Six Ways Technology Is Changing Healthcare Design

Amidst Rapid Change in Healthcare, One Priority Remains Constant: the Human Touch

March 26, 2019

Healthcare Architect / Partner, NBBJ

@JSLSaba

Editor’s Note: This post is adapted from a presentation delivered at the WSJ Tech Health conference on February 7, 2019.

In healthcare design, it’s difficult to predict how quickly technology will impact facilities. It takes seven to 10 years to plan, document and construct a new complex healthcare environment — that is a long time, and these buildings have to remain highly productive for 30 to 50 years. How can we even begin to think about the technology needs 20, 30, 40 years from now?

Our healthcare clients are worried about many aspects of technology today. For instance:

  • AI and deep learning: How much space do we provide for these things? How will they affect clinical workflows and the way we plan a facility?
  • Driverless cars and ride-sharing like Uber Health: Some regulations require that we provide x number of parking spaces based upon the patient volume that goes through a hospital — in some of our urban hospitals, as many as 1,000 parking spaces underground. We’re designing those to be flexible, but what about the future? Will there be a need for them?
  • Wearable devices, and how you connect with your provider: What will be the impact on ambulatory clinics? How many, and what kind, will we need? Will our patients feel isolated? What about the human touch with the care team?
  • Hospitals right now have robots delivering many materials: Will there be more? Should they share corridors with humans?

We believe there are bigger opportunities for technology to also raise our human potential and experience within healthcare facilities. For me, there are six takeaways:

  1. The virtual connection will be the norm throughout a patient’s care. We have to get comfortable with that.
  2. The virtual room will be just as important as, and maybe even more important than, the physical room, in terms of delivering care and an elevated patient experience.
  3. We want to be mindful of the potential isolation that the individual technology can bring forth. It’s important that there is still the human touch and human interaction in healthcare.
  4. The interaction between people and machines will require a whole new design approach. Already, a gap exists between technology and design, and we need to be cognizant of that in the future.
  5. Places of healing, recovery and connection are still very, very important. We are human, and we need to have those spaces alongside technology.
  6. Finally, we need to remember the basics: light, nature, the human touch and quality environments.

What will that look like? Imagine a patient room tailored precisely to you and what you require to become well. It measures and monitors your body systems and emotions, it understands your social needs, and it physically and visually adapts the room and its technology accordingly. It can predict your emotional needs, your mood, your metabolic rate, and impact them through what you see, what you feel and what you hear. It can proactively adapt so your family members can help you get well and be an active part of your care team. A space that heals you not just clinically, but socially, mentally and spiritually.

I don’t have all the answers, but it’s an exciting time. We know that technology is going to be more important today and for the future. I always return to one question: how can technology, in the field of healthcare, which has the most joyous times and the most difficult and stressful times, allow us to be more human?

Banner image courtesy Franck V./Unsplash.

All other images courtesy NBBJ.

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How Social and Technological Changes Are Reshaping the Practice of Architecture

“What We Care About”: A Roundtable Conversation with A+U

March 14, 2019

Managing Partner, NBBJ

@SteveNBBJ

Editor’s Note: This interview was originally conducted for the December 2018 issue of A+U. It has been condensed and is reprinted here with the permission of the publisher.

NBBJ roundtable participants:

  • Steve McConnell, Managing Partner
  • Jonathan Ward, Design Partner
  • Alyson Erwin, Interior Designer
  • Nate Holland, Design Innovation Director
  • Vivian Ngo, Architect

 

A+U: How do you create “community” in design?

Jonathan: I’ve often talked about the idea of exploding or deconstructing typologies. The most obvious example is the high-rise tower, which is the most anti-community building, certainly in its symbolism but, more importantly, in its space and organization. That typology literally has to change in order to make a place that’s appropriate for people to interact naturally. The more we can think about peeling it apart and putting it back together in a different way, still having in mind the resources that go into building and maintaining high-rises, the better.

