Healthcare Design Activism

Posted on August 28, 2010

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Sometimes I think what healtcare design needs is a dose of levity to institute change.

Rarely does anyone single out the institution which sometimes stands at the intersection of commercial and societal trends.  Hospitals do so much good, how could anyone pick a fight with them? Maybe from time to time someone should, along with the architects, engineers and construction team that serve the hospital target.

Change happens when attention is drawn to something—media involvement.  When a subject becomes an answer on NPR’s “Wait, Wait…Don’t Tell Me”, you have arrived officially as news.

I think when a hospital’s construction project opens and  they could have ‘gone green’, people should picket. I am sure there is a non-profit that could take up the Greenpeace banner for people wanting a more sustainable built environment, ‘Greenies for Green Buildings’. They would materialize spontaneously from tweets and Foursquare with witty, home-made signs, spread their message from ubiquitous smart phones and protest why the new hospital did not go green.  Why not be a little more critical?

For all the research and theories about the best in healthcare design, there is simply not enough shame spread around to get anything changed! If administrators knew the public would rant over just ‘your average tower addition project’, they might feel obligated to do something different, something revolutionary. We need a shareholder movement equivalent for healthcare design—community movement.

Design choices are stewardship decisions, decisions that represent organizations, and must be critically analyzed. Just as SUV owners on the West Coast were famously confronted by environmentalists with mock tickets, ‘Axle of Evil’ guerilla bumper sticker campaigns, and ‘What Would Jesus Drive?’ advertisements, healthcare design pundits need to wake up, get edgy and get creative— to send a message and elicit action. What is the harm in drawing more attention to status quo things that could be so much better, things which design and construction could help make better?

Peer admonishment is simply non-existent. Would it not be great theater to have one major health system publicly question why a competitor chose to bloat its room sizes—via Facebook and Twitter of course? “When will the horror of size creep end?” Wall Street does this (maybe not on Twitter). Or publicly ask in a press conference:  [sneering] why the mirrored glass? “Are they hiding something—their ignorance of low-e—or are they just stuck in the ’80s!”

No, I am not after the mud slinging of politicians—gad no! But designers and builders alike must understand who they might have to answer to when their project opens. They must think like Apple and be ready to be Steve Jobs and defend choices. If healthcare projects had some gamesmanship and friendly competition with a legitimate public forum and some image at stake, design and the performance of healthcare could really push some significant design thresholds.

I have yet to see a spirited roundtable or panel on healthcare design at a healthcare conference. There is too much corporate formality in the room. We need people with ‘fire in the belly’, characters like Howard Beale. We need avenues for healthy public discourse about design choices, not merely speculation and studies and then years of waiting to see if, 1) a particular idea is adopted, and 2) whether it is effective. We need something part gadfly, part Crossfire, part special interest group.

Let us find the real public passion for healthcare design, topics that get people fired up.

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Posted in: Design Zeitgeist