Taking Design to the Next Level

Like many accomplished people, Roz Cama stumbled into her success in the healthcare design field, the specialty for which she and her namesake firm are widely known and respected, almost by accident. Early in her career—only a few years out of school and in the midst of a recession—Cama was evaluating professional directions when her mother found a small ad in the local paper for a draftsperson at Yale-New Haven Hospital in her native Connecticut. She took mom's advice and applied for the job she thought would be a stopgap, ended up staying for six years, worked on a major building project and found her life's work. That experience introduced her to the fields of architecture and engineering and provided a tremendous education and understanding on what it was like to sit on the client's side of the table. It also introduced her to the medical field and once there, she was hooked. "When you sit down with the parents of sick children or the nurses who deal with chronically ill patients," Cama explains, "it doesn't take long to grab your heart and know that you're not ever going to do anything else in your life. Sometimes I think it would be nice to do an executive suite somewhere, but truth be known, these are people who need the nurturing surroundings that complement their medical care, and there's no turning back once you get there."Although firmly committed to her healthcare career direction, Cama turned to Sam Brody, one of the principals on the Yale-New Haven Hospital project, for pragmatic advice on what to do next. Sitting in his Manhattan office overlooking the Chrysler Building, she recalls his wonderful fatherly lecture."Roz, you have three choices. You can go back to school for a master's degree in architecture, but why would you want to do that? Or with the experience that you've just gained from this project you can call any architectural firm in this country that's doing healthcare and, in a minute, they will hire you. Or, you can do what I did—you can start your own business. The worst thing that will happen is that you'll fall flat on your face and then you'll just go out and get a job. So," Cama remembers him saying, "go find yourself a client. You can do this."Brody was right, and last year CAMA Incorporated celebrated its 20th anniversary. In addition to Brody, others have played significant roles in the firm's early successes including Rhoda Russota, a local residential designer Cama met through ASID, who taught her the business side of interior design, and Ed Bottomley, her second employee who became a partner in the firm in 1998. Housed in a historic 1883 Queen Anne-style Victorian building in downtown New Haven that Cama bought and renovated, the firm is currently 10-strong and, in its own words, "creates interior environments that improve life's experiences."CAMA is an interior design firm, hired either directly by clients or brought into a project by an architectural firm to help secure a job, or as partners to balance out a team. The evolution of these relationships has led Cama to believe that the dynamics between architecture and interiors practices are changing. "When we get asked to the table by a client, we get respected at a very different level than the interiors departments within architectural firms," Cama states. "However, I have noticed that many architectural firms now have integrated their interiors department into their practices, meaning that the interiors piece does come to the table a whole lot sooner and with greater influence."Clients, she believes are beginning to understand the interior designer's unique role and the importance of early involvement, well before the design development stage. If a building is already under construction by the time the interiors are planned, walls may have to be moved, power sources relocated and reflected ceiling plans revised—all at significant cost to the client. Cama tells of a birthing center project where the client, after meeting with her firm, decided to abandon the traditional labor and delivery rooms and incorporate a postpartum suite with live-in capability for the fathers. However, the original floor plans hadn't left sufficient room for a sleep chair or sofa, and after conferring with the owner, architect and construction manager, it was decided to put in bay windows to create more square footage in the patient rooms. This was an expensive solution, yet the client felt it essential as its marketplace was asking for this type of arrangement."It doesn't take too many of these kinds of experiences," Cama states, "before someone says, 'Hey, wait a minute, why aren't we asking these questions sooner?' The fact is, you want to explore different options well before you start your design, gathering what I call an evidence-based body of knowledge that is contingent on research and strategic thinking."Cama remembers in the early days of her career how she and most designers would say to their clients, "Trust me because I have all this experience so I know what's best." Today she knows that such experience-based judgments are hard to justify. Research, on the other hand, produces statistical data which proves, for example, that engaging a family member to participate in care-giving empowers patients and creates employee satisfaction. It presents a very different scenario that translates into economic benefits. "If I can say to the board of directors that putting a banquette in the room so dad can spend the night will save you hundreds of thousands of dollars a year because mom is relieved, stress is gone and the work demands on the nursing staff are reduced, then I, the interior designer, have their attention and that creates a very different business approach to the work we do. It's no longer just what color should we use or what fabric should we put on the banquette. We're talking about solving a strategic initiative and accomplishing a financial