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Presentations

The Dochitect – Where Medicine & Architecture Meet

June 19, 2016 / Dochitect / The Physician-Architect Model

Presentations

Podcast Title: The Dochitect – Where Medicine & Architecture Meet
Organization: The Doctor Paradox
Podcast Date: June 19, 2016

Podcast Excerpt:

“And I realized that I didn’t think I could work in places that didn’t support  how I worked”

Dr Diana Anderson is an Internal Medicine physician and trained Architect. Having the unique opportunity to view the healthcare environment though the lens’ of being both a physician and architect provides an incredible viewpoint on the world of healthcare. Dr Anderson is the founder of the website, dochitect.com, where the worlds of medicine and design collide.

Dr Anderson’s work is truly emblematic for everything this show represents in so far as it illustrates how physicians can add value in healthcare in a variety of ways.

hybrid-model

Click here to listen to the podcast.

Podcasts

Healthcare Design from a Universal Design Approach

May 5, 2016 / Dochitect / Evidence-Based Design

In The News

Organization: The Centre for Excellence in Universal Design (CEUD)
Event: Presentation on Universal Design in Healthcare
Location:
Dublin, Ireland
Date:
May 5, 2016

Universal Design is the design and composition of an environment so that it can be accessed, understood and used to the greatest extent possible by all people regardless of their age, size, ability or disability.

During this presentation, Dochitect discusses the application of a Universal Design approach in healthcare environments. The presentation looked at how hospitals and healthcare buildings can be designed from a Universal Design approach in order to:

DSCN1761– Improve care delivery and patient experience
– Prevent clinician burnout
– Integrate caregivers and family needs
– Foster interdisciplinary collaboration for improved care
– Address the changing practice of healthcare
– Apply design-thinking to medicine for enhanced efficiency

Click here to view the presentation slides.

Click here to view the keynote presentation video.

Keynote Presentations

A Dochitect and a User/Expert Share Views of Healthcare Design

December 15, 2015 / Dochitect / Design for Clinical Staff

Presentations

Presentation Title: A Dochitect and a User/Expert Share Views of Healthcare Design
Event: Institute for Human Centered Design Lecture Series
Presentation Date: Thursday, December 10, 2015
Event Location: Boston, MA

Dr. Anderson lectures at the Institute for Human Centered Care. Watch the session video here.

sketch2_colorSession Description:
Two experts, one an architect/physician and one a user/expert collaborated on an essay in the Health Environments Research & Design (HERD) Journal. Dr. Diana Anderson, MRAIC and Penny Shaw, Ph.D. present on the critical need for human-centered healthcare design.

Penny reached out to Diana after reading a piece in the Journal of the American Geriatrics Society (JAGS) in order to relate her story of how a window changed her experience dramatically while in long-term care. They teamed up to write a piece for HERD that builds on the topic of windows and exterior views. 

Read the HERD Letter to the Editors- A View From and On the Window here.

Read the JAGS article- Rx: Window Bed here.

Lectures

Finding Respite in the Moment: Designing for Clinical Staff

October 13, 2015 / Dochitect / Design for Clinical Staff

Presentations

Presentation Title: Finding Respite in the Moment: Designing for Clinical Staff
Event: 31st Annual Agency for Health Care Administration (AHCA) Seminar
Presentation Date: Tuesday, October 13, 2015
Event Location: Orlando, FL

Dr. Anderson speaks at one of the AHCA main speaker sessions where the theme was a focus on creating therapeutic healing environments that are inspirational to promote healing.

Session Description:

Diana CroppedHealthcare design has evolved around patient-centered care and health outcomes related to the built environment. However, clinicians face increasing workload demands and a shift in this design model is needed in order to understand the impact of space on staff efficiency, job satisfaction and multidisciplinary teamwork. Healthcare staff members utilize these areas for countless consecutive hours, working both day and night shifts. Dr. Anderson’s presentation will explain the necessity of providing staff respite areas inside the domains of the health care facility. These areas should be connected to the exterior environment to provide regenerative spaces to regain the perspective necessary for adequate care giving.

