Spectrum Health, a non-profit, award-winning US Top 10 Health System is in the midst of creating outpatient healthcare facilities to support the expanding Spectrum Health Medical Group (SHMG) physician network. These facilities are designed to respond to market volatility, express the SHMG mission and establish a new standard for programmability. They must also nurture and support efficient, effective, patient-centered care. With one facility operating, another one in design, and several more in the early planning stage, it is imperative that each new facility utilize lessons learned from previous projects, providing improvements in efficiencies for health care providers, patients and the built environment. Key team members will share their work in measuring effectiveness, post occupancy, in the clinical outpatient environment, and how that translates to the delivery of healthcare and the design of outpatient facilities.

LEARNING OBJECTIVES:

1. Define team-based care, team-based care cell and its applications
2. Illustrate the difference between simple facility assessment and the post-occupancy scorecard
3. Share the process used to develop metrics that supports continuous refinement and how to involve process engineers in the effort
4. Next steps. Communicate how team translates results into design and operations of next generation facilities

This presentation provides the opportunity for attendees to see themselves in a new light, and to ‘try on’ a new form of leadership that can transform their organization – irrespective of their role. We will examine how leadership is the key component to cultivating generative space in the built environment, starting with ‘designing’ the social environment, which can only be designed by individuals, and – unless it is designed as generative – it, most likely, won’t be. It takes an individual to cultivate generative spaces with other individuals, before it is possible to have an impact on a building becoming generative; one cannot happen without the other. In this session, we will explore how Health Design Leadership is the first step along this continuous journey. A case study will be presented that highlights this personal and continuous journey, as well as the evidence that has been gathered on the transformative outcomes that have occurred as a result.

LEARNING OBJECTIVES:

1. Learn how to distinguish social and physical space, and how to integrate both together.
2. Learn the distinction between being a leader and an “organizer”, and the benefits being an “organizer” provides to those individuals you are trying to support.
3. Learn how identifying the simplest “gap” can be the first step in leadership transformation.
4. Learn how to maintain consistent leadership quality in the face of any challenge.

Today's economics of providing high-quality healthcare in state-of-the-art facilities, requires a funding source which goes beyond traditional financing through operational means alone. The best academic and community hospitals in the US benefit from philanthropy, and are receiving monetary gifts at an unprecedented rate, despite the economy. This is not an accident or a happy coincidence, but the result of a highly skilled and coordinated effort between the capital campaign leaders of these institutions, the community at large, and at times, the design team. This session will illustrate the benefits of a coordinated capital campaign, and the utilization of design in this process. We will explore examples of major hospital projects which would not be possible except for philanthropy, and how this integration not only creates great architecture, but enhanced funding. Your hospital may be missing a golden opportunity if you have not considered the potential of philanthropy by design.

LEARNING OBJECTIVES:

1. Learn how a coordinated effort between designers and capital campaign leadership can enhance giving.
2. Learn how to create a grass-roots capital campaign in your community which enhances giving as well as the public perception of your hospital.
3. Learn about the importance of various tools including identifying gift opportunities, and managing the recognition of your gifts in a consistent way.
4. See success stories of integrated capital campaigns, and the benefits of this approach.

Patient satisfaction is a top goal of hospitals throughout the US and the physical environment can be a major factor in enhancing the patient experience. In the 2012 HealthLeaders Media Patient Experience Survey nearly 84% of top-level US healthcare executives said that patient experience is among their top three priorities, and 24% say it is their top priority. Can we build a case that the physical environment can improve the quality of experience for patients and family? What aspects of hospital design and planning can support a positive patient experience? Studies have shown that though clinical care was almost identical, it is perceived superior in a new facility. This session will feature six new designed facilities that scored well above the national average in HCAHPS scoring and share what aspects of the built environment were proven to enhance the patient and family experience through post occupancy studies, including what decisions gave the best value for money spent.

