Tag: architect

Stars and Light and Big, Big Art

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gag600

Michael Palladino, FAIA , Richard Meier & Partners Architects, Gagosian Gallery, Beverly Hills Expansion

Do you remember the most brilliant display of stars and art observed in your life (yes, stars and art—the combination)? If you were standing on the roof of the Beverly Hills-based Gagosian Gallery this evening the question would be easy to answer. Recently, design partner with Richard Meier & Partners Architects, Michael Palladino, FAIA, commanded a project steeped in memory, revisiting their original design of this gallery. Sometimes, returning to the past is beneficial, especially to an architect. Expanding or updating a project will offer its own set of unique challenges. This one—to build adaptive reuse of retail space, and expand upon the Beverly Hills-based Gagosian Gallery’s existing space to include a roof deck, library, and art preparation area—was such for Palladino and firm.

The expansion included adding 5,000 square feet to the existing 6,600. The addition, anchored by a new 3,000 square-foot, street‐level exhibition space, was designed for better use of natural light. Palladino stated in a press release, “Over 15 years and three construction phases, the Gagosian Gallery and Richard Meier & Partners, have collaborated to create exceptional galleries that take advantage of the quality of daylight we enjoy in southern California.”
The latest addition embodies the qualities of space and light which distinguish this gallery, yet departs with its expressive reuse of an existing wood-barrel-vault roof. The natural wood ceiling, trusses and steel beam, offer a distinctive counterpoint to the airfoil wing that scoops daylight into the existing gallery. The new space utilizes skylights to balance daylight from the north and south. The expansive day-lit gallery walls, which were already known for oversize, larger-than-life art, can now accommodate even larger works in gallery space with a quality of light consistent with the original Gagosian Gallery. The glazed public street façade blends seamlessly with the existing Gallery facade and provides pedestrians a glimpse into the gallery. A single 225 sq. ft. glass and aluminum sliding door at the street allows oversized artwork to be unloaded directly into the gallery and opens exhibit space to the active Beverly Hills street.

Major interior finish details include: painted gypsum board, acid washed concrete floors and natural finish maple floors. New second-level offices and a private sky-lit viewing gallery not only address the gallery’s exhibit needs, but also to house the growing staff, as there are now more administrative employees. At the roof, a sculpture terrace provides a unique outdoor setting for installations and offers views of the city and the surrounding Hollywood Hills—views which inspire and perhaps remind the observer that while moving forward and creating something better than before is always the goal, sometimes we must return to the original to do so.

Palladino, moved to Los Angeles in 1986 to open the Richard Meier & Partners west coast office, and to design the Getty Center. Palladino earned his Bachelor’s of Arts in architecture from Virginia Polytechnic Institute, and Master of Architecture from Harvard University. He is a frequent guest lecture for institutions including USC, UCLA and LACMA. Palladino co-founded the Museum of Contemporary Arts’ Architecture and Design Council in Los Angeles. In 2008, Palladino was elevated to Fellowship in the American Institute of Architects.

 

In Memory: Richard Engler, AIA

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The AIA California Council notes with sadness the passing, on October 8, 2012, of longtime AIA Central Valley member Richard Engler, AIA. Click here to see the obituary printed in the Sacramento Bee and to leave a note in the on-line guest book.

 

In Memory: Alden Barstad, AIA, and George Brook Kothlow

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passings650

Left, Alden Barstad; right, George Brook Kothlow, photo © Phil Malten


The AIA California Council notes with sadness the recent passing of two Central Coast architects. Alden Barstad died July 28, 2012. His obituary, as published in the Monterey Herald, can be found here. George Brook Kothlow of Carmel Valley died September 5, 2012. A rich, personal remembrance of his life can be found in “In Memory of George Brook-Kothlow, Architect. 1934–2012” on Richard Olsen’s Handmade Houses blog.

 

Discovering Julia Morgan

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Architecture, architect, architects, California, Julia Morgan, Hearst Castle, Berkeley City Club, Annenberg Beach House, events, exhibits, history, tours, Arts and Crafts, Asilomar, Landmarks California, Discovering Julia Morgan, Meredith A. March, Karen McNeill

Annenberg Beach House, Julia Morgan
Photo © Landmark Heritage Foundation/Berkeley City Club



This fall is the perfect time to explore the art and architecture of Julia Morgan (1872-1957), the first woman ever licensed as an architect in California. From October through November, the Julia Morgan 2012 Festival is bringing together tours, talks, exhibits and events throughout California in a six-week celebration of Morgan’s work.

