Health Design: Doing It Right

By Sara O. Marberry

Why interior design has a pivotal role in the future of healthcare design.


About one year ago, experts were predicting that healthcare construction would grow to $20 billion a year by 2010. According to a recent survey by Modern Healthcare, the complete cost of healthcare construction projects in 2005 already exceeded this mark at $20.7 billion. And a recent analysis by construction consultants FMI now forecasts annual healthcare construction spending to be more than $35 billion by 2008.

With so much new construction and renovation going on in the foreseeable future, an opportunity exists to use the emerging science of evidence-based design to do it right. That is the message that the Center for Health Design has been telling the healthcare and design community for several years now.

We aren't able to measure the full impact of our work quite yet, except to note that there are now more than 40 providers actively participating in our Pebble Project research initiative—all of whom have made a commitment to doing it right. There are already promising signs from the research that is under way and we are working to provide the tools and resources to accomplish that objective. That is the essence of the Pebble Project. It is not a Good Housekeeping seal of approval, but rather the acknowledgement of a commitment to build a better building, measure the results and share those results so that others can learn from them. The evidence needs to convey that design is not just about aesthetics; it's also about outcomes, and that is what we mean by doing it right.

Beyond the Pebble Project, a few hundred others have joined our community of affiliates to show their commitment, and many of them are accessing our various publications and resources. Thousands have downloaded the "Role of the 21st Century Hospital" summary report of evidence-based design studies from our Web site. The requirement of evidence-based design knowledge and/or practice is now appearing in many requests for proposals.

Interior design has such a vital role to play in healthcare design, particularly in environments where patients and staff spend a lot of time. Public spaces are important for first impressions and other reasons, but it is the design details in the patient rooms, nurse units, staff lounges, waiting areas, etc., that really separate the best facilities from the rest. And the design needs to be supported by the culture of the organization. For example, we recently toured a new hospital that had opened within the last year and while this award- winning facility was notable, we found a disconnect between the beautiful med/surg units and the ugly plastic paper holders someone had screwed into the wall outside the patient rooms. That is always why we have tours included in our conferences. It is one thing to talk about good design and look at photographs, but another thing to actually go out and see how it has been applied and maintained. We pioneered this idea in 1988 and each year we carefully evaluate many facilities and do site visits before choosing what we feel are the best.

Additional funding by the Robert Wood Johnson Foundation (RWJF) will enable the Center for Health Design to produce a Design Guidebook, a 60-page visual guide of exemplary design examples of typical rooms/areas in hospitals. Next year, also with the help of the RWJF, we are planning to launch Web-based tools that will provide virtual tours of exemplary facilities. It is our hope that both of these resources will provide valuable guidance for those designing healthcare buildings and interiors.

  • Sara O. Marberry, is the editor of Improving Healthcare Through Better Building Design, director of communications for the Center for Health Design, and president of Sara Marberry Communications in Evanston, IL. She can be reached at (847) 475-0427 or