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Presentations

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 20th 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.

speakingSession 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.

img_0118 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:

12 43 5 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.

img_4543Excerpt: 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.

c3-summit-image-cascade


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

c3-summit_sink-design

 

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.

ehd-critical-care-image

Dochitect speaks at European Healthcare Design 2016 about critical care design and provides an overview of winning design trends over the last 25 years. Click here to view a video of the presentation.

Dochitect also judges the European Healthcare Design Awards for Healthcare Design Projects over 25,000M2. Click here to learn more about the awards ceremony and winning designs.

Conference Presentations

The Dochitect – Where Medicine & Architecture Meet

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

Presentations

Podcast: The Doctor Paradox
Title: The Dochitect – Where Medicine & Architecture Meet
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
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