The Center for Health Design Blog

HEALTHCARE DESIGN Conference

Greetings from our annual conference, HEALTHCARE DESIGN, at the Gayord Texan resort in Dallas. I’m here with about 3,100 other healthcare and design professionals, product manufacturers and other vendors, students, educators, and consultants allied to the field. It’s our biggest conference ever, which is a testament to the growth of the healthcare design industry, and our collective efforts to advance the field of evidence-based design. Thanks to our conference partners, Vendome Group and the AIA Committee on Architecture for Health, for helping to make this happen.

Last night, I had the pleasure of interviewing CHD board member and interior designer Jain Malkin in front of about 120 attendees at the IIDA fundraising dinner. Actually, it really wasn’t an interview, because all I did was just ask her one question (”How did you get your start in healthcare design?”) and she launched into this amazing, highly amusing 30-minute tale of her early beginnings in the field.

For those of you who don’t know Jain, she is probably the “godmother” of healthcare interior design. Her projects have set the standards and won awards and been published everywhere. She has written three books, one of which is the “bible” for design students looking to get into this field. She speaks everywhere and is constantly absorbing new information and sharing it with others. She is a larger than life personality who is curious about everything, a perfectionist (in a good way), and incredibly passionate about healthcare.

The amazing thing about Jain is that she is a self taught designer. Her degree — from the University of Wisconsin — was in psychology. Needing money and not sure what to do, on a whim, she applied for a design job at Flad & Associats in Madison, and got it, despite the fact that she knew nothing about how to be a designer. She also worked for an office furniture dealer in Minneapolis, and then for her brother’s architectural firm in LaJolla, CA (which did medical space planning).

Before starting her own healthcare design firm, she spent a year going around to hospitals and observing what went on in them — material that eventually became the basis for her first book on medical and dental space planning. Of course, I have left out all the bizzare anecdotes that Jain told which had us all laughing out loud (If she lets us share the tape with you, we will), but you get the idea.

I am truly fortunate to have known Jain for almost 20 years and encourage you to go hear her speak if you ever get the chance. Her latest book, A Visual Reference to Evidence-Based Design (which is being published by The Center for Health Design with funding from the Robert Wood Johnson Foundation, will be out in January 2008.

Read Natalie Zensius’s blog post on Jain’s book.

Read a review of Keynote Speaker Don Norman’s opening address.

IHI’s National Forum

I got a brochure the other day about the Institute for Healthcare Improvement’s (IHI) National Quality Forum, December 9-12 in Orlando, FL. This is IHI’s big annual conference that is attended by 5,000+ healthcare professionals.

I attended the National Forum last year and found it extremely valuable. Although some of the sessions were too “hands-on” for me (not being a healthcare clinician or manager), the keynote speakers were top-notch and the networking outstanding.

The Center is working with IHI to imbed some of our research and thinking about how the environment impacts safety into its materials and information. Most likely, there will be some sessions on the built environment at the IHI National Forum, but the focus is mostly on improving clinical excellence and process.

For more information on the Forum, go to www.ihi.org. Maybe I’ll see you there!

Environments for Aging

Last week, I attended our first ENVIRONMENTS FOR AGING conference where AARP CEO Bill Novelli gave a fascinating talk on some of the aging issues AARP has identified. AARP has 35 million members worldwide. That is an astounding and powerful constituency.

Among other things, Bill told us that those of us 78 million Baby Boomers who reach age 75 will live another 12 years on average. Get ready — the “senior boom” is going to shape the 2010s, 2020s, and 2030s.

He told us that losing independence and mobility are the biggest fears of getting old and that keeping engaged in civic and social life is key to staying active. And no surprise — AARP surveyed its members and found that the majority of people want to age in place; as we all know, this has big implications for facility design.

Does that mean that people want to age in their current homes and that they need to be renovated to accommodate the physical changes that come with aging? For some, maybe. I can’t see myself reaching the active old age of 87 in the home I’m currently living in. And I can’t see myself living in one of today’s continuing care retirement communities — even some of the upscale ones that are winning our design awards. The current generation of those over 75 is much different than mine will be.

And, as Bill pointed out, transportation is a big issue. For people to age in place and stay active in their communities, they have to be able to get around. For anyone who is interested in this topic, I urge to you read AARP’s report, Stranded Without Options.

AARP definitely has a social impact agenda in this area, and hopefully, we will continue to keep them engaged in this discussion as we explore new environments for aging.

Notes from the Joint Commission Conference

I just returned from the Joint Commission “Hospital of the Future” conference in Orlando. CHD board members Ian Morrison, Ann Hendrich, Roger Ulrich, and Craig Zimring all spoke.

Roger Ulrich and Craig Zimring did a good job presenting the benefits of using evidence-based design to this audience of mostly healthcare managers and administrators. They spoke about CHD’s Pebble Project research and drew from the literature survey they conducted for CHD almost three years ago (the RWJF funded report), which they are currently updating.

Among other things, Ian described a typical hospital experience as “islands of excellence surrounded by the department of motor vehicles.” He also said that the “average baby boomer has $50,000 in assets. We’re all going to be limo drivers in Boca Raton someday.”

And, some of you have heard him talk about how hospitals are like MTV’s “Pimp My Ride” (PMR) show where they take beater cars and “trick” them out with cool interiors, blow-your-ears-off sound systems, super cool paint jobs, and huge chrome tire rims that go backwards while you’re going forwards (how do they do that?). The trouble is, they PMR homeboys never do anything to the chassis, so you have beautiful cars that will eventually break down again. He used this as a metaphor to describe how we’re designing many hospitals these days.

I also heard a fascinating talk on “medical tourism,” or “medical outsourcing,” as the industry prefers to call it. While it doesn’t seem like this will make much of a dent in the huge U.S. healthcare industry, it is becoming a viable option for the underinsured who can’t afford to pay for costly medical procedures in the U.S. Imagine paying just $5,000 for a hip replacement. It is happening in Thailand. Oversees hospitals that cater to that industry seem to be paying attention to the design of the built environment to attract patients and retain staff.

And, Uwe Rinehardt, the Princeton healthcare economist who is truly an industry guru, said this about investing in better building design: “I’m always astounded by how cheap it is to make a hospital attractive. People should have good experiences in your hospital. These things do seem to matter to attract revenue.” He also said that future labor shortages will mean create a need for “wireless long-term care,” in which hospitals become hubs of wireless, home-based, long-term care management.

Finally, in a review of a recent research project she did with Marilyn Chow of Kaiser, Ann Hendrich told us that “poor work processes will trump good design any day.” But she did acknowledge that physical design, work processes, and technology all need to be integrated for things to change.