The Center for Health Design Blog

Making the Case for EBD to the C-Suite

If you’re having trouble convincing the leadership at your hospital or your client’s hospital about the value of evidence-based design, you might want to have them watch two new videos from the Healthcare Leadership Project.

Aimed at C-Suite executives, the free 10-minute on demand videos can be viewed on the Healthcare Leadership website. “EBD Roadmap for CEOs” features Georgia Tech professor and EBD expert Craig Zimring, Ph.D., talking about the CEO’s pivotal role in successfully implementing an EBD process in a healthcare building project.

In “The Business Case for EBD,” former San Diego Children’s Hospital CEO Blair Sadler explains how well-designed facilities can positively improve a hospital’s bottom line.

And, if that’s not enough, there are also white papers on these topics that can also be downloaded from the Healthcare Leadership Project website. A podcast by EBD pioneer Roger Ulrich, Ph.D., of Texas A&M that discusses the EBD research literature, is coming soon.

New Device “Smells” Handwashing Compliance

Here’s an interesting idea — a new device detects whether staff has washed their hands by “smelling” the alcohol on their hands from the soap or gel they used.

The HyGreen system includes a handwash sensing device mounted next to each gel or soap dispenser, a bed monitor, and an electronic ID-badge holder worn. When staff applies gel or soap to their hands, they simply place their hands under the handwash sensing device.

The handwash sensing device confirms that the hands have soap or gel on them and identifies the person. A green LED light on the ID badge goes on to signal that the person has washed his or her hands. The date, time and location of the handwash event is transmitted to a central server — allowing the hospital to monitor and track compliance.

This is a great example of how technology can be used to promote safety. Placement of the sensing device, location of the sinks, etc., is still a design issue, though.

NeoCon A Sign of the Times

Attendance at NeoCon World Trade Fair — held this week at The Merchandise Mart in Chicago — was down from usual, which was not a surprise to the thousands of manufacturers who participated in the annual commercial furniture/furnishings exhibition. In a normal year, Mart officials estimate that around 50,000 people come to town for NeoCon. Having attended NeoCon since 1982, my guess is that more like 25,000-35,000 attended this year.

The manufacturers I spoke with at the show seemed to accept this reality, blaming it on the economy, but putting forth the best effort they could to showcase their latest products. There were the usual freebies — environmentally-friendly bags, stuffed animals, note pads — and the usual cocktail parties, although very few offsite events other than ones sponsored by professional associations.

Attendees I spoke with actually liked that the halls and elevators were less crowded. Although the focus of NeoCon tends to be office furniture, there is plenty of healthcare products to be seen. This is especially true when the economy is bad — all of the sudden, it seems everyone wants to be in healthcare.

Here are the healthcare products that were judged to be Best of NeoCon:

Arc-Com: Midori Collection (fabrics)
CF Stinson: Agion Collection (fabrics)
Cabot Wrenn: Graduation Push Back Recliner
Humanscale: T6 Point-of-Care Technology Cart
MechoShade Systems: EcoVeil Naturals Shadecloth Series
Peter Pepper Products: Health First - Infection Control Centers
Skyline Design: Botanica (architectural glass)
Wieland Healthcare: Versant Glider

Where Does the Built Environment Fit In?

Unless you’ve been living under a log, you know that the Obama Administration has put a priority on creating a better healthcare system so that every American has access to high quality healthcare. They want to do this by the end of the year.

Ambitious, yes, but not impossible. Here are the three key componente of the Obama healthcare reform agenda:

1. Reform the healthcare system: We will take steps to reform our system by expanding coverage, improving quality, lowering costs, honoring patient choice and holding insurance companies accountable.

3. Improve preventative care: In order to keep our people healthy and provide more efficient treatment we need to promote smart preventative care, like cancer screenings and better nutrition, and make critical investments in electronic health records, technology that can reduce errors while ensuring privacy and saving lives.

Where does the design of the built environment fit in to all this? Very simple — improving quality, lowering costs, reducing errors, and saving lives. We know that by making changes to the built environment and operations, we can create safer more sustainable facilities that can impact all those areas — and have the evidence to prove it.

So, we need to get our voice heard in Congress. The Center for Health Design is working with others in the industry to try to make this happen and hope to share more about our progress soon. I’ll keep you posted.

Book Review: “Evidence-Based Healthcare Design”

In the past 12 months, we’ve seen several new books on evidence-based design hit the shelves. The latest is a great new reference titled Evidence-Based Healthcare Design (John Wiley & Sons in association with the American Society of Interior Designers) by healthcare designer Rosalyn Cama, FASID, President of CAMA Inc., and a board member of The Center for Health Design.

Cama’s book is a step-by-step guide of how to implement an evidence-based design process. Instead of an eight-step process outlined in the EDAC (Evidence-based Design Accreditation & Certification) program’s study guides, she condenses it to four – and still manages to cover all the bases, and then some.

