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The Physician-Architect Model

The Journal of Health Design Podcast – Dochitect

September 4, 2019 / Dochitect / Evidence-Based Design, The Physician-Architect Model

Presentations

Podcast: The Journal of Health Design
Title: Diana Anderson: “Dochitect” who combines medicine and architecture
Date: September 4, 2019

Dochitect is featured on The Journal of Health Design Podcast!

The Health Design Podcast · Diana Anderson, “dochitect”, combines medicine and architecture.

Diana Anderson, MD, M.Arch, is a healthcare architect and a board-certified internist. She completed her medical residency training at New York-Presbyterian Hospital, Columbia University Medical Center in the United States. As a “dochitect,” Dr. Anderson combines educational and professional experience in both medicine and architecture. She has worked on hospital design projects globally and is widely published in both architectural and medical journals, books and the popular press. She speaks frequently about the impacts of healthcare design on patient outcomes, staff satisfaction and related topics. She is co-founder of the Clinicians for Design Group, an international network of leaders that seeks to inspire and accelerate the design of environments and systems. Dr. Anderson was recognized for her contributions to the field by the American Institute of Architects’ Academy of Architecture for Health U40 List of Healthcare Design’s Best under 40. As an immediate past Fellow at the Harvard Medical School Center for Bioethics, she explores space design and ethics. She is currently a geriatric medicine fellow at the University of California, San Francisco.

“Listen to @dochitect, who says every room in the #healthcare space deserves equal attention, including corridors. #architecture and #medicine work together to create better spaces and #Health outcomes. #PatientExperience #PatientCare#DesignThinking”

Podcasts

Habitats for Healers: Architectural Design for Clinicians

April 29, 2019 / Dochitect / Design for Clinical Staff, Evidence-Based Design, The Physician-Architect Model

Presentations

Event: Harvard University Graduate School of Design Lecture Series
Title: Habitats for Healers: Architecture Design for Clinicians
Date: April 29 2019

Dochitect was invited to the Harvard’s Graduate School of Design to discuss design for health providers:

 

Lectures

“There’s No Ramp Here” How do we cross disciplines?

March 30, 2019 / Dochitect / Evidence-Based Design, The Physician-Architect Model

Presentations

Event: Health Equity and Leadership (HEAL) conference, T.H.Chan School of Public Health, Harvard University
Title: “There’s No Ramp Here” How do we cross disciplines?
Date: March 30, 2019

Dochitect was invited to participate and run a workshop for the annual HEAL event at the Harvard T.H.Chan School of Public Health! 

CLICK HERE for more information about the event!

 

Conference Presentations

The Ethics of Healthcare Architecture

February 26, 2019 / Dochitect / Evidence-Based Design, Health Design & Ethics, The Physician-Architect Model

Commentaries

Publication: Architecture Ireland
Publication Reference: February 26, 2019
Authors Diana Anderson

View Online Journal Issue HERE

 

 

 

Click HERE to read the full article

Commentaries

Design Museum Boston – The Architecture of Health

January 25, 2019 / Dochitect / Evidence-Based Design, The Physician-Architect Model

Presentations

Event: Design Museum Boston
Title: The Architecture of Health
Date: January 25, 2019

Design Museum Mornings with Diana Anderson, MD, M.Arch, healthcare architect, and a board-certified internist.

Can architecture impact health? Increasingly, clinicians are asking not only for the architect’s perspective, but to develop a skill-set and knowledge-base that will allow them to help shape the future of health. Architects aim to engage clinical professionals in research, education, and practice. For some patients, design can succeed where drugs may fail. For clinicians, the built environment can support and improve efficient care delivery. We all have a shared goal in seeking to enhance health outcomes through innovations in the design of healthcare spaces.

Dochitect speaks at the Design Museum Boston Morning event about The Architecture of Health!

Keynote Presentations, Lectures

What can healthcare providers learn from architects?

