Bringing Hospitals to Life

Tye Farrow, B Arch, M Arch UD, OAA, FRAIC, MAIBC, NSAA, NLAA Farrow Partnership Architects Inc. Bringing Hospitals to Life © Farrow Partnership Architects / Credit Valley Hospital / photo: Tom Arban DESIGN QUALITY STANDARDS 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.

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?

Thunder Bay Regional Health Sciences Centre Farrow Partnership Architects

Credit Valley Hospital Farrow Partnership Architects

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 • Often dismissed by those who intangibles and believe that only things that tangibles is not always can be counted count. obvious. • Direct personal experience at © Farrow Partnership Architects • Typically valued at zero a hospital can change the by those who resist minds of those people assigning rough numbers.

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 discovery process that draws on the work of leaders in learning and group 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 © Farrow Partnership Architects boundaries.

source: Farrow Partnership Architects Inc.

Norfolk General Hospital Farrow Partnership Architects

A better way. Think through the possibilities © Farrow Partnership Architects together.

Pre-Design Workshops Format Purpose • Facilitated dialogue and • Uses shared learning approach discovery to raising aspirations • Half-day, includes steering • Identify and prevent roadbocks © Farrow Partnership Architects committee and key consultants

Diagnostic Tools Format Purpose • Create strategic criteria in • Highlight “say-do” gap between four categories good intentions and reality • Use as basis for • Monitor progress toward these © Farrow Partnership Architects constructive dialogue design and planning priorities • Fast, simple way to keep project intangibles on target

Brand Discovery and Image Analysis Workshop Format Purpose • Facilitated critique of built • Create better critics to assess design images intended brand image • Analyze message • Define how message will © Farrow Partnership Architects conveyed by various translate into physical form approaches to design

Pre-Design Workshops Format Purpose • Dialogue and discovery • Promotes shared responsibility for legacy we’re creating • Forum for thinking options through together © Farrow Partnership Architects • Aims to make design process transparent

National Oncology Center Trinidad and Tobago Farrow Partnership Architects

A better way. Capture the intangibles that © Farrow Partnership Architects emerge.

Balanced Scorecard • Monitor project “vital signs” • Basis of collaborative conversation • Assess progress toward shared goals © Farrow Partnership Architects

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.”

The Angus Reid report feedback “...provide hope and inspiration.” “...optimum balance between reaching all the desires of the facility and maintaining cost effectiveness.”

Interviews with six healthcare clients representing these projects: Bluewater Health Kelowna General Hospital Thunder Bay Regional Health Sciences Kaplan Medical Center Credit Valley Hospital Colchester Regional 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.”

Shared responsibility “…created a shared sense of responsibility for the outcome of our design standards amongst stakeholders and the architects.”

Specific and meaningful “The design standards we developed were specific and meaningful to our project stakeholders.”

Credit Valley Hospital Website Specific and meaningful: establishing a physical identity

Co-creation process “The process of developing and implementing design standards could be described as one of “co-creation” for what was achieved.”

The concept of co-creation Kaplan Medical Center Farrow Partnership Architects

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

Concluding Thoughts People inherently want to do / build something great for themselves and their community. © Farrow Partnership Architects

Concluding Thoughts Wade into the conversation on intangibles © Farrow Partnership Architects This is not about force-feeding or buy-in © Farrow Partnership Architects Human Process = Human Design

Tye Farrow, B Arch, M Arch UD, OAA, FRAIC, MAIBC, NSAA, NLAA Farrow Partnership Architects Inc. Bringing Hospitals to Life © Farrow Partnership Architects / Credit Valley Hospital / photo: Tom Arban DESIGN QUALITY STANDARDS INTERNATIONAL ACADEMY FOR DESIGN & HEALTH 6TH WORLD CONGRESS SINGAPORE | JUNE 25, 2009

Bringing Hospitals to Life

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