Creative Deficiency

We spend more than $20 billion a year on the design and construction of new health-care facilities in the United States. And yet, from a design perspective, the vast majority of these projects are banal, at best. Why is the bar set so low for hospital design?

Rosalyn Cama
President and Principal Interior Designer
Cama Inc.

Because health care is a regulated industry, spending is scrutinized. The fear of mismanaging a budget rules decision making. This is where the evidence-based design movement has made traction. For instance, it took the Institute of Medicine’s 1999 declaration that 100,000 people were dying each year from hospital-spread infections to make the design of the single-bed room an acceptable expenditure. Current health reforms and the Affordable Care Act will encourage design interventions and reveal the impact that they can have on well-being. The baseline evidence is slim now, but a business case must be formed. Only then will we see health-care budgets that include discretionary spending for interior design.

Richard F. Dallam

Health-care facilities are systems of great complexity. To create something great takes courage on the parts of both designers and clients to challenge assumptions, and to confront the overwhelming functional complexity, rigorous regulatory codes and reviews, and the multi-layered organizational structures of health-care providers. As designers, our role is to help our clients clearly articulate why they are building. That provides a sort of “true north,” keeping the entire team motivated to achieve something extraordinary. It is easy to make excuses and assign blame for mediocrity. There are many instances in health-care design where architects and health-care providers worked together to understand one another’s perspectives.

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Gianfranco Zaccai
President and Chief Design Officer
Design Continuum

It takes between two and four years to design and construct a new hospital. But in that time many aspects of the original design could become outdated due to changes in technology or focus. So it is critical that flexibility is designed in.

One of the biggest problems with hospital design is that caregivers and administrators are usually brought in to inform the process but patients and their loved ones are often not directly represented. Hospital rooms, which are at the core of the health-care experience, need to be functional both in the ergonomic sense and at the emotional level. Systems that allow health-care facilities to navigate change can help put the patient at the top of the design pyramid in a sustainable and cost-effective way.

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