The case for rigorous research in the design process of architecture is especially compelling in health care settings. Hospitals are costly to build and operate, and their performance is critical to both staff and patient outcomes.
Lynn Webster is a proponent of research methodologies for applied design. Architect and principal with Canadian architectural firm Cohos Evamy integratedesign™, Webster believes designers have a moral imperative to understand and address the issues faced by health care institutions. In Webster’s experience, good design has the ability to reduce patient length of stay in hospital, improve operational efficiencies and enhance employee recruitment and retention at a time when these are major issues for the health care system.
Cohos Evamy has developed an evidence based research process called integratedesign™ Research. It promotes meaningful collaboration between the design disciplines and with clients, resulting in higher quality designs and improved building performance based on research conducted at the pre-design, mid-design, and post-design phases.
The firm has a long-standing commitment to high-quality design, sustainability, meeting client needs and the communities in which it works; integrated design research strengthens its ability to deliver on those values.
Improving Building Outcomes
The existing context for health care design is challenging on several fronts. Issues include an aging workforce, shortage of staff, increasing rate of occupational injuries, high rate of absenteeism among staff, high rates of hospital-acquired infections among patients, in-patient injury leading to health and legal complications, and rising expenditures.
Webster explains that research is useful in guiding design to reduce stress among patients and staff and in the creation of wholesome environments. If design can redress the high level of absenteeism among nursing staff or reduce the amount of costly overtime hospitals pay, then the expense of design research and design innovation can be rationalized.
Translating research into design takes several forms. For example, interior designers are concerned with the creation of calm, restful spaces. Architects improve efficiencies by reducing the amount of time nursing staff must travel between points. Patient need for a sense of connection to the natural world is accommodated by patient room access to light and view made possible through the thoughtful placement of windows. Pleasant waiting areas and improved wayfinding make the visitor’s experience more hospitable.
Introducing Rigor into Design Research
Architects often lack training in social science research methods. To compensate for this discrepancy, Cohos Evamy’s team includes a Research Lead with a background in nursing and a PhD in the business of health care management. Claudia Steinke contributes to the firm’s health care practice as part of an interdisciplinary team.
As part of the integratedesign Research process at Cohos Evamy, a variety of techniques are used in gathering evidence, including surveys, tracking people as they go about their tasks, and interviewing. A thorough review of existing literature (industry and academic) forms the backdrop for all research conducted at the firm.
Optimizing circulation patterns in healthcare environments is one of the immediate benefits of integratedesign Research. Cohos Evamy has applied research to reduce the amount of travel distance for staff, and to reduce the distance between diagnostic equipment and patient rooms or treatment areas. Shorter travel times allow more time for direct hands on patient care.
Complex buildings like health care facilities require collaboration between designers, the client group, engineering consultants and other stakeholders. Integrated design allows Cohos Evamy to bring an interdisciplinary approach to solving these complex problems. Rigorous research ensures these efforts result in great architecture that includes an efficient and quality work environment where healing and health are promoted.
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