December 11, 2018 / Dochitect / The Physician-Architect Model

Blog Post

Publication: CLOSLER.org, Johns Hopkins Medicine
Title: What can healthcare providers learn from architects?
Publication Date: December 11, 2018
Authors Diana Anderson, MD

View Blog Post

Five Lessons From Architectural Design

Closler.org has an email subscription of ~6,000 healthcare providers and is regularly visited by thousands of individuals from 70 countries. 
Emerging professionals in architecture and medicine are moving beyond infrequent intersections and seek a convergence of career models. What can clinical practice learn from the design field of architecture?

Here’s what I’ve learned in my career as both architect and physician:

Lesson 1: “Always design a thing by considering it in its next larger context – a chair in a room, a room in a house, a house in an environment, an environment in a city play.” – Eliel Saarinen, Finnish Architect, 1873-1950
Architects are taught to respect context and design for the experience of being in a place. As providers, learning the context of our patients and their social determinants of health is key to the biopsychosocial model of care. It becomes more than just the pathophysiology of presenting illness or symptoms.

Lesson 2: One size does not fit all.
At a recent design meeting for a critical care renovation project, the intensivist noted the provision of a large conference room in the proposed floor plan which could be used for both rounds and to break bad news to families. The physician recounted that from his experience, under or oversized rooms can have an effect on the experience of these difficult conversations – a separate smaller room is often needed. As providers, we know that patients and disease effects are not created equal. Patient health burdens can be unequal within a similar pathophysiological framework.

Lesson 3: In architecture a “parti” is the central idea of a building, usually represented as a diagram in shapes to explain the design concept.
As designers, we need a way to explain the idea of our product. We use the parti as a guidepost in designing the many aspects of a building, and always consider how its design can express and reinforce the essential idea of the building. In medicine, our patient histories involve a chief complaint and history of present illness, but what would happen if our clinical parti was the social history and the patient’s overall narrative as our foundation –  who they are, what is important to them. These should never become lost and should always ground us in the care of a patient.

Lesson 4: “We shape our buildings: therefore they shape us.” – Winston Churchill
Architects design for experiences by developing spaces for people. Indoor and outdoor spaces, buildings, landscape architecture, and city planning have important effects on us – design can promote exercise and health, keep us safe, inspire us and made us feel good or bad. As providers, we care for people and in the process impact their lives. In return, patients can profoundly impact our practice and lives as well. Just like architecture, medicine is not only a science but also a craft.

Lesson 5: “The Sun does not realise how wonderful it is until after a room is made.” – Louis Kahn, American architect, 1901-1974
In architecture, the concept of void or negative space is something we incorporate into design of buildings. There is a well-known series of black and white photographs which capture the sky by viewing upwards within narrow European streets. The building facades are in silhouette around the edges and the sky becomes a form, shaped by the buildings. One cannot have a building without the framing of abstract spaces/voids; the negative can become the positive and the two work in harmony to create the whole. As clinicians we cannot forget this “negative space” in addition to the positive. Sometimes not pursuing a treatment may be the best option for a patient, or even just a silent pause during a patient history can give someone a chance to mention something important.

Together, clinicians and architects can find a balance between illness, health, and design, inspiring the emergence of a new mode of practice. Therapeutic design as a form of treatment and support requires participation of both the clinician and the architect.

Blog Post

The convergence of architectural design and health – The Lancet

December 7, 2018 / Dochitect / Design for Clinical Staff, Evidence-Based Design, The Physician-Architect Model

Peer-reviewed publication

Publication: The Lancet
Publication Reference: December 7, 2018
Authors: Diana C Anderson, Steph A Pang, Desmond O’Neill, Eve A Edelstein

View Article

The Lancet features Architectural Design and Health!

