- Senior Advisor, Blue Cottage from CannonDesign
- Intensive Care Unit Manager, CHI Health St. Elizabeth, Lincoln, Nebraska
When you work in healthcare facilities every day, you can see on a whole different level what works and what doesn’t for patients and staff. No designer or team can imagine or simulate all the different scenarios that we who work in the field can go through. Health professionals may point to certain furniture, equipment, technology or designed workflows that may be aesthetically pleasing but cause inefficiencies.
We all remember the intense stories from the early days of the pandemic when medical teams lacked PPE and healthcare facilities didn’t have enough space to properly care for patients. The ingenuity that healthcare showed at that time still inspires me, and many of the ideas teams came up with in those moments carried over to today.
But at the same time, health systems recognize that global pandemics are inherently unique and are focused on bigger ideas that improve care, pandemic or not: spaces rich in flexibility, beds and patient rooms that can be more easily upgraded to accommodate critical care, self-cleaning materials. and strategies to make isolation less lonely. All of this is driving significant change, but it’s not just about future pandemic prevention.
An interesting example of this can be found in our current work with the University of Cincinnati (UC) Health. Our teams at CannonDesign and Blue Cottage from CannonDesign have helped them incorporate a remarkable level of flexibility into the design of their new emergency department. Once completed, it will have a separate entrance with mass triage room and a 32 examination room pod that can run in “pandemic mode” to treat infectious patients. These responses bolster UC Health in the face of a future pandemic, as well as in several other scenarios.
CannonDesign’s Blue Cottage also works across all different sectors, and we see educational and commercial spaces bringing more health and care resources into their environment. Healthcare providers who also work in design can directly influence these projects. I’ve always felt that designers and healthcare providers care about patient experience in their own unique way. And when you can combine those unique perspectives and passions in one team, then the real magic happens.