Publication type: "Conference Presentations"

HUBWEEK 2018 Change Maker: How Architecture Impacts our Health

October 8, 2018 / Dochitect / Evidence-Based Design, The Physician-Architect Model

Presentations

Event: HUBweek 2018 Change Maker Conference, Boston
Title: How Architecture Impacts our Health
Date: October 8, 2018

Dochitect speaks at HUBweek 2018 in Boston as part of the Change Maker Conference event!

How Architecture Impacts our Health: Design Thinking for Medicine

The delivery and design of healthcare today is rapidly changing, and increasingly complex. How are we closing the gap between design intent and user experience? 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. Healthcare innovation can occur where architecture and medicine meet.

Conference Presentations

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

September 20, 2018 / Dochitect / Design for Clinical Staff, Evidence-Based Design, The Physician-Architect Model

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

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

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

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.

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

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:

Healthcare 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.

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

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.

It 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.

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

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

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