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Bringing Hospitals to LifeDESIGN QUALITY STANDARDS

Farrow Partnership Architects Inc.

Tye Farrow, B Arch, M Arch UD, OAA, FRAIC, MAIBC, NSAA, NLAA

INTERNATIONAL ACADEMY FOR DESIGN & HEALTH

6TH WORLD CONGRESS

SINGAPORE | JUNE 25, 2009

Patient-focused care & healing

environments have been espoused

in the industry for 25 years.

“Healthy people, healthy communities…”

Often staff entrance located in the back of hospitals, where they walk past the dirty laundry and the biohazard storage rooms.

Clearly, there is a gap between what we say

we want, and what we actually build.

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Dismal buildings that fail to answer

the most fundamental question…

What really happens here?

People don’t consciously want to

create something mediocre

So, there’s a say-do gap.

What is it we’re not doing?

What’s missing are the intangible qualities

that can’t be captured so easily.

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Thunder Bay Regional Health Sciences Centre

Farrow Partnership Architects

Credit Valley Hospital

Farrow Partnership Architects

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Credit Valley Hospital

Farrow Partnership Architects

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Intangible qualities have

tangible benefits.

“So much of long term success is

based on intangibles. Beliefs and

ideas. Invisible concepts.”

Isadore Sharp,Chairman and CEO,

Four Seasons Hotels, Resorts and Residences

What are some of “the givens”

of working with intangibles?

The nature of intangible qualities

• Connection between

intangibles and

tangibles is not always

obvious.

• Typically valued at zero

by those who resist

assigning rough

numbers.

• Often dismissed by those who

believe that only things that

can be counted count.

• Direct personal experience at

a hospital can change the

minds of those people

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How does something that important get left out?

It’s the result of a process that

pays little attention to precisely

defining and monitoring

human-centered design quality

standards.

Well…how can this be fixed?

Design Quality Standards

that take into account the

human nature of design

. . .created through open

inquiry that explores aspects

of the hospital environment

that decision makers may

never have considered

Using an dialogue and discoveryprocess that draws on the work

of leaders in learning andgroup dynamics, including:

Donald Schoen: reflective practice, MIT

Chris Argyris: organizational learning, Harvard

Karl Weick: “sensemaking,” foreseeing problems, Michigan

Malcolm Knowles: adult learning principles

Kurt Lewin: experiential learning

William Isaacs, dialogue & thinking together, MIT

A better way.

Jointly set

ambitious

boundaries.

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source: Farrow Partnership Architects Inc.

Norfolk General Hospital

Farrow Partnership Architects

Think through

the possibilities

together.

A better way.

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Format

• Facilitated dialogue and

discovery

• Half-day, includes steering

committee and key

consultants

Pre-Design Workshops

Purpose

• Uses shared learning approach

to raising aspirations

• Identify and prevent roadbocks

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Diagnostic Tools

Format

• Create strategic criteria in

four categories

• Use as basis for

constructive dialogue

Purpose

• Highlight “say-do” gap between

good intentions and reality

• Monitor progress toward these

design and planning priorities

• Fast, simple way to keep project

intangibles on target

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Brand Discovery and Image Analysis

Workshop

Format

• Facilitated critique of built

design images

• Analyze message

conveyed by various

approaches to design

Purpose

• Create better critics to assess

intended brand image

• Define how message will

translate into physical form

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Pre-Design Workshops

Format

• Dialogue and discovery

• Forum for thinking options

through together

• Aims to make design

process transparent

Purpose

• Promotes shared responsibility

for legacy we’re creating

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National Oncology Center

Trinidad and Tobago

Farrow Partnership Architects

Capture the

intangibles that

emerge.

A better way.

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• Monitor project “vital signs”

• Basis of collaborative conversation

• Assess progress toward shared goals

Balanced Scorecard

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What kind of words make an emotional connection ?

“ . . . . .together these guiding

principles will provide the

framework for planning the new

hospital.”?

…need to be more precise, more inspiring more human.

Mundane words lead to mundane results.

Wellesley Central Place / Rekai Centre

Farrow Partnership Architects

How do we know this is a better approach?

The Angus Reid Report

• Report based on anonymous interviews

with six healthcare client representatives,

undertaken by an independent North

American research firm1

1. Angus Reid Strategies

www.angusreidstrategies.com

The Angus Reid report feedback

“...learned as much about ourselves as

we did about the principles of design.”

“...raised expectations for what is possible.”

“...that iterative process

was really important.”

“...provide hope and inspiration.”

“...optimum balance between reaching all the

desires of the facility and maintaining cost

effectiveness.”

The Angus Reid report feedback

Interviews with six healthcare clients representing these projects:

Credit Valley HospitalKaplan Medical Center Colchester Regional Hospital

Thunder Bay Regional Health SciencesBluewater Health Kelowna General Hospital

The learning process

“We learned what our own important

values were in terms of design features

– they weren’t sold to us, they were

actually developed by us.”

“…created a shared sense of

responsibility for the outcome of our

design standards amongst

stakeholders and the architects.”

Shared responsibility

Specific and meaningful

“The design standards we developed were

specific and meaningful to our project

stakeholders.”

Specific and meaningful: establishing a physical identity

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Co-creation process

“The process of developing and

implementing design standards could be

described as one of “co-creation” for what

was achieved.”

Kaplan Medical Center

Farrow Partnership Architects

The concept of co-creation

Dialogue process

“...helped stakeholders understand relevant

issues, options and the significance of their

choices.”

Minimizing roadblocks

“... The design standards creation process

helped identify potential roadblocks and how

they might be circumvented.”

Raising expectations

“...raised my expectations of what is

possible.”

St Mary’s Hospital /Sechelt, British Columbia

Farrow Partnership Architects in association with

Busby Perkins + Will Architects

People inherently want to

do / build something great

for themselves and their

community.

Concluding Thoughts

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Wade into the conversation on intangibles

This is not about force-feeding or buy-in

Human Process = Human Design

Concluding Thoughts

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Bringing Hospitals to LifeDESIGN QUALITY STANDARDS

Farrow Partnership Architects Inc.

Tye Farrow, B Arch, M Arch UD, OAA, FRAIC, MAIBC, NSAA, NLAA

INTERNATIONAL ACADEMY FOR DESIGN & HEALTH

6TH WORLD CONGRESS

SINGAPORE | JUNE 25, 2009

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