“In this centennial year of California women’s first vote, it’s particularly exciting to celebrate Julia Morgan,” says Karen McNeill, a historian and Morgan scholar involved in the festival. Julia Morgan did more than just open doors for future women architects, McNeill points out: “She spent most of her career designing a landscape for women – they designed it, contributed to building it, worked in it, promoted and effected all sorts of Progressive Era reform in it.”

Architecture, architect, architects, California, Julia Morgan, Hearst Castle, Berkeley City Club, Annenberg Beach House, events, exhibits, history, tours, Arts and Crafts, Asilomar, Landmarks California, Discovering Julia Morgan, Meredith A. March, Karen McNeill

Hearst Facade, Julia Morgan
Photo © California State Parks

Hearst Castle, of course, is the Morgan masterpiece we all know—but she actually designed an incredible 700 buildings in her lifetime, most of them here in California. Luckily, festival events are happening all over the state, so chances are there’s something going on near you.

For those in the Bay Area, the historic Berkeley City Club is kicking off the festival with an evening gala event on October 12. The City Club, which Julia Morgan designed in 1930, was originally a women’s clubhouse, but it feels more like a Mediterranean castle with its majestic arched windows, lush courtyards and dramatic Romanesque indoor pool. (Swim it with a night’s stay in one of the hotel rooms!) Another beautiful but lesser-known Morgan building, San Francisco’s Native Daughters of the Golden West clubhouse, will open its doors October 6-7 for a weekend tour and tea as part of the festival.

Architecture, architect, architects, California, Julia Morgan, Hearst Castle, Berkeley City Club, Annenberg Beach House, events, exhibits, history, tours, Arts and Crafts, Asilomar, Landmarks California, Discovering Julia Morgan, Meredith A. March, Karen McNeill

Lodge at Asilomar

Photo © Landmark Heritage Foundation

If you’re near Monterey, your must-see destination is the Asilomar State Beach & Conference Grounds, home to eleven Julia Morgan buildings in classic, wood-rich Arts and Crafts style. Every weekend in October, Asilomar will host walking tours of Morgan’s buildings—or, for a full weekend experience, Asilomar’s Julia Morgan Discovery Package gives you a two-night stay, November 2-4, in one of the Morgan lodges, along with a day trip to Hearst Castle. The contrast between these two places is astonishing. “Asilomar seeks harmony with nature, emphasizes self-restraint and community, and shows us how California women tried to shape the landscape,” McNeill explains. “Hearst Castle is a phenomenal feat of engineering with many points of interest in terms of architecture, design, craftsmanship, landscape architecture, and antiques, but is really one powerful man’s fantasy writ large.”

Santa Monica has its own hidden Julia Morgan gem, the Annenberg Beach House, a magnificent 110-room mansion where the architect herself once lived. Previously closed to the public, the Beach House just opened in 2009 as a state park and community center. It will celebrate the festival with a Morgan exhibit and tours, opening with a reception on October 14.

For more places to find the Julia Morgan 2012 Festival, check out the full calendar of events online at Landmarks California, the volunteer coalition coordinating it all.

 

AIACC Announces Dreyfuss & Blackford Architects as the 2013 Firm Award Recipient

in: DA Press Releases / 4 Comments

The American Institute of Architects, California Council (AIACC) announces Dreyfuss & Blackford Architects of Sacramento as the 2013 AIACC Firm Award recipient. This annual award is the highest honor bestowed on an architectural firm by the AIACC, recognizing firms who have consistently produced distinguished architecture for a period of at least 10 years.

Established in 1950, Dreyfuss & Blackford Architects is known as a high-quality, design-oriented regional practice that is a leader in sustainability. The firm has a well-earned reputation for creating enduring, contextual modernist buildings and environments. Since the success of its first major commission in 1959, the Sacramento Municipal Utility District Headquarters, Dreyfuss & Blackford has consistently been selected to design complex, large-scale projects intended for long-term use, a remarkable achievement for a relatively small firm. The innovative use of steel frame construction and pre-cast concrete have long been hallmarks of the firm’s work, as seen in its award-winning headquarters for CalPERS, the Public Employee Retirement System, Sacramento. Since 2000, Dreyfuss & Blackford has also explored new ways of planning open, light work environments for high security control centers such as the California Emergency Management Agency headquarters, Sacramento, and the California Independent System Operator headquarters, Folsom.