LEARNING OBJECTIVES:

1. Learn the five proven elements for enhancing patient satisfaction
2. Explore current research on how the physical environment affects the patient experience
3. Review physical improvements that most cost effectively raise HCAHPS scores
4. Identify key services that designers can market to improve patient experience

Within the climate of healthcare accountability, general lighting must now be considered as a cost effective means for delivering patient safety thru early detection of life threatening conditions. With an emphasis on reducing clinician errors and limiting patient readmissions, design knowledge regarding the specification of ambient light sources is now critical. Long established for delivering effective clinician performance and improved patient safety, light sources which pass the Australian standard for early detection of cyanosis have been utilized worldwide. This session will explain the COI standard and provide examples of where general lighting compliant to the standard would also be of benefit for improving clinician visual acuity within senior living, medical imagining, physician offices, and walk-in clinic environments where this type of lighting has the potential to thwart occupant discomfort and negate unwanted visual impacts.

LEARNING OBJECTIVES:

1. Explore ambient general lighting conditions for enhancing clinician visual assessment of skin indicative of life threatening conditions.
2. Review lighting condition negative impacts on visual acuity when color saturated exterior glazing options are installed.
3. Review health care environments where international code compliant light sources are beneficial for reducing clinician errors and saving lives.
4. Acquire lighting specification skills targeting enhanced visual acuity of surface color specifications, skin observation, and facial features.

Healthcare in the United States is currently undergoing the most extreme transformational paradigm shift in over a century. As a technical builder of some of the nation’s most advanced healthcare facilities, DPR Construction conducted a research initiative to better understand the long-term trends that its healthcare customers will have to manage in the coming decade and asked owners, designers and management consultants. 42 healthcare leaders shared their insights into what the future holds for the healthcare industry and for their own systems. It should be no surprise that everyone agrees that uncertainty is one of the biggest challenges facing the healthcare industry today. While the healthcare industry is constantly tasked with change and doing more for less, there is an underlying optimism in the new focus on wellness, integration and community embeddedness. This session will focus on what was learned and where the industry is heading.

LEARNING OBJECTIVES:

1. Gain a better understanding of where the healthcare industry is heading over the next 10 years. What outside forces will affect the industry?
2. Gain an understanding on how healthcare will be delivered in the next 10 years.
3. Gain an understanding of future delivery methods that will affect the design and construction industry.
4. How will healthcare design and construction be different in the next 10 years and what might the physical market look like?

This presentation will describe how colors - on surfaces, in light, or combined in patterns - can be used to support improved user experiences in generative spaces. It will provide research-based guidance for designers, so that - as they are choosing color, they can use science-based knowledge to consider how hue, saturation, and brightness - as well as users' culture and personal factors - influence the effects of color on the wellbeing of the individual users. Since, in actual practice, surface colors are rarely experienced in isolation, the ramifications of color combinations and visual patterns will also be addressed.

LEARNING OBJECTIVES:

1. Understand how hue, saturation, and brightness can influence human wellbeing.
2. Learn how personal factors, such as age and mental health, can influence wellbeing-related implications of color selections on individuals.
3. Learn how to effectively access and use information on culture during the hue selection process to improve overall health-related outcomes.
4. Identify reliable sources of information on colored surfaces, colored lights, and patterns to scientifically inform color-related design decisions.

With humorous, but real examples, we will look at results of misinformed design and solutions to these dilemmas. Bringing to the table understanding of disease effects, visual-spatial capabilities, treatment processes, destination hierarchy, and expected response to color and pattern in visual elements is truly necessary to properly serve your healthcare clients. Attend to hear innovative design ideas that sprang from these examples: + Dementia care unit renovation included construction of an indoor, pretend front porch with many features that failed to accommodate a dementia population + Abstract art - a red splatter-shape on white background - hung in a cancer center reminded onlookers of phlebotomy procedures + A long-term care facility's interior was left to staff to decorate and became an uncoordinated jumble of elements + A wayfinding kiosk meant to provide a high-tech map resource was not accompanied by supporting cues, resulting in a dose of frustration as well as maps.