Tencent’s Seafront Tower is a great example. Tencent’s business connects people through the digital world, whether it’s WeChat, QQ or the Tencent Cloud. You quickly realize that the traditional building doesn’t match what they do in their business, it doesn’t align with where social connectivity is going, so we had to rewire the building to get closer to matching what they do in the world with their business, their product and the people who make the product. Our thinking was first to take the campus concept, with its spread-out, low-rise, multi-building approach, and apply it to a high-rise. Then we determined we needed to deconstruct the high-rise into two towers and bring social elements into connecting bridges. We also reprogrammed the elevator system to get more active participation and cross-collaboration.

Vivian: At the end of the day, we’re striving to find meaning. We want to help our clients find meaning in why they go to work every day, how they do the best work. You can imagine that meaning can be very diverse, so, in a building, you cannot have one solution. That’s one reason we always try for what’s next. Imagine the next generation of clients who started their careers working in buildings such as Tencent and Amazon. They’re changing too, so it’s cyclical: in the not-too-distant future, we and our clients can reciprocally drive each other’s creativity.

A+U: What role can new technology — like Rhino or augmented reality — play in defining community?

Steve: We have an obligation to our clients to mitigate risk while we push boundaries to unlock potential. We talk a lot about the realization of beauty and performance: we live in an era where computing is transforming our ability to demystify performance and quantify value, so we have the opportunity to leverage data analytics and computing to measure and anticipate performance in ways that go way beyond the intuition of the designer. Especially interesting is our ability to point our digital tools at elevating human performance and community-making at all scales.

Jonathan: We’re at a point right now where we have both traditional methods of design thinking and technology-driven methods of design thinking, which are working hand-in-hand, though sometimes one supersedes the other. I’m curious, if you looked out 5, 10, even 20 years, what do we see as the future of technology, and how will it affect the design process or design thinking?

Nate: I see the digital and physical blending a lot more. The distinction between the building and the building system is going to go away. When we design, the question of what is the “tool” versus what is the “model” and where is the “information” — all that is becoming obsolete. We’re heading to a place of rapidly going from a sketch on a piece of paper to a BIM model, and that will only continue to speed up. We have VR labs, but this is a temporary solution while the hardware catches up to where we’re practicing. We’re going to be seeing these things, if not fully embedded in our minds, at least on some sort of a screen that’s always with us, always mapped to the world. We’re going to be completely augmented in our design abilities.

And architecture will either have to become much longer-lasting or much shorter-lasting. Our needs are changing so rapidly that buildings will be either infinitely repositionable or  rapidly torn down and recycled — a new method of deconstructing that’s not wasteful. There’ll be 100-year projects or five-year projects, and fewer projects in between.

Alyson: We design to a finite program now, but in the future we’ll design buildings that are program-less, that will allow occupants to impose their own structure for what they need out of spaces. I see the beginnings of that in the Columbus Metropolitan Library. They had a set program for organizing their daily activities, and our job, of course, was to craft a space to facilitate those activities, but there’s a freedom within the building for users to occupy it in the ways that they see fit. There’s an overarching program in all the library’s branches, but the user determines what’s needed on a daily basis.

Jonathan: The best buildings, still, from 100-plus years ago are the ones that are program-less. They are these beautiful shells that can be fairly quickly transformed from one thing to the other.

Left to right: Alyson Erwin, Jonathan Ward, Steve McConnell, Vivian Ngo, Nate Holland

A+U: What is the role demanded of architects today?

Jonathan: It’s complicated, because on one end of the spectrum are people who say form and space is a decoration at the end of a functional process. At the other end of the spectrum are others who say form and space is a spatial experience — that it’s everything. Those are the two poles, and they have been fairly strong for centuries. Our challenge is to be in this interesting intersection, so that the functionality and the experiential thinking crosses over with the bold formalistic thinking, and they’re pushing each other.

Steve: The profession has to dramatically expand its definition of the possibilities that are inherent in architecture and urbanism, relative to the health of our planet and to the potential of society. What drives our practice is a central belief in the role that design has in solving really difficult problems and in protecting what is human. For us, it is about opening up possibilities and an exchange of ideas that resolve in a synthesis that’s beautiful, that’s provocative, and that advances the art and science of the built environment.

