Authenticity and the Patient Experience

Posted on July 31, 2010


Healthcare architects seek to deliver the most functional and empathetic design possible for the given need—functional for the owner (client) and emphathetic for the patient (user). In no small way, good healthcare architects use a combination of past experience, research and stepping inside the footsteps of the patient to create an ideal spatial solution.

The best way to get an account of patient needs is a first person account; it happens on occasion. Luckily I have not been admitted to a hospital, but I have been pretty close to the action numerous times—most recently when my wife had unexpected surgery earlier this year, and last year I spent two nights in the hospital after the birth of our daughter. Amazing lessons can be learned from the inside. However, the person in the hospital usually is distracted with the state of their own health, which is more pressing than documenting the positives and negatives of the patient experience.

The next closest thing to a direct experience is what a lot of projects rely on:  highlights and lowlights from patient satisfaction scores provided by hospital administration, previously successful projects, maybe a Pebble Project from the Center for Healthcare Design, and designer’s intuition. But nothing approximates the patient experience like being a patient.

Architectural Record recently profiled a building whose concept and design grew from a very specific patient experience. In this case the patient, Maggie Keswick Jencks, was well equipped to provide her perspective:  as AR related, Keswick was “outgoing, articulate, and an often-published writer”.  Additionally, she was asked by one of her doctors to provider her views on the subject.

More specifically, her gift to the body of knowledge for cancer treatment was an essay “A View From the Front Line” that explained both her ordeal with cancer and her ideas on how to improve and even redesign cancer treatment.  As a design criticism of healthcare environments she experienced, it is invaluable. Several years ago, I was lucky to have made the acquaintence of a colleague who blessed me with similar insight as a patient, which I plan to relate separately as the subject of a future post.

Unfortunately Keswick died in 1995.  Her legacy is an organization that bears her name and a series of cancer treatment centers which remedy some of the shortcomings she articulated as a patient:  “small-scale” and designs to “emphasize open space, daylighting, and selective use of color, plants, and landscaping.”  Architecturally the buildings, although performing the same function in different parts of Scotland, are not prototypes by definition.  In fact, they appear almost whimsical and folly-like, very different aesthetically, and very site-specific as excellent architecture always is. I can think of no better way to be immortalized.