In medicine, the old adage goes: “when you hear hoofbeats, think of horses not zebras”.
This nugget of wisdom is attributed to Dr Theodore Woodward, professor at the University of Maryland’s School of Medicine, as he instructed his medical interns during the late 1940s on diagnosing an illness based on the presenting of symptoms.
The logic of Dr Woodward’s advice follows that since horses are common in Maryland while zebras are relatively rare, one could reason confidently that the sound of hoofbeats is more likely to derive form a horse than a zebra. Medically, this translates as doctors analysing symptoms and checking initially for common ailments, not rare conditions. By 1960, the aphorism was widely known in medical circles. Diagnosticians have noted that “zebra-type” diagnoses must nonetheless be held in mind until evidence conclusively rules them out.
But applying this adage to architecture reveals a key question: are we too often considering “horses” for our hospital designs? Can we push the boundaries of design and convert healthcare design from a reactive process to one that is proactive, planning for what is to come? I propose three disruptive design ideas in order to challenge a relatively unchanged healthcare model.
Should the patient bed be the focal point of the room design?
Can corridors become more than an eight-foot wide wayfinding path?
On-stage/off-stage – is separation of flows the answer?