Presentations

Clinicians for Design: A Convergence of Expertise to Enhance Cognition and Healthcare Design

Presentations

Event: The Academy of Neuroscience for Architecture (ANFA) – Congress, Salk Institute, CA
Title: Clinicians for Design: A Convergence of Expertise to Enhance Cognition and Healthcare Design How Architecture Impacts our Health
Format: Poster presentation
Authors: Eve Edelstein, Diana Anderson, Thomas Grey, Desmond O’Neill
Date: September 20-22, 2018

Dochitect participates in a Poster Presentation at The Academy of Neuroscience for Architecture 2018!

Click here to see the full 2018 ANFA Conference abstract proceedings from the “Shared Behavioral Outcomes” event

ABSTRACT:
Background:
Increasingly, clinicians are asking not only for the architect’s perspective, but to develop a design skill-set and knowledge base that will allow them to help shape the future of hospitals, medicine, and healthcare.

Purpose/Objectives:
Clinicians for Design is an international network of clinicians and researchers with a vision to inspire and accelerate the design of environments that enhance health outcomes through innovations in healthcare spaces, technologies, care delivery systems and policies (1). The inaugural Clinicians for Design workshop was hosted at the Royal College of Physicians, during the European Healthcare Design conference, London, UK in June, 2017. Thereafter, workshops and research activities with hospitals and academic medical centers are exploring key lessons learned from the clinicians, healthcare system leaders, and medical researchers. Specific objectives include the application of research to improve practice, meetings to increase clinician understanding of the architectural process, and integration of clinical expertise with design-thinking.

Methods/Results:
As ‘neuro-architectural’ research converges with clinically-informed design, it has inspired the emergence of new models of practice for dementia care. A network of like-minded clinicians, neuroscientists, and a team of geriatricians and designers have formed an alliance to enable a deeper understanding of the elements which contribute to dementia-inclusive design in healthcare facilities. A leading cause of institutionalization for those with dementia is often spatial disorientation (2). Absence of cognitive mapping in dementia can be partially compensated for by using other forms of orientation strategies (3). Therefore, the design of healthcare facilities can significantly influence one’s spatial orientation and wayfinding abilities (4). This grant funded study aims to develop a ‘Design Audit Tool’ in line with Dementia-Inclusive Design Guidelines, ensuring equality across healthcare users (5). The goal is for inclusive, accessible, and easily understood environmental design for people with dementia, based on neurological and architectural research.

Implications:
Clinicians and designers discuss their progress in identifying dementia care pathways and research outcomes using a transdisciplinary approach. The advances towards a dementia inclusive healthcare audit tool is described, including the role of experts and emerging professionals in medicine, research, and design who seek an enduring connection between clinical practice and architecture.

REFERENCES:
(1) Anderson DC, Pang SA, Edelstein EA, O’Neill D. The Convergence of Architectural Design and Health: Clinicians for Design. The Lancet. 2018. Unpublished [Submitted, under review].
(2) Monacelli AM, Cushman LA, Kavcic V, Duffy CJ. Spatial disorientation in Alzheimer‘s disease: The remembrance of things passed. Neurology. 2003 Dec 9;61(11):1491-7.
(3) Poettrich K, Weiss PH, Werner A, Lux S, Donix M, Gerber J, von Kummer R, Fink GR, Holthoff VA. Altered neural network supporting declarative long-term memory in mild cognitive impairment. Neurobiol Aging. 2009 Feb;30(2):284-98. Epub 2007 Jul 17.
(4) Marquardt G. Wayfinding for people with dementia: a review of the role of architectural design. HERD. 2011 Winter;4(2):75-90.
(5) De Suin A, O’Shea E, Timmons S, McArdle D, Gibbons P, O’Neill D, Kenneally SP, Gallagher P. Irish National Audit of Dementia Care in Acute Hospitals. Cork: National Audit of Dementia Care. 2014.

Conference Presentations

Extreme Makeover: Hospital Edition. Physician & Architect, Dr. Diana Anderson

September 18, 2018 / Dochitect / Design for Clinical Staff, Evidence-Based Design

Presentations

Podcast: PeersSpectrum Podcast
Title: Extreme Makeover: Hospital Edition. Physician & Architect, Dr. Diana Anderson
Date: September 18, 2018

Dochitect is featured by PeerSpectrum Podcast!

What is PeerSpectrum? “The practice of modern medicine is rapidly changing, and increasingly complex. Finance, negotiation, communication, technology, personal branding and data analytics are just some of the “non-medical” skills now required of modern physicians. Simply keeping up isn’t enough. Going it alone won’t cut it either. Staying ahead requires the help of specialized experts who can be resources for your practice. This is the podcast to find those experts, both inside and outside of medicine. Turn your downtime into up-time and recharge with incredible stories and unique perspectives from your entire spectrum of peers.”

