Editorial: First Do No Harm

March 27, 2009

In thinking about healthcare interiors—the focus of this issue—I was reminded of the famous phrase I selected for the headline above that is commonly (and erroneously) believed to be contained in the Hippocratic Oath. Regardless of its true origin, the phrase has been, for physicians, a sacred expression of hope, intention, humility, and recognition that human acts with good intentions may have unwanted consequences. While the phrase expresses one of the principal precepts that all medical students are taught in medical school and is practiced by doctors, it occurred to me that it is equally applicable to interior designers.

Regardless of the type of project being designed, interior designers would be well-advised to consider the impact their designs will ultimately have on the occupants of their spaces, even when they have the best intentions in mind. Still, the precept is especially true in healthcare settings, as Susan Long, director of interior design on the Dell Children’s Medical Center of Central Texas—the focus of this issue’s cover story—points out. “It’s not like a home or office, where you’re spending limited time. People could be spending days, weeks, or months there without a break. It’s our duty to provide environments that are not harmful.”

For Long and the design team at Karlsberger, that meant designing the Dell project to LEED® standards—and not just at any level: LEED Platinum certification was the goal from the get-go. As a result, the 169-bed Dell Center became the first hospital ever to earn a LEED Platinum-level certification, the highest designation granted by the U.S. Green Building Council. Although designing a hospital to such stringent standards poses numerous challenges, the Karlsberger team never strayed from the green element, even when dealing with issues such as comfort, familiarity, ease of maintenance, and a design theme with cross-generational appeal.

In addition to creating sustainable, healthy facilities, designers can also incorporate Evidence-Based Design into their projects to ensure that their designs do not have harmful or unintended consequences on occupants. As defined by the Center for Health Design, “Evidence-Based Design is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes. Evidence-based healthcare architecture creates safe and therapeutic environments for patient care and encourages family involvement. It promotes efficient staff performance and is restorative for workers under stress. These designs ultimately should improve the organization’s clinical, economic, productivity, satisfaction, and cultural measures.”

As James Brothers points out in this issue’s NCIDQ article, the founders of InformeDesign had a similar idea when they created their database of research summaries from juried journals of design, architecture, and yes—medicine. “The mission of InformeDesign is to facilitate designers’ use of current, research-based information as a decision-making tool in the design process, thereby integrating research and practice,” writes Brothers. In short, InformeDesign wants all design practitioners to become consumers of research so that the outcomes of design solutions can be systematically examined.

The problem, according to Brothers, is that, unlike the healthcare industry, which has achieved cooperation and collaboration among peers with respect to sharing best practices, “the difficulty in getting designers to share data and become analysts of this data may lie in the perception that these tasks are not creative or the feeling that the time used toward such activities is not billable.” Complicating matters further is the fact that “interior designers are not trained to appreciate the benefits of work done by other designers,” says Brothers, quoting his colleague Ernest Rhoads. “The fear of sharing one’s own innovations, and possibly losing one’s market-edge, takes precedence over the perceived benefits of not having to reinvent the wheel.”

Clearly, this short-sighted (if not self-serving) attitude is one that needs adjusting. The obstacles Brothers points out are ones that need to be overcome if designers hope to serve their clients as well as many medical practitioners serve their patients. But first, do no harm.

P.S. In your efforts to create healthy spaces that are both beautiful and sustainable, you’ll need to find green products to specify. Be sure to view the coverage of the annual Bloom Awards, developed by Interiors & Sources and the American Society of Interior Designers to honor products that embody both aesthetics and environmental responsibility.

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