All images courtesy NBBJ.

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Seven Ways that Life Sciences Buildings Can Support Today’s Advanced Research Needs

As Research Methods in the Life Sciences Develop at an Unprecedented Rate, How Can Our Buildings Keep Up?

April 22, 2019

Science and Higher Education Practice Leader, NBBJ

Editor’s Note: This post is condensed from an article co-authored by Alinea, NBBJ and Arup and originally published in Building magazine.

By 2023, experts anticipate the UK economy will create an additional 142,000 new jobs in science, research and engineering. The way scientists work is changing, and so must their environments. Here are some of the key drivers affecting life science spaces today:

  • Attracting talent
    While the UK’s demand for highly skilled researchers, technologists, scientists and engineers is growing, the talent supply is falling short: the Open University found 91% of organisations struggled to find skilled talent in the last 12 months.
  • High workspace expectations
    More than one-third of knowledge-based workers work outside a traditional office setting, and the design of academic and science workplaces goes beyond just offices and laboratories: these spaces must support collaboration and focus as well as embody the vision, values and culture of the research organisation. Workspace expectations are also high in relation to the health and wellbeing agenda.
  • Advanced technology and processes
    Due to increasing technological support, in the last 10 years laboratory designs have shifted away from the traditional wet lab with separate office, to include a larger proportion of dry lab spaces and engagement areas.
  • Highly optimised and efficient buildings
    Some organisations now lean towards shared spaces and equipment, in which lab benches are booked rather than assigned permanently, lab concierges designate space and arrange ‘just-in-time’ apparatus deliveries, and scientists and specialist technicians pool their complex analytical equipment.
  • Future flexibility
    Despite ongoing demand for highly specialised spaces, research facility design can be based on generic, flexible configurations to allow a wide range of multidisciplinary scientific activities. The most successful future-proofed environments provide long-term adaptability without overdesigning and overspending.

 

Design Responses

The trends and themes described above have specific implications on the design of lab spaces, as designers rise to the challenge of meeting the future needs of the fast-growing and constantly evolving science sector:

  • Facade design may need to respond to the increasing desire for ‘science on show’ while fulfilling high-building performance requirements.
  • Adjacencies of different relevant functions must be captured, connectivity provided and the ‘chance encounter’ encouraged.
  • A sustainable and flexible approach to soft and hard facilities management should be adopted within the design approach.
  • Flexible space will offer the potential for future adaptation and allow users to flex between wet and dry lab space.
  • Testing the layouts for potential usage options at an early stage allows the team to make a considered provision for central plant, with strategies for locally flexing the provision as usage changes over time. Overprovision of services does not benefit the scheme economically or strategically, adversely affecting floor heights, plant sizes and capital cost.
  • The location of plant needs careful consideration to accommodate vibration-sensitive equipment often associated with life science research. Early identification of zones where low vibration can be safeguarded helps define equipment zones, support spaces and influences plant locations. Providing sufficient distance between fume extract requirements and intake locations adds further constraints.
  • Structural solutions need to respond to floor-loading requirements to keep the building’s use flexible over its lifespan and to meet localised vibration criteria requirements. Structural layouts should be developed to set a rational grid that responds to design efficiencies, while at the same time creating ‘swing space’ for laboratory or office planning modules.

 

Controlling Costs

As the volume of research accelerates, so too is the increasing pressure to monitor operational costs associated with running these highly serviced and complex environments. Designing alongside specialists and users helps building designers improve functionality, increase efficiencies and create more sustainable buildings.

The design process itself can be made increasingly efficient by using a data-driven approach. Smart tools are allowing designers to determine the ideal spatial relationships at the onset of the design process. Design computation allows clients, designers and consultants to explore numerous variables simultaneously — and to review the impact on space requirements and costs in real-time.

These tools, combined with the closer integration of architecture with structural and building services design, are challenging traditional laboratory design concepts, allowing teams to create more efficient buildings that add value while minimising capital and operational cost expenditure. As with any building project, understanding and developing the brief with the client leads to improved and successful long-term outcomes.

Banner image courtesy jarmoluk/Pixabay.

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