You can find the podcast on iTunes, and the PeerSpectrum website (along with other platforms like Google Play and Sticher)

Podcasts

Geriatric Care at the Intersection of Medicine and Architecture

February 27, 2018 / Dochitect / Design for Geriatrics

Webinar

Webinar Title: Geriatric Care at the Intersection of Medicine and Architecture
Webinar Date: February 27, 2018
Organization: Regional Geriatric Program of Toronto

Overview:

Healthcare design’s recent revolution towards improved patient well-being and care delivery has remained similar for several decades. Can we disrupt our current design thinking by combining medicine and architecture in order to reinvent some best practice design trends for an aging community?

By combining the knowledge of geriatric medicine and physical environmental design, the focus on prevention, rehabilitation, and independent living can allow for the building itself to become the fourth healer in addition to the patient, their family members and the clinical care team.

Webinar Feedback from Geriatricians, Clinical Staff and Administrators:

“Some of the topics presented have been things I’ve wondered about or thought myself. So this webinar has given me more confidence to suggest changes and to share this same info to others.”

“I will consider this information when doing any type of renovation or furniture purchase for our hospital. With limited funding, we can be creative in how we improve our space to meet the needs of our patients.”

“I will look for opportunities to take patients to windows and more nature friendly spaces when in my care and as much as possible.”

“I may consider approaching the patient differently. I will pass on the information to my CEO. We are currently in the process of building a new hospital and I think the information was amazing.”

“I will consider different options in areas where there is no window or natural light.”

“I will try to remember the inherent dangers that hospitals pose for patients (e.g., infections, falls, de-conditioning, pressure sores, etc) and try to always emphasize prevention over treatment.”

Webinars

Getting it Right: Designing the Process to Achieve Transformative Outcomes

November 7, 2017 / Dochitect / Evidence-Based Design, The Physician-Architect Model

Presentations

Presentation Title: Getting it Right: Designing the Process to Achieve Transformative Outcomes
Event: HealthAchive, A program by the Ontario Healthcare Association
Presentation Date: Tuesday, November 7, 2017
Event Location: Metro Toronto Convention Center, Toronto, Canada

Dochitect spoke at HealthAchieve in Toronto for the annual Capital Planning session along with Architect Tye Farrow on Process Design to Achieve Transformation Outcomes!

Read more about dochitect’s ideas on the ways clinicians and architects can find a balance between illness, health, and design in this article leading up to the talk entitled ‘Getting it right: merging medicine and architecture‘

Click here to watch this short video for a preview on what Dochitect will be discussing at the conference!

Process Design to Achieve Transformative Outcomes

Presiding:
Matthew Kenney
Director, Capital Planning and Biomedical Technology
Hamilton Health Sciences

Welcome and Opening Remarks
1:00pm

Getting it Right: Designing the Process to Achieve Transformative Outcomes
1:10pm

Despite a relationship between medicine and architecture since ancient times, the professions of hospital architecture and medical practice have rarely converged, and this convergence is recent. Since the advent of critical care technologies and advanced pharmaceutical treatments, hospital design moved into a machine-like period. Architects became challenged to maintain a sense of humanity and overcome the technical apparatus through design. Increasingly, professionals in health care and design seek shared knowledge and expertise.

An anastomosis represents the connection of two normally divergent structures; in medicine, this can mean blood vessels, or other tubular structures such as loops of intestine. This connection of separate system parts then forms a network, such as a river and its branches. How do clinicians and architects find a balance between illness, health, and design – and work together to inspire the emergence of a new mode of practice? To consider therapeutic design as a possible form of treatment requires participation of both the clinician and the architect – a true anastomosis of fields.

Dr. Diana Anderson
Physician
American Board of Internal Medicine (ABIM)
Architect
American College of Healthcare Architects (ACHA)

Tye Farrow
Senior Partner
Farrow Partnership Architects Inc.

Question and Answer Period
2:15pm

Adjournment / View Exhibits
2:30pm

Conference Presentations

MedX: Architectural Design for Improved Healthcare Delivery

September 17, 2017 / Dochitect / Evidence-Based Design, The Physician-Architect Model

Presentations

Presentation Title: Architectural Design for Improved Healthcare Delivery
Event: Stanford Medicine X
Presentation Date: Sunday, September 17, 2017
Event Location: Stanford University, Palo Alto, California, USA

How might we re-envision the hospital going forward?

Designers can walk the halls and talk to clinicians, but it can be challenging to learn the intricacies of a profession and its details of practice. Hybrid professionals can provide integrated solutions which cross disciplines in new ways, thus bridging this gap. Encouraging architects to experience medicine from a perspective that is typically hidden and allowing physicians to realize how design can create a context for participation would allow for a deeper understanding of health care delivery. By applying design-thinking to medicine, multidisciplinary approaches for solving current health care challenges can be developed.

