It’s More Than Just a Building

We are taught in school that good architecture is elegant yet bold. It is aware of its surrounding context. It preserves green space and uses environmentally friendly resources. It addresses the scale and proportion of the surrounding buildings and, among other things, it needs to accommodate the program and the people who will be using it. But what does it mean to know the program? Is it enough to know what types of people will be occupying the building or space you are designing, or do you need to really get to know the people that will occupy the building?

As one of my first exercises in graduate school, our entire class was admitted to a hospital for a night to experience the patient’s perspective first hand. This exercise opened my eyes to understanding space as more than a building program, and to really understand what someone using the building may be experiencing. How bright lights were bothersome while lying on your back. How every bump on the floor was felt while on a stretcher or in a wheelchair. And how simple acts of independence, like operating the window blinds from the bed control rather than calling for the nurse to do it, really made a big difference.

While we can’t always do this each time we work on a project, we can make efforts to understand what the patients, staff, and family members may be going through. As an example, I was fortunate enough to complete a full week immersion at Craig Hospital, a project we won in partnership with local Colorado firm RTA Architects. This immersion process included shadowing patients, family members, and staff members as they completed their daily routine, which allowed me to gather a much higher and different level of information that I can get in a user group meeting in a conference room. I was able to walk alongside the staff as they delivered medication and see what surfaces they set things down on, what they bump into, what steps they take to get from point A to point B. And I watched as they diligently turned a spinal cord patient from side to side every two hours in order to avoid bed sores and to increase blood flow, which then made me think about what a largely immobile patient is looking at for hours at a time, which in turn made me think about the design importance of not just the footwall but the sidewalls. These small but not inconsequential details begin to inform every design decision. I better understood the importance of designing spaces for one-on-one interaction or for groups of four or five, and for large collaboration spaces where I could see the social progression of patients with brain injuries.

When this level of observation isn’t possible, having a patient advocacy group to help you see the design from their perspective is a good substitute. When designing the National Intrepid Center of Excellence, a wounded soldier and his wife participated in our user group meetings. As we navigated our way through a program that had no direct precedents, we relied on them to speak on behalf of their own experiences as well as for others with similar conditions. His insight helped us design solutions that made him feel comfortable, and functionally accomplished the goals of the program.

I speak as a professional in the healthcare architecture sector; however, this empathic approach could and perhaps should apply to all sectors. Because it is always more than just a building.