Mentoring future generations of architects is central to the firm’s culture. Under the leadership of principals John Webre, AIA; Kris Barkley, AIA; Gus Fischer, AIA; Peter Saucerman, AIA; Jason A. Silva, AIA; Scott Shannon, AIA; and Courtney McLeod Golden, AIA, the firm provides internships for high school and college students and promotes professional development amongst its staff of twenty-eight, pairing seasoned professionals with emerging architects on its project teams. The Awards jury praised Dreyfuss & Blackford Architects as “the complete package” for an architectural firm. “They have achieved the ideal balance between quality design and mentorship. Their commitment to community involvement is impressive, and their collaboration with other firms sets them apart.”

Dreyfuss & Blackford Architects has received over 100 regional and national awards for its work, including previous recognition from the AIACC with its 2003 Savings By Design Energy Efficiency Integration Award. In 2012, the firm received a Green Leadership Award from the Sacramento Business Journal for its leadership in environmental, energy-efficient design.

The AIACC congratulates Dreyfuss & Blackford Architects on this impressive accomplishment.

 

2013 AIACC Distinguished Practice Award Recipient

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2013 Distinguished Practice Award, Jonathan Segal, FAIA

Photo © Jonathan Segal, FAIA

2013 Distinguished Practice Award, Jonathan Segal, FAIA

Photo © Jonathan Segal, FAIA

2013 Distinguished Practice Award, Jonathan Segal, FAIA

Photo © Jonathan Segal, FAIA


2013 Distinguished Practice Award

Jonathan Segal, FAIA

Jonathan Segal, FAIA, has created a unique form of practicing architecture. He has lectured extensively throughout the United States and in Europe on his work and his way of creating meaning for architects. No longer does the client control the architect. In 2007, he created a full day seminar in which other architects could learn to become Architects as Developers. Attendees ranged from students, to established practitioners from Central America to Europe. With two key lectures, in Los Angeles and Washington DC, Jonathan’s intention was to allow access to all of the architectural community.

 

Edward McCrary, 77, Bay Area architect

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architect, San Francisco Airport

Edward McCrary - Photograph courtesy of HOK

Some architects win public acclaim by designing buildings that capture the eye. Others earn the respect of their peers by making sure those buildings move from the drawing board to reality.

Edward McCrary, who was 77 when he died Thursday of cancer at his home in Hillsborough, was the latter.

Trained as a structural engineer, Mr. McCrary spent decades in the Bay Area working out of the limelight on such high-visibility projects as the Coliseum in Oakland and the International Terminal at San Francisco International Airport. Read more

 

Book Review

in: arcCA 10.3 / 1 Comment

arcCA 10.3, book review, Iggy Peck, AIACCIggy Peck, Architect, by Andrea Beaty, illustrated by David Roberts
New York: Abrams, 2007
Peter Exley, FAIA, and Sharon Exley, MAAE

Iggy Peck is the architect we all want to be, the engineer and author of lovely, exuberant structures made from the most exceptional and unexpected materials. Who couldn’t help but love a Gateway Arch if made of towers of pancakes and coconut pie?

Iggy’s tale is of one loved and encouraged by parents to follow his heart. Many of us will recall parents who were nurturing—if perhaps a tad curious about our creative quirks—or a teacher who tolerated our eccentricities, if not with approval, with fondness and patience. Yet it is Iggy’s teacher who first takes a jab, makes a joke, and attempts to extinguish his creative efforts. Banished with his chums to the periphery of the classroom, Iggy the outsider doodles his escapist architecture, and, as the class become victims of a terrible calamity, it is he, our hero, who uses his architectural nous to save the day. Bravo Iggy! Even his resuscitated teacher is impressed, and Iggy’s pals give the reader that look of told-you-so smugness—perhaps they didn’t exactly understand Iggy’s fascination with architecture, but he’s their friend, and they never doubted his brilliance.

Andrea Beaty’s poetic story of Iggy is most charming, but it is David Roberts’s illustrations that bring Iggy to life (and give away his Midwestern location). The drawn Iggy is tiny and quirky, especially set against his own towering structures, but he is a master builder, in charge of his destiny. Each page is a visual treat, filled with architectural details and historical references that lend themselves to close inspection. A clever use of white space and the double page spreads help create the sensation of height and urban density on every page, while giving the impression that Iggy’s imagination grows along with each new creation.