Can architectural design impact health care delivery?

A 1984 study changed the way architects design health care spaces. Post-operative patients assigned to a room with a nature view had shorter hospital stays, took fewer analgesics and received fewer negative evaluative comments. This marked the advent of Evidence-Based Design (EBD), now standard practice in health facility design. Architects moved away from design decisions based solely on tradition or opinion, and towards built environments grounded in credible research to achieve the best possible outcomes- analogous to physicians utilizing evidence in making patient care plans. EBD research has demonstrated that design interventions can impact patient outcomes by decreasing iatrogenic infections, medical errors, and length of hospitalization. The business case demonstrates ongoing operating savings when the market share impact of EBD interventions is realized.

What is the model for architects and clinicians to work together towards a common goal of evidence-based practice?

Despite this shift towards evidence-based practice, hospitalization can often result in complications unrelated to the reason for admission, followed by an irreversible decline in functional status and quality of life. Certain aspects of hospital design can contribute to this decline. Although there is no therapeutic value to bed rest, patient rooms have remained focused around the bed. How can we re-envision design to shift the focus to early mobility? Design guidelines set minimum standards for single-patient rooms given evidence for improved privacy, infection control, and quality of care. How can design find a balance between privacy and easy physical and visual accessibilities? Research has demonstrated that certain room layouts are more conducive to clinician interactions and therefore improved teamwork. Should we begin to move away from a one-size-fits-all model for patient room design?

It may be time to disrupt our current thinking and reinvent best practice design trends.

Can we leverage architectural design to solve health care challenges?

Despite the inclusion of clinicians into the design and construction process, there remains disconnect between the initial vision of those who design the hospital and final clinical use of the space.

Conference Presentations

Virtual Windows and Beyond: Design solutions to improve the mental health of clinical staff

May 27, 2017 / Dochitect / Design for Clinical Staff

Presentations

Presentation Title: Virtual Windows and Beyond: Design solutions to improve the mental health of clinical staff
Event: 6th Annual Mental Health Symposium, Virtual Ability Island Second Life
Presentation Date: Saturday, May 27, 2017
Event Location: Online in Second Life

Virtual Ability enables people with a wide range of disabilities by providing a supporting environment for them to enter and thrive in online virtual worlds. In addition to hosting the annual Mental Health Symposium, a free professional conference open to the general public, the Virtual Ability community posts exhibits and displays related to mental health on its Healthinfo Island. The theme this year was “I can relate to that.”

Dr. Anderson speaks at The Sojourner Auditorium on Virtual Ability Island in Second Life about ways in which design and virtual technologies might support the mental health and well-being of clinical staff.

Dr. Anderson was also an invited guest on The Drax Files Radio Show to discuss the topic of ‘Mental Health in a Virtual World’. Click here to listen to the podcast.

Conference Presentations, Podcasts

Therapeutic Sanatorium Design: Where Hospital Architecture & Medical Practice Converge

February 25, 2017 / Dochitect / Evidence-Based Design, The Physician-Architect Model

Presentations

Organization: Texas A&M Health Science Center
Event: 2nd International History of Medicine Symposium
Location: Bryan, Texas
Date: February 25, 2017

Dochitect delivers the Keynote Address at the 2nd International Symposium on the History of Medicine and Related Disciplines, presenting the historical convergence between Medicine and Architecture.

As Keynote Speaker, Dochitect was introduced by Kirk Hamilton, Fellow & Associate Director of the Center for Health Systems & Design and Professor of Architecture at Texas A&M University.

ABSTRACT

Historical overview
The notion of our health is no longer identified primarily by the absence of illness, but instead has expanded to include a general state of well-being. In medicine, as in architecture, it seems that our ambition for total well-being has become fragmented, due in part to the subspecialisation of medical science, in addition to the rise of complex chronic illness and the need for multiple buildings types for delivering care- from our homes to traditional hospital buildings and now freestanding ambulatory centers.

The sanatorium as therapeutic architecture
The histories of hospital architecture and medical practices have rarely converged. The design of the tuberculosis sanatorium during the early 20^th century illustrates this infrequent intersection; the healthy building emphasizing contact with nature, developed to prevent the spread of contagions by isolating patients and preparing them for a return to normal life. As it preceded the era of antibiotic therapy, the sanatorium model did not necessarily offer any true effective treatment. With the advent of pharmaceutical treatments and critical care technology, hospital design moved into a more industrial period of machine-like centers designed to provide all levels of life-sustaining care. While medical science can often disguise mortality with technology, we are now revisiting the sanatorium model to de-medicalize architecture.

