Janet Dugan

Janet Dugan

Principal, NBBJ
Janet designs environments that support and enable wellness. With more than 20 years of experience designing for healthcare, she sees architecture as a tool that empowers patients, energizes care teams and enhances the financial health of the modern medical center. She is also a frequent contributor to publications including Healthcare Design, Architecture Week, and the Journal of Neonatal Networking.

Person-Centered Design: The Importance of Balance in an Era of Constant Change

September 10, 2020

Principal, NBBJ

Editor’s note: Our healthcare clients are on the front lines of the coronavirus crisis. We seek to support them as they courageously care for the sick. So we’re posting design ideas based on work with them, in the hope that we can contribute from our base of expertise to help combat the epidemic. From all of us at NBBJ to the many doctors, nurses and support staff in hospitals and clinics, thank you from the bottom of our hearts.


As a child, I loved seesaws — one moment having my feet on the ground and the fate of the other person in my control, the next second trusting them to lift me so high into the sky I could see over my mom. I learned to create a balance of sorts across from my older brother by sitting far back or scooting closer so that he had a harder time throwing me off.

I’ve been thinking a lot about balance lately. As designers we use it as a basic element in composition; as a civilization we equate it with stability and fairness; as humans we need it to simply stand upright — all dynamic equilibriums needing our attentiveness lest an unknown thing threaten the equation.

This is how the world seems to many of us right now — all was moving along fairly balanced with a degree of control until the pandemic sent us teetering.

Recently, I’ve started two projects that have me thinking deeper about what role balance plays in design, specifically in creating hospitals for person-centered care. Person-centered care is the compassionate perspective that we are all individual human beings first before we are anything else: spouse, parent, student, friend, employee, patient.

Founded by Planetree — an organization that promotes the thoughtful response of healthcare systems to individuals’ human need for respect, control and supportive care — this philosophy focuses on creating environments for positive human interactions between patients, families and care givers. Primary tenets include empowerment with information, integration of the arts and complementary therapies and the nurturing aspects of nutrition, spirituality and human touch — all creating better outcomes.

The physical space within a hospital or clinic plays an important role for connection to take place. It can bring equilibrium between the often-conflicting goals of human-centered experiences and operational efficiencies — that’s where our design teams come in.

So how do I design something centered around another person when I barely feel centered myself in these turbulent times? Can my environment be a part of my solution just as we expect it to be for the patient?

The real work for the patient — and for me in this pandemic — comes from within. Perhaps the space we build outside the patient is only successful if it enables the construction of a healthy space inside the person.

One way to empower this internal effort is to create environments that anticipate personal needs. For example, we know through inquiry and observation that the most frequently asked question at information desks is often the location of the restrooms. Anticipatory design places those elements in easy sightlines before patients stop to ask. By developing experience maps, we can identify and eliminate the outside struggle with blockades that throw people off.

Another aspect is to make spaces that become easy portals to colleagues, friends, and family — more thoughtfully crafted to individual needs, making connections readily available to overcome the disruption of distance. Smart televisions in patient rooms that can accept a video chat from a private phone accompanied by an overbed table device to hold the phone camera would connect families during this isolated time.

By removing barriers to compassionate human interactions in the healthcare setting, we can create conditions for the patient to do the hard work of centering themselves emotionally in their new world of diagnosis, treatment and healing. To find a fulcrum for grounding. To feel themselves again.

On a seesaw, when both people put their feet on the ground, they create a bridge between them, a stable connection built on trust. Design created through a lens of person-centered care enables both those receiving care and those providing it to create balance, building bridges between them.

In a world that is teetering, perhaps extra attentiveness to human-centered design is our chance as architects to scoot closer to those for whom we design, stretch our feet down to the ground and bring back some balance on both ends.


How are you and your healthcare organization dealing with the coronavirus? We’d like to hear from you. Drop us a line at socialmedia@nbbj.com.

Banner image courtesy Adobe Stock.

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Lines of Sight

Sometimes a Moment of Connection Matters More Than Great Design

January 2, 2014

Principal, NBBJ

I lay in an MRI machine last week. One more step on a personal patient journey that informs my professional path.

As designers, we fret over everything: from big site issues to the detail of the grout color. Certainly, these are important for a pleasing, functional composition, but this recent event reminded me that to design great experiences, we have to have more in our sightlines than just the architecture.

In an MRI, you lay on a table that moves into a tube of only about 30″ in diameter. It’s tight. And it causes claustrophobia in a lot of people.

For my diagnostics, I was placed face-down with my head in a massage-table-like support that allowed me to keep my eyes open. Face-down is a preferred position partly because patients are less anxious when less aware of the tiny barrel they’re captured in. Reducing anxiety is important to help the patient remain still for the time it takes to get good images.

As I lay in the tube, I noticed a thing new to me. A small mirror had been placed below the head support piece. It was angled so that I could see through the barrel to the radiology tech as he positioned my IV. If he placed himself correctly, we could have made eye contact.

What a small thing. And yet what a difference it made. I felt less alone. I was connected to another person at the very time I needed support. And even though I’m not claustrophobic, it calmed me some to be able to see out of the barrel — to have a vista in front of me that was deeper than ten inches.

So let’s not fool ourselves, designers. I couldn’t tell you what color the floor was or if the ceiling was acoustical tile or if the exterior skin was precast or curtainwall. I simply didn’t register those things in my journey as a patient.

I did register that the tech was friendly and the nurse went out of her way to make me laugh. Although I recall indistinctly that the room was in sore need of an overhaul, the warm attitude of the people diluted my memory of the cold ambiance of the space.

Don’t get me wrong: I firmly believe in the power of design to contribute to the healing process — that architecture can shape events and transform lives. But that day, in that experience, for me personally, the only thing that really gave me comfort was a tiny mirror about as big as a Band-Aid.

So I challenge us moving forward: What small metaphorical Band-Aids can we place well to enhance life and inspire human potential? Is our vista deeper than the 24 inches to our computer screens? What mirrors can we position to see out of our own architectural tube?

Sometimes all it takes is a little bit of reflection.

Image courtesy of Flickr.

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