Iggy “quirks” up quite a few of our favorite buildings: architectural aficionados will enjoy the many references to iconic buildings and structures, though they may be a bit obscure for those who’ve never taken an architectural history class. Iggy’s ambition is heroic and original, for sure; a little ugly and ordinary might make the details of the subject matter more accessible. But maybe that’s okay; an impossible Leaning Tower crafted from diapers is certainly funny and could be fine inspiration for a mischievous reader.

Iggy Peck, Architect, is a lovely parable of the power of creativity and an oddball manifesto to challenge the linguistic and logical biases of most educational curricula. Will it be the antidote? Likely not, but faith in creativity and invention saves the day in this book, and perhaps that will encourage a bit more tinkering with building blocks, glue, cereal boxes, and yogurt pots and inspire some future problem solvers. Read it at bedtime (it’s a quick read!), chuckle with your children, and send them to dreamland to build alongside Iggy.

Design on the Edge: a century of teaching architecture at the University of California Berkeley, 1903-2003, edited by Waverly Lowell, Elizabeth Byrne, and Betsy Frederick-Rothwell San Francisco: William Stout Publishers, 2009
Sunil Bald
From the edge, perceptions become amplified. This has certainly been the case when it comes to Berkeley’s College of the Environmental Design. One might argue that no school of architecture has been so identified with its location on the nation’s geographic and political spectrum. A handsome and thorough compendium, Design on the Edge paints a complex portrait of this influential institution.

The pedagogical contributions of the College of Environmental Design during the sixties and seventies are undeniable. The social, political, and environmental disciplines that it incorporated into architectural education are now being re-discovered, reconsidered, and reimplemented. It is, however, unproductive and inaccurate to define the school solely on these terms and by this era. Berkeley, an outpost that eventually became a touchstone in the national consciousness, struggled like other schools with tradition, history, the changing desires and values of students, the personalities of faculty, and the academy’s relationship to practice. Yet, there always seemed to be the pervasive sentiment that, distanced from the expectations of the East Coast academic hegemony, Berkeley was reinventing architectural education as it was inventing itself. A unique set of characters, from Bernard Maybeck to J.B. Jackson, and the democratic ideals engrained in California’s mythology—from the consistently high percentage of female students to the early introduction of open juries and free faculty/student dialogue—helped construct an architectural ethos that was inextricably interlaced with the sense of being on the western edge.

In the second two thirds of the book, the more recent intellectual concerns of the curriculum are described, usually firsthand by those who created it. In many ways, the pedagogical inventions of this period—from those planned, to those that were a response to local events that became national spectacle (People’s Park), to those accidentally stumbled upon (Sim Van der Ryn’s wonderful descriptions of his communal experiments in Inverness)— foreshadow much of the recent interest in design/build and sustainable communities. While some schools are finally taking these on, sometimes, as one takes a daily dose of Castor Oil, one understands how they have become germane to Berkeley. It is the latter part of Design on the Edge that holds the multiple overlapping, often contradictory voices that must have made for lively pedagogical debates and interesting faculty meetings. This latter part of the book includes seven sections, among them, “The Research Environment,” “Communities and Cultures,” “Ecology and Building Sciences,” and “Systematic Approaches.”

A section dedicated to the design studio is, however, conspicuously absent. Indeed, save for Dan Solomon’s erudite and entertaining article, the school’s influential design figures from the last thirty years (Saitowitz, Mack, Fernau, and others) are mentioned only in passing. This is a striking contrast to how the history through William Wurster’s deanship is told, with change and interdisciplinarity happening through design, not in spite of it.

A the editors note, writing a history of the period since the 1980s is difficult, there not being sufficient time for reflection. Accordingly, Design on the Edge feels more like a 75-year history than reflections on a century, and it misses the opportunity for the CED to show how its recent past, while much debated, is ready to be reshaped for a world engulfed in globally interconnected academic, architectural, and environmental exchanges. As Asia’s rise continues, Berkeley is clearly no longer at the edge. The natural question is, “Where does it go from here?”

