Wanted: Flexibility in HC Design

Posted on April 11, 2012

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Architect reported on a surprising stat from a recent Mortenson Construction healthcare industry survey: 93% of architects and 91% of healthcare providers place a heightened priority on flexibility in healthcare design.

Excellent—near consensus from healthcare designers and healthcare design buyers!  Now the tough question:  what exactly does “flexibility” look like?

Within the context of healthcare, flexibility may be as difficult to define as quality. Customers say they want quality (some even admit they will pay for it), but what does quality mean?  Durability?  Recognizable manufacturers and brands?  “No-maintenance”?  Superior design aesthetic?

I contend flexibility is a similarly slippery goal.  Flexibility is most commonly defined as the ability to easily adapt to change.  We know technology is changing spatial needs in healthcare.  We know research is changing spacial needs.  Teaching and learning methods are changing spatial needs.  Sustainability is changing spatial needs.  How can this be  achieved?

In design, that could be done through modularity.  It could mean making the fixed, movable. Some architects think ‘flexibility’ in healthcare is evident in high ceiling heights and minimal structure interrupting a floor layout.  And yet, in a prominent quote in BD+C from Mass. General Hospital’s Director of Planning and Construction, David Hanitchak stated:  “Given the choice of an extra floor or more flexibility for the same cost, I’ll take the extra floor.”  In his eyes, traditional flexibility meant lack of vertical constraint; however, administrators I talk to can likewise equate flexibility with having lots of space.

As architects and builders, we automatically assume flexibility is defined by healthcare administrators in the context of space and the physical infrastructure. Maybe flexibility, which is inanimate, can be manifest holistically and infiltrate the hospital (like culture, which is also invisible), rather than be sought on a project-by-project basis.  Is flexibility an absolute value (you have it or you don’t)?  If you had it and lost it, can you get it back?  If so, how?

Healthcare design flexibility needs further definition before anyone can take aim. Both creators and consumers of healthcare environments admit they want it, so they both must collaborate to determine, in lay terms, what flexibility is, what it looks like in action, goals and benefits,…heck, an entire SWOT analysis is in order. In fact those three words, healthcare design flexibility, sound like the agenda to an entire three-day conference.  I’ll be the first to sign up.

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