As a practicing evidence-based healthcare designer who has helped to shape the field, Cama has served on many interdisciplinary project teams, which as she explains in the book, is an “important concept imbedded in evidence-based design methodology.”

In addition to a foreword by Georgia Tech professor Craig Zimring, Ph.D., chapters are sprinkled with (and in some cases, comprised almost fully of) essays by those involved in the case studies she cites, as well as other industry experts – a veritable “Who’s Who” of healthcare design. So, in that sense, this book is not only Cama’s voice, but the voices of many others as well.

Each chapter begins with a relevant quote from a famous person and ends with a checklist that summarizes the key “take aways.” There are also plenty of engaging black and white images – charts, drawings, photographs, as well as a group of color photos to add visual interest.

The book is an easy read with lots of good information and resources – another “must have” addition to the evidence-based practitioner’s library.

Access to Capital Through HUD

Last month Jim Rasche and Dave Sheedy of Kahler Slater Architects traveled to Washington D.C. and New York City to meet with various experts on the Department of Housing and Urban Development’s (HUD) Section 242 mortgage insurance program, including the HUD loan officers themselves. Here is a very brief summary of what they learned:

1. HUD 242 is essentially a program that increases access to capital. An application process allows the government to thoroughly vet an organization and evaluate its debt capacity. An accepted HUD 242 application is like a seal of approval from the government that allows clients who may not be able to access capital achieve an AA or AAA rating and borrow at lower interest rates.

With no capital limit, the HUD 242 program is designed to be of most benefit to larger projects. HUD also has programs designed specifically for smaller communities (fewer than 20,000 residents) and certain geographies.

2. The application process has been streamlined; and the money is there. Applying still requires a significant investment of time, but they learned from the lawyers who have closed 90% of these deals that the money is there to be had. There is also a new element of the program – Design Build – for projects under $30 million.

4. Successful applicants have put together a team of experts to assist them with the application. One step in the process is identifying the capital project need. This is a service Kahler Slater provided in 2003 for the Grand Itasca Clinic and Hospital in northern Minnesota, which received HUD 242 funding for its replacement hospital.

It’s great that Kahler Slater took the initiative to become experts in this area. Who says architects just have to design buildings?

Tips for Winning a Design Award

This week, I attended the judging for Healthcare Design magazine Architectural Showcase issue in Chicago. About 129 projects were submitted and a team of 20 distinguished judges sifted through them to determine if they should be included in the issue and which ones were deserving of citation awards.

I won’t spill the beans and tell you who won (the issue comes out in September), but it was interesting to hear the judges talk about the submittals themselves and what it takes (besides outstanding design) to get a citation. Here are some tips:

1. Read and follow the submittal instructions to the letter. Don’t include your firm name in the submittal if it says not to (this just annoys judges). Make a checklist to insure that you have included everything that you’re supposed to.

2. Answer all the questions thoughtfully and talk about how you did what you did, not why. As one judge said, “Show me the money. Tell me how you are using evidence-based design or green design to achieve outcomes, not just that you used it.”

3. Avoid marketing jargon. Ask project designers, and if possible, the client, to help write the narrative. Judges can tell when narratives are written by marketing people rather than the people who actually worked on the project.

3. Invest in good photography and quality floorplans and/or renderings. Don’t just provide images of the pretty public spaces. Include a comprehensive collection of images that tell the whole story. Incomplete submittals are also frowned upon by the judges.

4. Don’t submit projects that don’t demonstrate any kind of design innovation or thinking. Look at past issues of the Architectural Showcase to see which projects made the cut and which ones received citations. See if you project measures up — even if it’s only in one or two areas.

Intersection of EBD and EED

Yesterday, I heard a fascinating presentation at the Clean Med conference in Chicago about the relationship between “eco-effective design” (EED) and evidence-based design (EBD).

Mardelle Shepley of Texas A&M and Mara Baum of Anshen+Allen Architects did a research study in which they found that the two are indeed compatible. The term “eco-effective design” is theirs, and I think it is a better description than “sustainable design” or “green design.”

They plan to publish their results in the HERD Journal, but essentially they asked experts to help identify design interventions for each EED and EBD, created a matrix, and then had people indicate where they thought there was a relationship.

Clear intersections occur in design interventions in the areas of nature, positive distractions, materials, and daylight. And there are many others. Look for more on this to come, but I think it is time that we began to talk more about the two as compatible approaches and start integrating it into our work.

Most Influential People

Healthcare Design magazine is publishing a list of “Most Influential People in Healthcare Design” in its December issue. Nominations are being accepted until June 12 and voting will begin on June 15.

Who do you think are the most influential people impacting the design and construction of healthcare facilities? There are many architects, interior designers, facility executives, healthcare managers, product manufacturers, researchers, professors, nonprofit/association leaders, and others in our industry who are making a difference.

Nominate someone now! Then go and vote.