“During my medical residency, I realized how much burnout affected us as trainees on the front lines of care. In particular, I noticed that much of that difficulty was tied to the areas in which we worked—constant noise, poor lighting, and lack of daylight. Space design made patient care challenging at times, too; for example, not being able to access the correct side of my patient to perform the physical exam as I had been taught. I often considered that the built environment could improve care delivery with more collaboration amongst designers and clinicians.”— Diana Anderson

 

The disciplines of public and environmental health have long recognised the impact of the built environment on health. Yet clinicians have limited opportunity to engage with architects and design professionals, and the impact of health-care design is largely absent from health policy discussions. However, this is beginning to change.

Read more HERE!

 

Peer-Reviewed Publications

Why your practice needs a makeover

December 6, 2018 / Dochitect / Design for Clinical Staff, The Physician-Architect Model

Blog Post

Publication: KevinMD.com, Blog Post
Publication Date: December 6, 2018
Authors: Diana Anderson, MD, MArch & Keith Mankin, MD

View Blog Post

Why your practice needs a makeover

The spaces where we live and work can exert both strong and subtle influences on the way our brains function. They can make us anxious, distracted, inefficient or tired, affecting not only our cognitive ability but also our emotional state, mental stability, and physical well-being. Clinical medical practice, like much of life in our society, is tethered to indoor space, so physicians, staff and patients alike are particularly prone to these psychological effects.

The good news is that continued study of the effects of design on our well-being, and of those we work with, has led to better recognition of “trouble” points and ways to improve them. Many of these improvements are easy and inexpensive to accomplish and may lead to a better environment for engagement and healing.

The first step is an honest assessment of the clinical space and the throughput from the focus of the physician, the staff and the patients. Look at the surroundings, listen to the ambient noise, feel the amount of room and the sense of space. Let your staff do the same thing and compare responses. Even consider a simple survey of the patients.

5 design flaws that can hurt your practice

  • Lack of space for staff-to-staff interactions
  • Lack of “reset” rooms – a place where staff or provider can step away from the practice work and recharge for a couple of minutes. Many clinicians have offices, but their desks are full of distractions. A reset room should be the opposite
  • Inefficient and clumsy exam room design
  • Lack of natural lighting (or an alternative if the space doesn’t allow windows to the outside)
  • Noisy, overly hectic waiting rooms

So what can be done about these and other problem areas in the practice design? The following is a list of suggestions, but the most important factor is a willingness to try changes. Most of these are easily reversible if they don’t work. They are workable even in shared environments (although compromises about stylistic designs may need to be made). Most importantly they will not fundamentally change the organization of the practice, although clinicians should be open even to more drastic changes if necessary. The entire healing system may be in the balance.

8 simple ideas to improve your practice

  • Find the clinic’s quiet spaces and use them. Recent guidelines have called for stricter control of blood pressure, but many practices do not even have a quiet spot to measure vital signs. A small comfortable room can be set aside for BP measurement, or even as a “coping” room for patients or staff
  • Design the patient (and staff) flow for efficiency and convenience. The goal should be to minimize steps and prevent everyone from having to retrace their steps
  • Make the waiting rooms productive spaces. Patients don’t really want the television blaring at all times. Having a usable Wi-Fi, having a small library, presenting informative information, setting up the chairs so people can interact can all go a long way towards minimizing stress and improving the mood and receptivity of the patient.
  • Choose colors carefully
  • Use the windows for natural lighting whenever possible
  • Invest in artwork
  • Design the clinic for universal use. Unless the space is dedicated to one age group or type of patient, or if it is truly a solo practice, it is useful to pick colors, furniture, and lighting that will be useful and engaging to a broad range. This doesn’t mean the palette needs to be olive drab
  • Develop spaces for education and engagement. The ambulatory care experience is not just about the doctor/patient interaction anymore. It now encompasses teaching, prevention, and resources for making healthful decisions. A resource center (as simple as an orderly selection of booklets or as complicated as video and computer learning stations) can be incorporated into the clinic setting. A small conference area can allow teaching sessions

In summary, the key to making a clinic work better is to first, understand what doesn’t work; second, know what the research suggests; and third, make small incremental changes (or even large ones if necessary) that will put these practices into effect. We as clinicians must understand that the healing process is not just the “laying on of hands.” It is the entire scope of a patent’s experience from the moment they step through the office door.