LEARNING OBJECTIVES:

1. Describe what is meant by "toxic visual elements."
2. Identify end-user issues to consider in design and what expertise is needed on your team to fully address these.
3. Use the examples to help you look at your own projects with fresh eyes to prevent any similar faux-pas.
4. Take away "pearls" about effecting stress reduction in healthcare and how that knowledge can change designs and improve satisfaction with a facility.

Generative space is the new design frontier for improving individual lives, organizational performance, and overall community wellbeing. This discussion – facilitated by Heather Fennimore, a leading generative space practitioner – will introduce several other practitioners who will be presenting their detailed work in the Generative Space Track. Attendees will have the opportunity to critically question, challenge, and engage these presenters as a means to develop a generative space overview.

LEARNING OBJECTIVES:

1. Why generative space is the new design frontier.
2. How improvements can be made with generative space.
3. How to measure generative space improvements.
4. How both systemic and sustainable improvements are made with generative space.

This presentation provides the opportunity for attendees to see themselves in a new light, and to ‘try on’ a new form of leadership that can transform their organization – irrespective of their role. We will examine how leadership is the key component to cultivating generative space in the built environment, starting with ‘designing’ the social environment, which can only be designed by individuals, and – unless it is designed as generative – it, most likely, won’t be. It takes an individual to cultivate generative spaces with other individuals, before it is possible to have an impact on a building becoming generative; one cannot happen without the other. In this session, we will explore how Health Design Leadership is the first step along this continuous journey. A case study will be presented that highlights this personal and continuous journey, as well as the evidence that has been gathered on the transformative outcomes that have occurred as a result.

LEARNING OBJECTIVES:

1. Learn how to distinguish social and physical space, and how to integrate both together.
2. Learn the distinction between being a leader and an “organizer”, and the benefits being an “organizer” provides to those individuals you are trying to support.
3. Learn how identifying the simplest “gap” can be the first step in leadership transformation.
4. Learn how to maintain consistent leadership quality in the face of any challenge.

Growing concern over the potential hazards of increased computer usage and the adoption of electronic medical records (EMR) in healthcare settings has prompted a recent and increased emphasis on improving workplace design with advanced ergonomic concepts. According to the U.S. Bureau of Labor Statistics, nurses are 200% more likely to suffer from job-related injuries than construction workers or farmers. Conventional efforts to improve workplace user interface outcomes in healthcare settings have focused primarily on increased product-related adjustability. Recent research, however, suggests that adjustability alone may not be sufficient to affect postural improvements and reduce injury rates. This session engages the attendee to personally explore and experience emerging advanced ergonomic design concepts for healthcare settings. Documented case study examples of successful design installations, and their associated health impact, will also be presented and discussed.

LEARNING OJECTIVES:

1. Identify high-risk areas for musculoskeletal injury in healthcare settings.
2. Understand how workplace design can improve or decrease caregiver health.
3. Learn how to apply advanced ergonomic concepts to improve health.
4. Gain new knowledge of ergonomic health improvement strategies through hands-on personal experience of actual workplace products.

Meet the recipients of the 2013 ‘Generative Space Award’ (to be announced). See their submittals; learn from their presentations; engage with these leading pioneers in a discussion about how both systemic and sustainable improvements to health, healthcare, and wellbeing can be made through the design of the environment; and then plan your own strategy for submitting your pioneering projects to the 2014 ‘Generative Space Award’ in June 2014.

LEARNING OBJECTIVES:

1. Learn how ‘action research’ can be applied to healthcare design projects.
2. Learn how to make systemic and sustainable improvements with generative space.
3. Learn how generative space can improve lives, organizations, and communities.
4. Learn how to make an award-winning submittal to the ‘Generative Space Award’.