Grid/Street/Place: Essential Elements of Sustainable Urban Districts, by Nathan Cherry with Kurt Nagle
Chicago: American Planning Association, 2009
David Thurman

In Grid/Street/Place, Nathan Cherry, Kurt Nagle and their collaborators pursue the ambitious goal of identifying, analyzing, and summarizing the key attributes of sustainable urban districts around the country. The book’s figure-ground diagrams, charts, perspectives, and photographs form a valuable resource, a worthy complement to the toolkit of any urban designer and architect who works at such a scale.

In the first two chapters, the authors lay the groundwork by presenting examples of both classic districts—Country Club Plaza in Kansas City, Mizner Park in Boca Raton, and Malaga Cove Plaza in Palos Verdes Estates and contemporary mixed-use districts, such as Playa Vista and L.A. Live in Los Angeles and Mockingbird Station in Dallas. They considerimportant elements of districts, such as squares, greens and parks, shopping streets, and “places” (reflecting a yet smaller scale).

The book’s restrained drawing style is applied with consistency and rigor. Detailed, same-scale diagrams nurture comparison, encouraging the reader to make back-and forth, page turning journeys. The diagrams document scale, open space, resources, transit, and general relationships of chosen districts, along with dimensionally accurate plans. The authors have the good sense to compress the district plans on one or two pages in each chapter, further enabling comparison. Each chapter includes a summary of findings and common attributes, and, although the text lacks literary flourish, one comes to appreciate the no-nonsense, “focus on the essentials” attitude.

The book betrays an unstated geographic bias in its selection of districts. As an Angeleno, it is a bias I appreciate and applaud. The authors choose a number of districts from the Los Angeles metropolitan area, which reflects their professional interests but is also a unique service to the region, considering the Southland’s enduring reputation as the front line of sprawl, lacking significant public spaces. L.A. is important, because it is not a bucolic environment, is very much a contributor to the global environmental crisis, and needs a toolkit of real solutions.

Early in the book, the authors discuss the necessity of using branding as a key part of the urban re- envisioning process, an approach that seems directly related to their professional expertise and is highlighted by a later chapter on “shopping streets”—a welcome chapter, given that retail design can be a very misunderstood topic dominated by specialists, and that it is not an area of deep expertise in most architectural offices.

If there is a less satisfying aspect to the book, it is the light touch on the topic of sustainability itself. While the chosen districts are clearly sustainable places, the attitude seems to be that their sustainability is self- evident, owing to their compact, mixed-use, and transit-oriented character. Yet this approach bypasses a critically focused discussion of sustainable performance, climate change, and other significant environmental pressures, none of which are in fact mentioned. In this area, the book is missing significant data and analysis, comparable to that applied to the physical characteristics and retail circumstances of the districts.

One would expect that performance in delivering solutions to greenhouse gas reduction, addressing stormwater needs, incorporating sustainable buildings, or reducing often excessive parking ratios (a potentially critical means to discouraging automobile use) would be central to the discussion. One could easily imagine highly aggressive performance indicators and checklists added to each chapter that analyze how the districts deliver on the critical global deadlines we face. This is the evolving core of professional practice. If there is one suggestion I would have, it is that the authors consider such issues in a revised version.

 

Economic Recovery in California is Hampered by Declines in Public Spending

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“The economy is fundamentally sound in California but recovery will continue to be slow,” Cliff Brewis, Senior Director of Editorial Operations at McGraw-Hill Construction, told the AIACC Board of Directors at their recent meeting. A variety of different media and economic analysis models contribute to this assertion. It is interesting to see how markets in throughout California are faring.

While overall the marketplace is improving cautiously, there are limits on how much it can grow in 2012. The biggest issue is public construction funding, which continues to decline. While there was an upturn in 2008/2009 as a result of the federal stimulus funding, this market segment is once again losing momentum as those funds are eliminated; it is anticipated that public spending on facilities (prisons, fire stations, etc.) will continue to decline through 2013. However, while public funding of school facilities has been cut back in every state in the country, in California, this model will continue through 2013 but ultimately increase somewhat because of growth in school age populations.

“These declines in public spending have to be offset in private spending to see real economic recovery,“ according to Brewis. While California has historically been largely dependent on new home construction as an economic agent, new housing starts continue to move cautiously, due to the current large inventory available. It may be three to five years before we see increases in new home construction; however, spending on housing for the aging population and renovation work are two segments that are definitely on the rise. And retail, which has been sluggish in its recovery, may offer a new opportunity in construction of distribution centers as the public’s buying habits are moving from “brick and mortar” facilities to online purchasing.

