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So you don't do hospitals

Can evidence-based design, which is transforming the healthcare sector, be applied to other types of projects? The experts offer a resounding yes.

February 01, 2003 |

Your firm doesn't "do" healthcare, you say. Fine. How might the principles of evidence-based hospital design be applied to your work on other types of facilities?

Leonard L. Berry, Distinguished Professor of Marketing and holder of the Zale Chair of Retailing and Marketing Leadership at Texas A&M University, sees the kinds of design initiatives being used in healthcare projects as applicable to many other business sectors.

"Many businesses sell products that are either intangible, or technically complex, or both, and when you sell those kinds of products, you need to manage the evidence, manage the clues, so that customers can understand the service story you want them to understand, even though they can't understand the technical product or see it," says Berry. "That's what we're doing with evidence-based design: managing the clues, to help patients interpret what they can't otherwise interpret."

Berry concludes that, no matter whether your client is a hotel, an airline, a software company, or a car rental firm, "managing the appearance of these intangibles is really important." Thus, design that reinforces positive intangibles — and that can be backed by evidence-based outcomes — could provide a key competitive edge to any Building Team.

As we have seen in this report, hospitals have numerous layers of ownership — not just the corporate board or the CEO, but also the medical staff, patients, patients' families, and, perhaps most important of all, the nursing staff.

The lesson here is to rethink the common view that the building owner is your only client. In the case of hospital design, much of the impetus has come not from the boardroom or the CEO's office, but from the nursing staff. They're at the front line. Without their involvement, evidence-based design could not possibly succeed.

So, for your next project, it might be worth asking: Who is the ultimate customer? For many kinds of jobs, the real client is not merely the building owner, but also the building's occupants and the public. Would it not be worthwhile to spend some time, say, observing how customers shop in a department store you've designed, or whether guests can find the public bathrooms in a hotel or restaurant you refurbished?

You don't have to devote a thousand hours to the task, as Ann Hendrich did observing how nurses moved about Methodist Hospital in Indianapolis. But there's probably a great deal to be learned from even a short period of observation of the other "owners" of your building, the users. This is information that can keep your firm more competitive, no matter what the market sector or building type.

Roger Ulrich, considered the founder of evidence-based design in healthcare, points out that there is ample literature related to the impact of indoor air quality, color, fenestration, lighting, and other elements of design on office workers. The difference is that, with healthcare facilities, there is more rigorous scientific evidence to support outcomes.

Says Ulrich, "We need to take an accompanying tack in workplaces and other spaces," to measure how design can impact employee turnover, productivity, and even creativity and idea development — factors that are crucial to success in today's business environment.

When you do that, your firm is going to have a significant edge over competitors in the race for new business.

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