Hospitals are the only places where patients are relegated to performing all their activities of daily living in bed; and rarely by medical necessity or patient choice. Patients are designed into their beds by the paradigmatic assumptions made by architects, medical device designers, and hospital managers. Despite best-intentioned efforts to create mobility by all concerned stakeholders, these efforts are unsuccessful - resulting in minimal benefit, if any, for the patient. In this participatory workshop session, we will explore designing a more generative patient room with its conventional bed as a ‘murphy style bed’, apply lean concepts to eliminate waste, and articulate the conditions of a new future state that will become the vision for a new hospital planning and design reality.

LEARNING OBJECTIVES:

1. Understand the concept of mobility and its benefits in recovery and health.
2. Debunk the myths and traditions prevalent in hospital design and examine the true needs of the patient..
3. Apply generative space design and lean concepts to our re-imagining process
4. Create a mobility checklist for universal application to patient room design.

A follow up to the 2011 presentation at the Symposium, this session looks at the new ED which saw its first patients in the fall of 2012, and answers the question: ‘How is it really working?’ Sparked by the challenge to create an “environment that staff would want to come to on their day off”, the new ED at Nanaimo in Canada may be the first in the world to include nature imbued courtyards within actual patient treatment zones. The pre-design programming phase established design goals and objectives as well as sustainability strategies to achieve a LEED Gold solution around the four values of: Timely, Respectful, Quality of Care, and A Place People Would Want to Come to Work. The most important considerations informing the design were: improved patient flow, functionality, privacy/confidentiality, safety, and an abundance of natural daylight. Stantec Principal Bruce Raber is a participant in The Leading by Design research project. Guided by the Generative Space principles, the Stantec team and clinicians led by Suzanne Fox, Director for Emergency Services and Trauma Care, believed the new ED environment could be designed to systemically and sustainably improve health and healthcare. Together they worked to not only create innovative design concepts based on research, sustainability, and lessons learned from European hospitals, but demonstrated at every stage of design the cost-benefit of increased day lighting on overall productivity gain. This presentation will address the question of: ‘how has it actually turned out?’ and ‘what is the “evidence” really showing?’ ‘Is it, in fact, “A Place where People are Flourishing”?’

LEARNING OBJECTIVES:

1. Learn the steps from “community” engagement through to documented evidence that can improve health and performance for project participants.
2. See first-hand how an integrated design process incorporating, sustainability, research-informed design, and full clinical involvement can produce “a place to flourish”®.
3. Learn how to apply cost-benefit analyses to “sell” Generative Space, sustainability, and design excellence.
4. Discover whether the research and evidence that has been gathered over the first 12 months actually supports the goals established during the design process.

This presentation will describe how colors - on surfaces, in light, or combined in patterns - can be used to support improved user experiences in generative spaces. It will provide research-based guidance for designers, so that - as they are choosing color, they can use science-based knowledge to consider how hue, saturation, and brightness - as well as users' culture and personal factors - influence the effects of color on the wellbeing of the individual users. Since, in actual practice, surface colors are rarely experienced in isolation, the ramifications of color combinations and visual patterns will also be addressed.

LEARNING OBJECTIVES:

1. Understand how hue, saturation, and brightness can influence human wellbeing.
2. Learn how personal factors, such as age and mental health, can influence wellbeing-related implications of color selections on individuals.
3. Learn how to effectively access and use information on culture during the hue selection process to improve overall health-related outcomes.
4. Identify reliable sources of information on colored surfaces, colored lights, and patterns to scientifically inform color-related design decisions.