Additional pockets of opportunity include apartment complexes, assisted living buildings, and data centers. The complications in single family housing are driving increasing demand for apartments, and they are likely to be a good source of construction for a number of years. Assisted living has been relatively stable, and cloud computing will drive further demand for data centers.

For the complete report, click here

 

Metrics in Healthcare Architecture

in: AIA California Council / 2 Comments

Sacred Heart Medical Center, Anshen+Allen/Stantec, photo © Cesar Rubio

The healthcare industry is in crisis right now, and not just because of spiraling costs. Despite the Hippocratic principle to “first, do no harm,” an enormous amount of harm occurs in healthcare facilities—from misdiagnosis to medical errors to hospital-acquired infections. The growing evidence-based design movement seeks to identify and measure how the building environment can improve patient outcomes in healthcare environments.

Plenty of statistics demonstrate that being hospitalized is one of the most dangerous things that can happen to a person. According to the World Health Organization, each year 1.7 million patients in the United States pick up an infection while in the hospital, and 100,000 die. The built environment has a significant role to play in either contributing further to the problem or helping to solve it. What architects and interior designers need is credible evidence that can inform design decisions, as opposed to anecdotes or personal preference.

Sacred Heart Medical Center, Anshen+Allen/Stantec, photo ©David Wakely


Testing hypotheses
For example, Anshen+Allen (now a part of Stantec Architecture) designed a new facility, Sacred Heart Medical Center at RiverBend, for the Oregon-based nonprofit medical center PeaceHealth. PeaceHealth is a partner with the Pebble Project, the main research initiative of the Center for Health Design (CHD), a nonprofit organization formed in 1993 that works with healthcare providers to document examples of healthcare facilities whose design has made a difference in the institutions’ quality of care and financial performance. Each partner in the Pebble Project chooses which areas they are interested in evaluating. For PeaceHealth, one of the key areas of focus was reducing staff injuries.

One way to do this is to provide a patient lift in each patient room, which helps staff immensely and also reduces the risk of patient falls. These lifts are expensive to install, however, and the initial hypothesis was that given the estimated savings from reduced injuries, the return on the investment would likely be ten years. Based on that, the preliminary decision was made to incorporate patient lifts into 10 percent of the new hospital’s patient rooms.

To test the hypothesis, PeaceHealth decided to measure the potential effectiveness of the patient lifts during the design process for the new hospital. The organization converted a few patient rooms in its existing hospital in downtown Eugene into mock-ups of the ones intended for the new hospital, including patient lifts. These mockups functioned as actual patient rooms for over a year. The study found that patient lifts drastically reduced patient falls, staff injuries, missed time from work, and the need to train temporary replacement workers. According to the results of the study, the actual return on investment would be only about two to three years. And so the decision was made to install patient lifts in all of the rooms. The Center for Health Design shared the results of that study with both the design and healthcare professions, and patient lifts have since become accepted as a best practice. In a recently completed hospital, Mills Peninsula in Burlingame, we installed patient lifts in one hundred percent of the rooms. Subsequent studies showed that most injuries were caused when hospital staff were moving relatively light patients. We anticipate that this small improvement will dramatically reduce staff and patient injuries.

Integrating architectural and operational solutions
Architectural interventions alone are not enough. Of course, some evidence-based design strategies are purely architectural in nature, such as incorporating high levels of natural light. Numerous studies have shown that when patients are in an environment with views and access to daylight, their hospital stay is shorter and they have a better recovery. Natural lighting and views also improve staff satisfaction and reduce distractions, lowering the rate of medical errors.

But most evidence-based design strategies, such as patient lifts, single-patient rooms, and acuity-adaptable patient rooms, are operationally driven but architecturally implemented. An acuity-adaptable patient room, for example, allows practitioners to change the level of care around the patient, as opposed to the traditional solution of moving the patient from a critical care unit to a medical/surgical unit or a step-down unit. Every time a patient is transferred, it creates an opportunity for complications—patient or staff injuries, clinical errors, and increased possibility of infection, miscommunication, and even simple confusion over whether the patient is going to the right place. Acuity-adaptable rooms minimize the number of physical transfers for the patient, thus minimizing risk. But staff must be properly trained in order for the system to work.

Green Patient Lab, Anshen+Allen/Stantec

Navigating complexity
Healthcare projects are extremely complex, and often the challenge of implementing evidence-based design and other metrics to healthcare is that introducing any one strategy creates a variety of results, and solving one problem may create others.