goal for an institution," Cama concludes.Much of Cama's thinking has evolved from her very active volunteer participation in two organizations. The first, the American Society of Interior Designers (ASID), has been focusing on a research-based approach to design and marketing since the mid-'90s. It was then that she started seeing people talk about design at a very different level, and as the organization's marketing and communications chair followed by a term as its national president in 1999, Cama was one of the principal players in the development of ASID's progressive programs.Although she remains extremely active in ASID, Cama is focusing her current volunteer energies as the chair of the board of directors for the Center for Health Design, a non-profit organization that promotes the relationship between quality healthcare and evidence-based design for the built environment. One of the center's most exciting initiatives is the four-year-old Pebble Project, which is examining how facility design ripples throughout the healthcare industry much as a pebble tossed into a pond creates a ripple effect in the water. Twenty-one hospitals are engaged in pre- and post-construction research in order to demonstrate that facility design can impact the quality of care for patients, the work experience for staff, have a positive financial benefit and improve community and corporate support."We realized," Cama states, "that if we really wanted to make a difference we needed to arm designers and their clients with the information they need to take decision-making to the next level. Whether it's the director of engineering going to a vice president of planning, or a COO who has to present to the CEO, or the chairman of the board who has to go to the community to raise the funds, the more information they have, the stronger their case will be and the more we will put in place the types of building projects that incorporate the kinds of things that enhance the healthcare experience. By arming the practitioners who then arm the business decision-makers, we are taking design to a higher level of respect."The Pebble Project has received a good deal of attention of late in both the design and healthcare media, and Cama is particularly excited about its effects on the design profession. The future, she believes, lies in multi-disciplinary professional teams that will understand the necessity of research enriched knowledge, interactions and constant questioning. One of her firm's most provocative questions asks, "Do you know what comes after what comes next?"What comes next for Roz Cama is more of the same, just more so. She's grateful for the opportunities she's had to participate in these forward-thinking organizations and content with her personal life and professional direction. She hopes her future involves giving back and inspiring the next best thing from her employees, peers, students, young designers, hospital administrators, contractors—anyone who can contribute to improving the environments in which people live and heal. Her firm is doing more and more consulting with smaller, community-based hospitals who are asking for help in articulating a lot of these concepts into their building programs. Rather than being hired to do a project in the traditional way, CAMA is participating with the entire team in developing direction and managing the experience for their clients. Especially satisfying is a just-completed project for the firm's oldest client, Yale-New Haven Hospital, which has recently opened its new Shoreline Medical Center, a satellite annex to satisfy the residential community's need for emergency, ambulatory care and other services. Also, the hospital is about to build a $380 million Cancer Center Pavilion that is proposed to be LEED-certified, a project which Cama anticipates will become all-consuming.Even so, Cama and her partner Ed Bottomley are happy with the size and tenor of their practice. "It's perfect for the kind of work that we do," she says. "It's big enough to get us into the types of projects we want to do, yet small enough for Ed and me to manage. It gives me the freedom to participate in ASID, the center and other activities that come up. If we were larger and had more partners, I probably would have to make difficult choices between the firm and my philanthropy."When Cama speaks before groups she conducts what she calls "a silly little exercise" where she asks people to close their eyes and imagine themselves in their ideal place, and is continually surprised that almost everyone, including those who design interiors for a living, select an outdoor spot. "Given these results, I would hope that someone listening to me will be inspired to develop a new building type that recreates everything we respond to in nature and brings it indoors. I think a lot about how most people live in homes that aren't always pleasant. We may love our homes, but we have been victims of a building and construction industry that has dictated how we live."Cama is similarly critical of developers who build the big box commercial buildings which, by definition, confine the architects and designers hired to fit them out to narrow parameters in lighting, colors, textures—all the things that our senses respond to. The time has come and the technology is there, she believes, to be able to develop very different environments. "No good idea is housed by just one person," Cama continues. "People paying attention to what's going on in the world are bound to have the same ideas at the same time because we're all being influenced by the same things. It isn't about any one of us, but it's about the collaboration between us. I give you a great idea and force you to think a little differently about what you're doing, then you'll spark it in someone and this great chain reaction for innovation is created."CAMA Incorporated31 Audubon St.New Haven, CT 06511(203) 777-9921www.camainc.com