Learning Objectives:

  • Understand the medical staff experience, including design and layout requirements to accommodate movement patterns and space needs.
  • Explore the spaces needed for staff emotional support during intense periods of training, for those who serve on the front lines of patient care.
  • Gain an understanding of successful environmental components promoting staff efficiency and multidisciplinary care.
  • Describe the work hour restrictions currently underway within medical training programs across North America, changing the way physicians practice and gain an understanding of how this change affects space and design requirements.

sketch6

 

 

The sketch demonstrates the change towards a shift-work model for physicians, where work periods are regulated and hand-offs of patient information take place more frequently.

 

Conference Presentations

Epidemiology of Hospital System Patient Falls: A Retrospective Analysis

April 8, 2015 / Dochitect / Evidence-Based Design

Peer-Reviewed Publication

Publication: American Journal of Medical Quality
Publication Date: Am J Med Qual. 2015 Apr 8. pii: 1062860615581199.
Authors: Diana C. Anderson, MD, MArch, Thomas S. Postler, PHD, Thuy-Tien Dam, MD

Abstract

Patient falls are the most common type of in-hospital accidents. The objective of this retrospective descriptive study was to describe the locations and characteristics of hospital-related falls. Data on patient characteristics, including locations and fall circumstances, were collected through incident reports and medical records. A total of 1822 falls were documented at a 921-bed, urban academic hospital center over a one-year period; 1767 (97.0%) of the falls occurred in the hospital setting, 55 (3.0%) in ambulatory care. The majority of falls (80.8%) occurred within inpatient units; the remainder within the greater hospital campus. In all, 73.4% of fallers had fall prevention protocols implemented prior to the fall. The youngest age group (≤49 years) had the highest percentage of fallers. This study provides novel insights into variables found to be associated with falling, including location of falls within the hospital campus, efficacy of fall prevention protocols, and age groups.

Additional Press:

Note This research was presented at Medicine Grand Rounds, Department of Internal Medicine Resident Research Day, Columbia University Medical Center, March 26, 2014:

2014 Resident Research Poster_compressed copy Lectures, Peer-Reviewed Publications

Bricks and Morals: The Ethics of Architecture for Healthcare

February 27, 2015 / Dochitect / The Physician-Architect Model

Presentations

Presentation Title: Bricks and Morals: The Ethics of Architecture for Healthcare
Event: 2015 Meltzer Fellowship in Medical Ethics, Department of Medicine, Columbia University Medical Center
Presentation Date: February 27, 2015
Event Location: New York, NY

Jay I. Meltzer Fellowship in Medical Ethics
The Meltzer Fellowship gives internal medicine residents the unique opportunity to research medical ethics issues and present their findings to their peers. The fellowship program was conceived by Dr. Jay Meltzer, clinical professor of medicine, and designed by Dr. Lerner in collaboration with Dr. Rothman. It is funded by the Vidda Foundation. Each Meltzer Fellow selects one case for an in-depth analysis of its ethical issues and analyzes the relevant literature. The work culminates in a case presentation to the medical center community.

To learn more about the Jay I. Meltzer Fellowship in Medical Ethics click here.

Overview:

As a physician-architect, I propose to address the issue of design ethics as applied to the healthcare environment. Throughout my clinical training, I have noted instances of the harmful effects of unpleasant spaces. Through this presentation, I consider the need for an alliance between design and ethics whereby the architect can assist the physician.

Meltzer Fellowship_2015

Beyond Traditional Clinical Ethics

Architects working on healthcare projects face ethical choices:

  • Do the designs for healthcare facilities include elements which enhance or harm the institution’s duty of care for the patients and families?
  • How do architectural designs emphasize the well-being not only of patients, but also those who care for them?
  • Do architects acknowledge ethical issues surrounding patient vulnerability and family stress associated with hospitalization?
  • To what extent should non-medical needs of family members and visitors be a factor in deciding the merits of specific designs for hospital architecture?

Designing for Basic Rights

Privacy and confidentiality are considered basic rights. Safeguarding personal health information is an ethical and legal obligation. Can privacy be created architecturally when shared patient spaces are still a reality? As we move into an era of high-tech environments, what are the ethical implications of cameras integrated into the patient room design? In the realm of institutional design, some prison buildings have been shown to violate human rights. Healthy design is a growing topic, where natural light and ventilation are considered fundamental for those incarcerated. In contrast, patient and staff spaces within hospitals are still often without access to daylight. Are building codes changing?

