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Publication type: "Commentaries"

Architecture and Bioethics: A new value proposition for health care facility designers

February 5, 2022 / Dochitect / Health Design & Ethics

Commentaries

Publication: Health Facilities Management Magazine
Publication Date: February 5, 2022
Authors: William J. Hercules, Diana C. Anderson, Stowe Locke Teti, David Deemer
View article

Excerpt:
“Johann Goethe, the 18th Century polymath, once remarked, “Architecture is frozen music,” by which he meant architecture interprets and expresses the values of its time — sometimes in a general epoch and sometimes at a very precise point. Experienced health care architects will appreciate this phenomenon, as current project drivers may have eclipsed those of decades past. It is in precisely this context that designers are studying the decisions and tradeoffs that result from these normative preferences.

In health care architecture, design is being increasingly employed to affect patient outcomes, alter specific behaviors and mediate the interactions of those within health care spaces. The advances in design science have progressed to the point that the built environment in health care can be considered akin to medical interventions. And, as with medical interventions, the nature, risks, benefits and alternatives should be disclosed to patients and caregivers.

The ethics of buildings and construction typically involve environmental impacts and social equity of the built environment. And while these are important, the focus of this article is on the health care setting itself and how it affects patients, families and health care teams. While some of these effects bear on individual patients, such that an informed consent process may be sufficient, others have a population-level impact that will persist for generations, well after the designer’s direct influence.

Focused work in medicine, neuroscience and psychology is being employed to several ends but, to date, there has been little investigation of these practices. This is because the elements affecting control are neither providers nor medications, but the health care facility building itself. Broadly, this raises issues about the nature of the built environment, what constitutes a medical intervention, what architecture is expected to do and, importantly, what obligations emerge from designers’ choices.”

Read the full article HERE.

Commentaries

No Place Like Home: As the pandemic proved, long-term care homes are a health hazard

September 1, 2021 / Dochitect / Design for Geriatrics, Design for Resiliency

Commentaries

Publication: Zoomer Magazine
Date: Published in print and online Aug/Sept 2021
Author: Nora underwood
View Article

As the COVID-19 pandemic proved, long-term care homes are a health hazard. In this Zoomer Article, Nora Underwood investigates how better building design can help.

Excerpt: For Dr. Diana Anderson, design is a parameter of care, as important as other determinants of health, such as where you live and what you eat. “We don’t talk about that a lot, but buildings have a huge impact on us,” says Anderson, a Boston-based doctor and architect who calls herself a “dochitect.” “It’s almost akin to a medical intervention. It has that much of an impact on people.”

Read the full article HERE.

Commentaries

How will COVID-19 Change Healthcare Design?

January 1, 2021 / Dochitect / Design for Infection Control, Design for Resiliency

Commentaries

Publication: Design Museum Magazine
Date: Published in print and online Winter 2020
Author: Diana Anderson, MD, ACHA & Matthew Holmes, ARB, RIBA
View article

Globally, the COVID-19 pandemic has tested the overall resilience of our health system infrastructure to cope with increased demand. It has also brought the importance of design and the built environment to the forefront when considering emergency preparedness and infection control.

Now, nine months into the pandemic, there have been lessons learned from the immediate challenges of medical facility design, in addition to ongoing discussions of the long-term changes which are likely to impact how, where, and when we access our care.

Read the full article HERE.

Commentaries

Resilient Design in Healthcare Will Affect Pandemic Response

September 11, 2020 / Dochitect / Design for Infection Control, Design for Resiliency

Commentaries

Publication: HealthTech Magazine
Publication Date: September 11, 2020
Author: Diana Anderson
View article

“Has your company implemented safety strategies when returning to work? One of the most important strategies is to make room for safe socializing and distancing, reducing risks while maintaining comfort. Thank you for sharing, @dochitect!”
– Cindy Dunnavant, SVP of Sales & Marketing, EMI Health

Excerpt: Hospitals have always been places of healing, and the challenges of COVID-19 further underscore the value of evidence-based design to ensure care and continuity. This practice relies on empirical data to inform changes that better position physical and technological infrastructures to handle an evolving pandemic.

Simply put, buildings can protect our health.

https://www.dochitect.com/wp-content/uploads/2020/09/article-audio-44186.mp3

Read the full article.

Commentaries

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

Peek into the Future of Hospitals: Smart Design, Technologies and Our Homes

June 6, 2017 / Dochitect / Evidence-Based Design

Commentaries

Publication: The Medical Futurist Website & Newsletter
Publication Date: June 6, 2017
Authors: Dr. Bertalan Mesko (The Medical Futurist) & Dr. Diana Anderson (The Dochitect)
View article

Excerpt: A simple, round table with a desktop computer and a projector, where the patient and the doctor have their friendly chat. Whenever an examination is necessary, they cross the “blue line” in the room indicating the “boundaries of the clinic” elegantly. It’s definitely not rocket science, but the patient satisfaction index is soaring. What’s the secret?

Click here to read more about The Medical Futurist and The Dochitect ideas on the Future of Hospitals!

Commentaries

Hearing hoofbeats: time to think zebras?

April 13, 2016 / Dochitect / Evidence-Based Design

Commentaries

Website: The SALUS Global Knowledge Exchange
Date: Published online April 13, 2016
Author: Diana Anderson, MD
View article

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.

Read more about Dochitect’s ideas on the following questions in healthcare design:

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?

Commentaries

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

New Medical Staffing Procedures Call For Design Solutions

October 11, 2013 / Dochitect / Design for Clinical Staff

Commentaries

Publication: Healthcare Design
Publication Date: October 11, 2013
View article

HCD BlogThe hybrid medical professional—physician-writer, physician-researcher, physician-educator, and the physician-editor—is often mentioned in literature and popular press. As a self-labeled “dochitect,” I propose a new hybrid model, the physician-architect, with the intent of bridging the gap between architecture and medicine through the field of healthcare design.

An architect now working as a resident physician, I maintain two notebooks in my white coat pocket: one for medical facts, a common finding amongst trainees, and the other for design notes and sketches.

Click here to read about how the changing practices of medical training can impact staff space, and the subsequent needs for effective care delivery.

Commentaries

Catalysts for Change

April 1, 2011 / Dochitect / Commentaries & Event Reviews

Commentaries

Publication: World Health Design
Publication Reference: 2011;4(2):14-15.
View article

2011_CoverHealthcare reform in the US is still in transition, with the end-goal being to provide the highest quality care at the lowest possible cost. Experts anticipate that increased access to care will inevitably lead to more demand being placed on facilities and the existing building infrastructure. Changing the way that care is delivered will no doubt have an impact on space needs, prompting the design of environments that are cost-effective, functional and flexible.

With major healthcare reform underway in all corners of the globe, what role should designers and architects play in rising to its challenges?

Read what three experts who take a personal view from their own territory have to say, including North America, Australia and the UK.

Commentaries
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