The future of healthy design
How do clinicians and architects find a balance between illness, health, and design? To consider therapeutic design as a possible form of treatment requires participation of both the patient and the caregiver. It may be time to shift our thinking and develop healthcare architecture focused on prevention, rehabilitation, and independent living by taking lessons from the sanatorium model. A future in which design of collective spaces can promote this convergence of care alongside cure should be our goal.

Keynote Presentations

Disruptive Innovation: Is it time to re-think our healthcare design strategies?

November 14, 2016 / Dochitect / Design for Clinical Staff, Design for Geriatrics

Presentations

Presentation Title: Disruptive Innovation: Is it time to re-think our healthcare design strategies?
Event: Healthcare Design Expo & Conference 2016
Presentation Date: November 14, 2016
Event Location: Houston, Texas

Dr. Anderson co-leads a round table session with Dr. George Taffet, MD, FACP, Chief, Geriatrics, Baylor College of Medicine, Houston Methodist Hospital, to discuss the impact of space design on geriatric patients and clinical staff.

Session Description:

Healthcare design’s recent revolution towards improved patient experience and care delivery has remained similar for several decades. Hospital activist Dr. Leland Kaiser stated that “The hospital is a human invention and as such can be reinvented any time.” Given that there is no therapeutic value to strict bed rest, which can in fact be detrimental and lead to deconditioning- most notably in the elderly population, should the patient bed continue to be the focal point around which we design the room? Hospital corridors are already dynamic spaces of patient physical therapy, multidisciplinary team rounding, family discussions and infection control practices. Can a hospital corridor become more than a long narrow space with equipment spilling over and laundry bins scattered throughout? The notion of separating patient and staff circulation has become best practice in healthcare design over recent years. With healthcare moving in the direction of the patient becoming the advocate of their own healthcare and clinicians providing the expertise to aid patients in their decision-making, should the physical design separate what the clinical model is trying to unify? It may be time to disrupt our current design thinking and reinvent some best practice design trends.

Learning Objectives:

To challenge current healthcare design thinking through the integration of medical knowledge and upcoming clinical trends.
Outline new ways of thinking about the space needs of clinicians by considering staff utilization of space given changing medical practices, including areas for information transfer and multidisciplinary rounding practices.
Understand the geriatric patient needs and how to accommodate complex chronic illness models within the built environment.
Review circulation and flow patterns of clinicians, patients and visitors in order to discuss the on-stage/off-stage model of wayfinding within an acute care space versus the ambulatory care model.

Session Panels:

Conference Presentations

Designing for Patient Safety: Best Practices to Reduce Medical Errors

September 27, 2016 / Dochitect / Design for Patient Safety

In The News

Event: C3 US-Arab Business & Healthcare Summit
Location: Union League Club, New York, New York
Date: September 27, 2016

About: The C3 U.S.-Arab Healthcare Summit is an annual event with the goal of developing bilateral solutions to address global healthcare challenges.

Excerpt: National and regional quality and safety strategies regarding patient treatment, patient safety and costs include actions for building knowledge about quality problems and solutions, and actions for planning and implementing solutions at different levels of the health system in order to deliver effective healthcare services. These strategies must target the needs of the population at large, with emphasis on poor and marginalized (vulnerable) populations, which have poorer access to care. Effective quality and safety improvement is the result of many activities using systematic methods over a period of time. The development of tailored strategic plans and interventions plays an important role in creating conditions to stimulate and guide the various stakeholders to improve quality of performance and resource use.

Patient Safety Panel:
Designing for Patient Safety: Best Practices to Reduce Medical Errors
Dochitect participated in a panel discussion in order to speak about healthcare design as it relates to patient safety, infection control practices (for example sink design) and imagining the hospital of the future.

Can architecture affect our health?

Can we prevent disease using architecture?

“The architect is like the physician… he must simply see to it that what he does makes everyone feel better.” – Herman Hertzberger, Dutch Architect

Click here for more information on the agenda and overview of the speaking panel on patient safety.

Panel Discussions

Intensive Care Unit Design – 25 Years of Winning Trends

June 27, 2016 / Dochitect / Design for Critical Care

Presentations

Presentation Title: Intensive Care Unit Design – 25 years of winning trends
Event: European Healthcare Design Congress
Presentation Date: June 27, 2016
Event Location: Royal College of Physicians, London, UK

Session Description:
The goal of intensive care is to provide the highest-quality treatment in order to achieve the best outcome for critically ill patients. Research supporting the impact of the built environment has exerted a strong influence on multidisciplinary design teams as they seek solutions to maximize operational efficiency and create supportive healing environments for patients, families, and clinical staff.

The ICU is an ever-changing and rapidly advancing environment, with the integration of advanced informatics adding a new layer of complexity to design planning and operations. Future ICU designs will require planning for long-term flexibility by incorporating design decisions that accommodate changing care practices and information technology.