Diana Anderson is an architect and physician. She is principal, Steffian Bradley Architects, Boston, MA. She can be reached at Dochitect. Keith Mankin is a pediatric orthopaedic surgeon and host, PeerSpectrum Medical Podcast.

Blog Post

Bricks and Morals—Hospital Buildings, Do No Harm

October 25, 2018 / Dochitect / Evidence-Based Design, Health Design & Ethics, The Physician-Architect Model

Peer-reviewed publication

Publication: Journal of General Internal Medicine
Publication Reference: 2018 Oct 25 [Epub ahead of print]; In print 2019;34(2),312-316
Author: Diana C. Anderson

Abstract

The volume and rigor of evidence-based design have increasingly grown over the last three decades since the field’s inception, supporting research-based designs to improve patient outcomes. This movement of using evidence from engineering and the hard sciences is not necessarily new, but design-based health research launched with the demonstration that post-operative patients with window views towards nature versus a brick wall yielded shorter lengths of hospital stay and less analgesia use, promoting subsequent investigations and guideline development. Architects continue to base healthcare design decisions on credible research, with a recent shift in physician involvement in the design process by introducing clinicians to design-thinking methodologies. In parallel, architects are becoming familiar with research-based practice, allowing for further rigor and clinical partnership. This cross-pollination of fields could benefit from further discussion surrounding the ethics of hospital architecture as applied to current building codes and guidelines. Historical precedents where the building was used as a form of treatment can inform future concepts of ethical design practice when applied to current population health challenges, such as design for dementia care. While architecture itself does not necessarily provide a cure, good design can act as a preventative tool and enhance overall quality of care.

Read more here!

Peer-Reviewed Publications

IHCD: Architectural Form + Clinical Function: A Design Paradigm Follows

October 9, 2018 / Dochitect / Evidence-Based Design, The Physician-Architect Model

Presentations

Event: Institute for Human Centered Design, Boston
Title: Architectural Form + Clinical Function: A Design Paradigm Follows
Date: October 9, 2018

Dochitect is invited to speak at the Institute for Human Centered Design (IHCD) in Boston as part of their HUBweek 2018 open door event!

“A thought-provoking talk. I also loved your sketches.”

“Diana was amazing! So articulate and thoughtful, we are excited to see what you do next!”

“‘Design matters & design can prevent disease’ – Dr. Diana Anderson @dochitect – on #ethics in architecture & design for healthcare – speaking at @IHCDesign for #HUBweek #architecture #designmatters”

Lecture overview: The delivery and design of healthcare today is rapidly changing, and increasingly complex. How are we closing the gap between designer intent and user experience? Increasingly, clinicians are asking not only for the architect’s perspective, but to develop a skill-set and knowledge-base that will allow them to help shape the future of health. Architects aim to engage clinical professionals within research, education and practice. We all have a shared goal in seeking to enhance health outcomes through innovations in the design of healthcare spaces, technologies, care delivery systems and policies. Specialized experts who can offer unique perspectives and hybrid models in problem-solving of complex systems are increasingly seen. Through combined thinking, research-based design has expanded to understand and improve the experience within healthcare spaces.

For some patients, design can succeed where drugs may fail. For clinicians, the built environment can support and improve efficient care delivery. Current trends, ideas and next steps for design to enrich our healthcare interface are presented, including an overview of:

(1) the infrequent historical intersection and recent convergence of medicine and design;
(2) the impact of architecture on health for preventative care;
(3) the future of health with an emphasis on multidisciplinary collaborative space, technology, and health spaces within our homes.

Conference Presentations, Lectures
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A Book from Dochitect

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

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Recent Articles/Publications

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    May 1, 2022
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