Anshen+Allen has created what we call flight-ready checklists, which we implement at the very beginning of a project. The checklists allow us to identify at the outset all the best practices that we believe are important to achieve in a given project. Different practices may rise to the top, depending on the particulars of the project—for example, reducing errors, enhancing patient or staff satisfaction, and improving building performance. As we go through the process of design and are challenged by both financial and schedule restrictions, the checklist helps us hold onto those original values. It also helps resolve potential conflicts between strategies. The purpose of the checklist is not to automate the evidence-based design process, but rather to help the design team manage and retain the best practice features to assure they are not eroded during subsequent design phases. Recently, the checklists have been expanded into matrices that simultaneously track best practices for both evidence-based design and sustainable design, so a solution in one realm does not unintentionally compromise a solution in another.

Building information modeling is useful, allowing designers to simulate the performance of the building, whether that means the amount of daylight that reaches into patient rooms, the amount of heat transfer, water consumption, or distances that staff have to travel. The challenge is to put all these different criteria into the mix and understand how a change in one area may affect another.

For a project for the University of California San Francisco, we teamed with chemists at McDonough Braungart Design Chemistry (MBDC) to evaluate the long-term human health aspects of building materials by identifying known toxins used in their composition. To investigate materials is time-consuming and challenging, especially since the research isn’t always in agreement and manufacturers don’t always fully disclose the contents of their products. We started with the patient room and exam room, considering materials commonly used on different surfaces: walls, floors, and ceilings. We then prioritized the surfaces according to which ones have the most impact on occupants—for example, people are more likely to come into contact with the walls than the ceiling. The results of the study influenced which finishes and products we chose, not just in the patient and exam rooms, but throughout the facility.

Yet measuring the impact of materials on environmental health is equally crucial. Unfortunately, some products perform well in one area and very poorly in the other. For example, paints with antimicrobial additives are highly toxic to the environment. Realizing this led us eliminate the use of these materials and to focus on other strategies for preventing the spread of infection.

Given rising healthcare costs, we are in a time of acute financial scrutiny. Major decisions are made on the basis of cost. Almost every institution is looking for ways to reduce square footage to save money. Balancing the cost implications of architectural and operational decisions is necessary—and not always intuitive. It took many years for the Facilities Guidelines Institute, which establishes minimum standards for healthcare planning throughout the United States, to change its guidelines to recommend that hospitals switch to all single-patient rooms. There was a perception that the switch would cost more, because if every room is private, that requires more square footage. Even with strong evidence that private patient rooms significantly reduce the spread of infection, reduce medical errors, eliminate the need for patient transfers related to roommate incompatibility, and increase patients’ willingness to share their medical history, it took a long time for this approach to gain widespread acceptance. Initially, it seemed obvious that one of the metrics should be square footage. But if single-patient rooms enable better bedside care, more point of care procedures, better clinical outcomes, shorter lengths of stay, and less turnover, then minimizing room sizes might actually be the more expensive solution. Right-sizing rooms, as opposed to downsizing them, could easily become not only clinically but also financially beneficial.

The future is in knowledge sharing
There are a growing number of organizations and resources for metrics related to the intersection of healthcare and design. The Healthy Building Network’s Pharos Project provides health and environmental data about the manufacture, use, and end of life of common building materials. The Health Environments Research and Design Journal is the first interdisciplinary, peer-reviewed journal to focus on healthcare environment research. Kaiser Permanente has also partnered with the Center for Health Design to create the Ripple Database, an open-source, searchable, web-based database of Kaiser’s best practice design strategies related to patient safety, worker/workplace safety, and environmental safety. In addition to the Center for Healthcare Design, other organizations engaged in research into metrics include The CARITAS Project, the Center for Medicare and Medicaid Services, the Institute for Healthcare Improvement, Health Care Without Harm, and the Robert Wood Johnson Foundation.

Healthcare institutes historically have not shared statistics about medical errors in their facilities, and design firms have traditionally been protective of intellectual property. But the healthcare crisis is serious, and attitudes are changing. There’s a growing trend toward sharing information, as designers and institutions recognize that those that share knowledge are often perceived as leaders in this collaboration.

Green Patient Lab headwall, Anshen+Allen/Stantec;
right, Sacred Heart Medical Center, Anshen+Allen/Stantec, photo ©David Wakely