Why Great Healthcare Design is About the Details

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08/05/2016

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When architect Ludwig Mies van der Rohe said, “God is in the details,” he was making a point that when something doesn’t work like it should, it’s because we forgot to pay attention to the details.

Is that why only 102 of the 3,617 hospitals in the U.S. received a five-star rating for overall quality in the latest data published by CMS? Did they forget to pay attention to the details?

Given that much of the data for these ratings is collected from HCAHPS surveys filled out by patients, they might have. But, whether or not you agree with CMS's methodology, details do matter.

Good to Great in Healthcare Design

In healthcare design, paying attention to the details is the difference between a mediocre project and an exemplary project. And I'm not just talking about spectacular architecture or stunning interiors. That's just eye candy.

I'm talking about the design details that impact patient outcomes, like those that mitigate noise or prevent falls. The design details that make it easier for staff to do their jobs, like those that reduce steps or relieve stress.

The CEO is in the Details

The best healthcare facilities I've seen also had the CEO in the details. One who collaborates with the project team in making decisions about even the tiniest of tiny design details, like the color of the rubber strip guard on the bottom of a corridor wall.

Some of you may be rolling your eyes at that. You may not want the CEO in the details. But he or she should be, as should representatives from other important groups who work in or use the facility.

The key is to not get ridiculous about it and just make sure that the CEO and all user groups feel that their voices are heard. Good leaders will listen to their project teams and know when to step away.

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Photo Credit: Bridgepoint Hospital, designed by Stantec Architecture / KPMB Architects (Planning, Design and Compliance Architects) and HDR Architecture / Diamond Schmitt Architects (Design, Build, Finance and Maintain Architects). Photography: © Tom Arban.

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Dennis Librandi

8 years ago

Good short comments. I have been preaching this my entire career. I say preaching because that is what it is. Because the details have architectural impact which in-turn have cost associated with them almost all but a few "Owners" CEOs or project managers for Healthcare tend to disregard details.

I had the privilege of working in hospitals for many years and understand the interdependence between departments, and patients. The details such as travel paths for stretchers should not have any manual doors that need to be opened, or door widths in an ED department from the lobby to the inside of the ED department need to be wide enough for bariatric wheelchairs to mention a few.

Sign me up as one of your choir members and I will help you preach the word. Design is in the details that make your staff, patients, and visitors life easier. The eye candy as you put it is a given, but the details is another story.

Dennis C. Librandi, Principal @ M-I-T.info

Marjorie Serrano

8 years ago

So well said Dennis. The maintenance of those details and associated costs and savings should be considered up front as well.
-From a fellow choir member

Sara Marberry

8 years ago

Thanks for your comments, Dennis! Keep preaching the word!

Robert Beach

8 years ago

This is like a breath of fresh air! A full 80% of the work we do annually is in healthcare. We have seen healthcare institutions try cutting design costs for years here in our area and it's never cost effective in the end. When dealing with patients, infection control, noise control etc.. the design needs to be on point. The last thing we want to do as a contractor is to go into these sensitive areas without having every detail possible ironed out, every submittal approved and every long lead item on order with all delivery dates nailed down. We as healthcare designers and contractors owe it to the patients and their families to be organized and efficient. We need to be able to go in and execute efficiently so that we do not put the patients or their families at risk. We need to get done a quickly as possible so that we do not disturb the patients well being for any longer than needed. This all starts and ends with a proper design.