Healthcare Design - December 2016 - 32

In Focus

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ning to provide metrics to back up design intuition tied to these variables.
There are three different ways that design processes change as a result of
data and integrated technology.

RESEARCH AND DESIGN

C L I E N T A N D D E S I G N T E A M C O M M U N I C AT I O N

Virtual tools (digital simulations of reality) are used by design and construction firms to tackle the process of describing building options and
facilitating consensus among varied client groups. For example, a 3-D virtual model allows designers and stakeholders to experience the space and
configuration of equipment, while newer hands-on tools like virtual reality glasses and gloves allow a full-sensory spatial experience. Users can test
in real time whether operating room booms and lights will interfere with
one another; owners can preview the effectiveness of lighting and sight
lines.
An animated walk-through of the entry sequence to a new hospital lobby
can assure clients that the architectural team delivered an arrival space
that provides the appropriate first impression, security control, and key
wayfinding cues.
The accuracy of these visual models is tied to the amount of real data that
can be utilized. Specific building and environmental information as well as
an overlay of occupant tracking data are required. Who's coming through
the door and at what rate? Where are they going and where do they stop for
help? This is where the work becomes dependent on larger quantities of
data to really understand the human experience within a facility.
THE EVOLUTION OF BIM

Construction documentation is changing with the use of building information modeling (BIM), affecting team structure, information flow, and
document standards. All work on a project is tied to a live model where all
design information is available to export, measure, test, and manipulate.
While BIM alone isn't big data, it provides a platform of data to utilize for
new lines of inquiry. For example, architects and engineers can push BIM
to new levels to provide optimization, predictive modeling, and operational and statistical analyses.
Sustainability issues can be explored, such as how to control heat gain or
increase thermal comfort through façade design. Parametric modeling-
producing a series of options based on a combination of fixed relationships
that respond to a finite set of variables-can be employed to enhance traditional ways architects study building solutions. For instance, if an architect
proposes a façade treatment using external shading devices, parametric
modeling can be used to illustrate a sophisticated response, such as window shading louvers outside patient rooms on the west side of a building.
One can model, perhaps with a 3-D printer, the variations required for other exposures of the building and the sun angle.
There's also potential to run an analysis examining financial patterns that
cross building parameters, such as the efficacy of different exam room-toclinician ratios. Or if accidents are mapped to floor plans, including variables such as the age of patients, types of accidents, and times of day, it might
be possible to find trends to inform design that prevents falls.
These types of inquiries
are possible given the roVARIABLES SUCH AS AGE OF PATIENTS,
bust infrastructure of the
BIM model and how data
TYPES OF ACCIDENTS, AND TIMES OF
can be pulled from it and
DAY CAN REVEAL TRENDS THAT INFORM
conversely input to generDESIGN THAT PREVENTS FALLS.
ate graphic relationships.

DECEMBER 2016

HCDMAGAZINE.COM

Architects propose, measure, track, and evaluate alternate design solutions with a scientific
eye. There are several prominent methodologies
being used, including Lean/process development, evidence-based design (EBD), patient
safety metrics, and the WELL Building Standard. All of these are grounded in setting objectives and measuring end results.
For instance, an EBD project may try to decrease the prevalence of slips and falls by introducing a new flooring surface. Measuring
the current state and then remeasuring after
the flooring is installed may show a significant
decrease in incidents. That decrease can be
measured monetarily in savings to the hospital
through shorter lengths of stay and fewer medical interventions.
The complexity of an investigation and how
many variables are tracked tie back to the
threshold of big data. Are patient age, diagnosis, time of day, unit location, status of "accompanied" or "alone," cleaning schedules, and
medication all being tracked for a richer understanding of slips and falls? This will help determine if incidents are due to floor conditions
or something beyond the environment of care.
These types of layered investigations studying
multiple variables can lead to more complex
strategies in addressing operational challenges.
THE FUTURE

Looking forward to the next 10 years, healthcare
architecture will continue to transform. The
trends outlined here will grow, and it's probable
that building design will be tied to populationbased medicine. The issues are huge-where will
healthcare occur? Will it be at home, at work, or
in traditional healthcare environments? Will
patients interact with healthcare providers in
person or via telemedicine? And what role will
buildings play?
Much of the process of healthcare design is to
cover all the possibilities-all the what-ifs. The
tasks are to understand the current state, predict human behavior, and anticipate change.
Data and analysis will provide a stronger foundation for addressing these variables. 
Milly Baker, AIA, ACHA, LEED AP, is an associate at
Payette (Boston). She can be reached at MBAKER@
PAYETTE.COM.

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Healthcare Design - December 2016

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