AIA, NCARB, CSI, ICC
Constructive Criticism columnist Paul Gladysz, AIA, NCARB, CSI, ICC, is the principal architect at BDA Architecture. The Albuquerque, New Mexico, firm specializes in the planning, design and construction of animal care facilities. Gladysz has over 35 years experience in design and managing animal care facility projects. He has been involved in more than 300 veterinary designs, including 20 award-winning projects. His areas of special interest include project delivery methods, including design/build and construction management; lighting; acoustical control and new construction materials and methods.Read Articles Written by Paul Gladysz
Creating a new veterinary hospital is a big task. So many parts to consider, so many needs and constraints to balance. Everyone expects a building to do the basics: stand up, not leak, have working lights and plumbing.
However, truly good buildings are expected to be more of a home than a house, more of a museum than a collection of objects, more of an experience than a store. A clinic also can be more than rooms full of medical things; it can be a healthful place. I’m referring to a place that both provides healing and enhances the well-being of all who pass through the doors: patients, clients and employees.
Traditionally, the building is an efficient machine designed to resolve patients’ medical issues. Indeed, it should be. But just as a home is more than a house, a clinic can be more than surgery and an ICU. How can designers and hospital owners work toward doing that?
Do You Feel It?
When someone walks into an impactful space, feelings — sometimes emotional — are generated as the result of skillful design. What aspects of that space cause us to “feel” it? Surprisingly, until recently there has been little empirical research into this subject.
The Academy of Neuroscience for Architecture, an organization I’ve connected with, has begun to change the thinking. ANFA says its mission “is to promote and advance knowledge that links neuroscience research to a growing understanding of human responses to the built environment.”
In effect, when someone walks into a cathedral, part of the visitor’s brain makes him say, “Wow!” ANFA wants to identify aspects of the cathedral space that are neurologic triggers. Turns out, it’s not one trigger but a collection of overlapping attributes. Without the play of light showing it off, the cathedral’s impactful space is greatly diminished. Contributing factors include the acoustic signature — such spaces sound differently — and its scent, temperature and sense of discovery.
The takeaway is that hospital designers know we must address the whole experience.
Construct a Place of Refuge
If you are interested in creating healthful space, you must consider the patient, the client and the staff because one plays off the other. Patients can be anxious, even fearful, of a clinic. Why is that? Intuitively, we say it’s because they pick up on other fearful animals. It also may be linked to their owners.
A study published in October in Animal Cognition established a link between the stress of a person and that of domestic dogs through chemosignals alone. Add to that a dog’s ability to read body language and facial expressions — see a report at http://go.nature.com/2gKqkwO — and you will see that client comfort greatly impacts patient comfort. Make clients happy and it’s far more likely their pets will be, too.
The client experience begins before she enters the hospital. Is the parking adequate? How does the building present? Does it reflect the practice’s character and quality of care delivered? Many visits are made by clients in distress. They are fearful for their loved one and are anxious because of uncertainty. People fear the unknown. Your building needs to say: “You are welcome here. This is a place of refuge.” The goal is to elicit a sense of calm; a safe harbor has been reached.
Designers of human hospitals strive for these features, and we can, too. Once the pet owner is through the door, the architectural message continues but the staff now becomes the driver. Is the client acknowledged as she walks in? Is she greeted in a welcoming manner and by both her name and her pet’s? Is the paperwork ready? Is there a comfortable place to rest? Is water offered? The message you want to convey is, “We will take care of you and your pet.” Client anxiety goes down and, as we’ve seen, so does the pet’s. The healing has begun. That same theme carries through as the technician brings them to the exam room, as the doctor enters and greets everyone, as concerns are heard and acknowledged. This is the art of medicine showing its value.
A Science and an Art
Notice I haven’t mentioned much about the space itself. The fact is, architecture does not create an excellent practice, but it can facilitate one. The job of a hospital designer is to create a place that helps you practice your way more effectively. After completing hundreds of clinic projects, I’ve yet to see two exactly alike.
Much like the practice of medicine, architecture is both a science and an art. The science means common features such as durable and cleanable floors, attention to odor and noise control, properly sized rooms. The art is in creating spaces to comfort and inspire. Well-located bright and airy spaces make for a happier place to work.
I use a term learned from one of my best clients: staff agility. The client described it as how quickly and efficiently a task can be done. Fewer steps and less effort result from proper attention to organizational planning. Making someone’s job easier makes them happier. Clients pick up on a happy staff. While a set of rooms cannot create a well-managed practice, it certainly can enhance one. Attracting and keeping excellent staff is much easier and will save a pile of money.
According to international architect Norman Foster, when considering the average cost of a building over a 25-year period, the physical envelope comprises only 5.5 percent of the total. Occupying the building represents 86 percent. Foster’s experience highlights the fact that a small investment in design quality can quickly make a significant impact on the much larger percentage. We see this firsthand. Over the last five years, our clients’ average net revenue increase has been about 20 percent in the first year. This is not primarily driven by an increase in new patients, though a new building will generate interest. The numbers grow because of a more efficient staff, better morale, less absenteeism, a higher level of client compliance with recommended procedures and follow-up care, and a marked increase in feline visits.
Other industries have exploited this strategy for decades through typically big-budget projects. Most veterinary practices are not that large, so the challenge for designers has been to glean lessons learned elsewhere and find creative ways to apply them to smaller projects. The good news is there are many examples of excellent small designs that we can learn from and be inspired by.