Therapeutic Architecture

  • Patient and staff satisfaction can be greatly enhanced by well-designed facilities.
  • Beyond patient satisfaction, the architecture can be considered in the therapeutic benefit or harm to the patient. The growing field of Evidence-Based Design demonstrates that architectural design itself serves as therapy and the environment can improve healing.
  • There exists a relative shortage of compassionate spaces in healthcare facilities and clinical staff is too often excluded from being provided areas for emotional expression.

Architectural design solutions are increasingly recognized as impacting the well-being of those using the spaces, both in causing harm and improving clinical outcomes.

Lectures

What Will the ICU of the Future Look Like

December 11, 2014 / Dochitect / Design for Critical Care

Popular Press

Publication: Society of Critical Care Medicine, Critical Connections Newsletter
Date: December/January 2014, Volume 12, Number 6
Authors: Sandy Swoboda, RN, MS, FCCM; Diana C. Anderson, MD, March; D. Kirk Hamilton, FAIA, FACHA, EDAC; Charles D. Cadenhead, FAIA, FACHA, FCCM; Neil A. Halpern, MD, FCCM; Dan R. Thompson, MD, MA, FCCM
View article

Demand for intensive care unit (ICU) beds is increasing as the nature of medical practice shifts to become more multi-professional and multidisciplinary. These trends likely will be reflected in both our critical care space design and working practices. Clinicians are spending more time at computers to complete docu­mentation and more time discussing cases with the multi-professional team. Parallel to this shift toward healthcare provider teams is a growing awareness about the impact of evidence-based design principles on patient care and staff efficiency. The environment’s impact on the healing process, infection control practices and safety increasingly are studied in the context of a unit’s design and architectural layout. Hybrid professionals and interdisciplinary groups provide integrated solu­tions that cross disciplines in new ways.

In addition to assembling a task force to update the Guidelines for Critical Care Unit Design, members of the Society of Critical Care Medicine’s (SCCM) ICU Design Committee are champions for change and healthcare improvement. In this article, this diverse group shares their thoughts on the ICU of the future.

Click here to read more from the SCCM ICU Design Committee members about what the ICU of the future will look like.

Additional Press:

Note Dr. Anderson’s viewpoints on this topic, entitled “View from the Dochitect: Reflections of a Physician-Architect on ICU Design,” are presented as part of a panel discussion on the future of ICU design at the Society of Critical Care Medicine’s 43rd Annual Congress in San Francisco, CA; January 13, 2014.

Commentaries, Panel Discussions

From Bench to Bedside: Exploring the Impact of Space Design on Multidisciplinary Collaboration

November 16, 2014 / Dochitect / Design for Clinical Staff

Presentations

Presentation Title: From Bench to Bedside: Exploring the Impact of Space Design on Multidisciplinary Collaboration
Event: Healthcare Design Expo & Conference 2014
Presentation Date: November 16, 2014
Event Location: San Diego, CA

Dr. Anderson co-leads a round table session discussing the impact of space design on multidisciplinary collaboration between scientists and clinicians.

Session Description:

Diana Anderson, M.D., MRAIC, LEED AP, Resident Physician, Department of Medicine, New York-Presbyterian Hospital – Columbia University Medical Center; Thomas Postler, Ph.D., Post-doctoral Research Scientist, Department of Microbiology and Immunology, Columbia University Medical Center.

Lab hospital 1It has been documented that 80% of scientific breakthroughs occur outside the laboratory environment in social settings. Take an inside look at the research and clinical environments through the eyes of a scientist and a physician working on the same academic healthcare campus and understand the interface between the two, a true bench to bedside approach. Discuss the unique features of collaboration in the research setting and subsequent application to clinical treatment. The types of interactions that occur in the research and clinical environments will be shared , and subsequently translated into a discussion of the built environment’s impact on collaboration.