Since the invention of electric lighting, architects and designers have pondered the role of light for building interiors, day and night. But until the 1940’s, the limits of electric lighting continued to demand daylight as the principal source of illumination by day, with the less powerful incandescent light sources allowing activity in the evening and night hours at far lower light levels. Then, the nearly concurrent inventions of air conditioning and fluorescent lighting made large windowless buildings possible. No longer confined by the night, interior space could be illuminated to resemble daylight at any time. The result is a society that works 24 hours a day, with the unfortunate side effects of sleep disorders, Vitamin D deficiency and other struggles to maintain the pace. Interior architecture and design have responded strongly to the practical challenge with decades of inventive and often artful solutions integrating electric lighting into interior spaces, making ever more massive structures possible. But over time, the growing problems of energy cost and global warming have conspired to drive interior lighting to levels well below the threshold of biological darkness. With people spending over 90% of their lives enclosed in buildings, Nature’s circadian systems struggle to find correct zeitgebers, the signals needed by all living beings to properly manage the systems and routines of biological life. Oddly, we have learned to provide indoor plants with a certain amount and type of light every day, but we have fail to do the same with people. It is time to add the benefits of light to the mere appearance and utility of light. Generative space is a new movement in architecture in which the design seeks to: “…encourage, support, and reinforce increasing (human) performance effectiveness in health, healthcare, and/or quality of life.” All aspects of human performance require proper doses of light and of darkness. Regardless of the artfulness of lighting “design” in interior architecture, it only stands to reason that without proper doses of light and dark, any design will ultimately fail to achieve its generative goals. Moreover, light is one zeitgeber and others, including temperature and food intake, must be conducted in harmony and must be carried on by occupants even when they leave the generative space. This two-part presentation will address the role of light and lighting in generative space through the designing of daylighting and electric lighting.

Learning Outcomes:

1. How to define and design human light needs and doses.
2. How to distinguish and design for nature’s and human’s cycles.
3. How to use generative Lighting design to inform decisions for daylighting design, electric lighting design, and designing controls and scheduling.
4. How to access relevant references and resources for generative lighting design.

Since the invention of electric lighting, architects and designers have pondered the role of light for building interiors, day and night. But until the 1940’s, the limits of electric lighting continued to demand daylight as the principal source of illumination by day, with the less powerful incandescent light sources allowing activity in the evening and night hours at far lower light levels. Then, the nearly concurrent inventions of air conditioning and fluorescent lighting made large windowless buildings possible. No longer confined by the night, interior space could be illuminated to resemble daylight at any time. The result is a society that works 24 hours a day, with the unfortunate side effects of sleep disorders, Vitamin D deficiency and other struggles to maintain the pace. Interior architecture and design have responded strongly to the practical challenge with decades of inventive and often artful solutions integrating electric lighting into interior spaces, making ever more massive structures possible. But over time, the growing problems of energy cost and global warming have conspired to drive interior lighting to levels well below the threshold of biological darkness. With people spending over 90% of their lives enclosed in buildings, Nature’s circadian systems struggle to find correct zeitgebers, the signals needed by all living beings to properly manage the systems and routines of biological life. Oddly, we have learned to provide indoor plants with a certain amount and type of light every day, but we have fail to do the same with people. It is time to add the benefits of light to the mere appearance and utility of light. Generative space is a new movement in architecture in which the design seeks to: “…encourage, support, and reinforce increasing (human) performance effectiveness in health, healthcare, and/or quality of life.” All aspects of human performance require proper doses of light and of darkness. Regardless of the artfulness of lighting “design” in interior architecture, it only stands to reason that without proper doses of light and dark, any design will ultimately fail to achieve its generative goals. Moreover, light is one zeitgeber and others, including temperature and food intake, must be conducted in harmony and must be carried on by occupants even when they leave the generative space. This two-part presentation will address the role of light and lighting in generative space through the designing of daylighting and electric lighting.

Learning Outcomes:

1. How to define and design human light needs and doses.
2. How to distinguish and design for nature’s and human’s cycles.
3. How to use generative Lighting design to inform decisions for daylighting design, electric lighting design, and designing controls and scheduling.
4. How to access relevant references and resources for generative lighting design.