Learning Objectives:

  • Understand the impact of an interdisciplinary research approach, which is then applied to patient care. Learn how space can accommodate the independent needs of the scientist, while maintaining a balance of social interaction and discussion.
  • Recognize how this research is then taken from the bench and applied at the bedside by a clinician and how physicians use interactive spaces with the multidisciplinary team for patient care.
  • Explore ways in which the physical environment can foster this model of teamwork and enhance communication between the two environments to promote application of research. Identify barriers to effective collaboration within both the laboratory and the clinical settings.
  • Describe the types of interactions that occur in the laboratory and hospital environments in order to explore design solutions for creating interdisciplinary discussion forums within both the research and clinical settings.
Lab hospital 2

 

Conference Presentations

Drafting Meets Doctoring: An Architect’s View of Health Design as Resident Physician

September 24, 2014 / Dochitect / The Physician-Architect Model

Book Chapter

Book Title: get better! the pursuit of better health and better healthcare design at lower costs per capita. Proceedings of the 33rd UIA/PHG International Seminar. Toronto, Canada. September 24-28, 2013
Publisher: University of Florence: TESIS Inter-University Research Center, 2014
Editor: Romano Del Nord

Chapter Title: Drafting Meets Doctoring, An Architect’s View of Health Design as Resident Physician
Chapter Author: Diana C. Anderson, MD, M.Arch.
View chapter

TESIS_cover-2013

The architect Louis Kahn said that “once challenged, the architect will find completely new shapes and means to produce the hospital, but he cannot know what the doctor knows.” Imagine the lessons learned if the architect could know what the doctor knows. Take an inside look at the hospital environment through the eyes of a dochitect, a hybrid professional in medicine and architecture.

See health design from the perspective of an architect pursuing internal medicine residency training at a large New York City teaching hospital. A design journal was kept throughout the dochitect’s medical internship to record functional annotations for each subspecialty space and their relation to form the urban hospital. Join the dochitect through core rotations including the medical intensive care unit, emergency department, cardiac care unit, outpatient clinics, infectious diseases, general medicine, and geriatrics. Case studies highlighting the importance of space design are presented. Design anecdotes and functional analysis of hospital departments emphasize the practical importance of design qualities that impact the work environment for staff and the healing environment for patients and families.

The dochitect’s practical knowledge of environmental design qualities promotes health and well-being within the hospital environment. The clinicians will find the design perspec­tives useful in providing insight into their daily workspace, empowering them to return to their facilities and promote changes or become involved in renovation or new construction projects; the designers will benefit from the medical perspective and the lessons learned from an architect working within various clinical environments.

Personal anecdotes from patient case studies allow for a behind-the-scenes look and a practical understanding of the use of hospital space. The architect can know what the doctor knows.

Click here to read more dochitect diary entries detailing the design lessons learned as a medical practitioner.

Links to Purchase Book:

Standard Edition Premium Edition

 

Additional Press:

Note This topic, “An Architect’s View of Health Design as Resident Physician,” was presented at the International Union of Architects Public Health Group (UIA/PHG) Annual Healthcare Forum in Toronto, Canada; September 26, 2013.

Book Chapter, Conference Presentations

The Hospitalization Cascade: Healing or Hazardous?

September 18, 2014 / Dochitect / Design for Clinical Staff, The Physician-Architect Model

Webinar

Event Topic: The Center for Health Design, Pecha Kucha Healthcare Facility Networking & Design Event: “Innovations in Healthcare Design”
Presentation Title: The Hospitalization Cascade: Healing or Hazardous?
Event Date: September 18, 2014

Dochitect’s Pecha Kucha discussion addresses the hazards of hospitalization.

What is Pecha Kucha?  It is an informal, energetic, creative, short format presentation of 20 slides at 20 seconds per slide.

Although hospitals are places designed to diagnose, treat and heal illness, often the process of hospitalization itself causes a cascade of physiologic decline. Hospitalization is a major risk factor for older patients and is often followed by an irreversible deterioration in functional status. The negative effects begin immediately upon admission and they progress rapidly, often by the second day. A high percentage of hospitalized elderly patients end up being discharged to nursing homes, never to return to their homes or communities. What are the implications for designers who plan the healthcare campus?

Follow the process of hospitalization from the initial emergency department assessment through to discharge planning. Understand the clinical decision processes which go into making key triage decisions that determine where patients will go within the hospital. Vital medical spaces within the acute care setting are reviewed, along with ways in which hospital layout and room design can assist in preventing some of the hazards associated with the healthcare setting.

Panel Discussions
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New Book from Dochitect

The Dochitect’s Journal: A collection of writings on the intersection of Medicine and Architecture

Find out more here.

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