Design Review in VR

Elliot Hospital team members review proposed design for new Urgent Care center.

As the dust settles from the recent explosion in Virtual Reality [VR] technology, one thing is becoming clear: it is changing the way we interact with the digital environment. Up until recently, developments in CAD and BIM technologies, as impressive as they are, had been stymied by the limitations of computer monitors and print media. The arrival of VR headset technology breaks through the traditional limitations of the screen and puts people “in” the design to experience, evaluate and comment from a first-person perspective. Over the past few years, we at E4H have been exploring ways of incorporating VR in the design review process, starting in the office and then bringing it to our clients.

At the Office

One of the most important things an architect can do is open their work up to their peers for review and commentary. This has historically been by pinning up work on the wall or showing things on a monitor, but lately we have been incorporating VR into these informal design review meetings in the office. One of our team rooms in the Boston office doubles as VR Lab, with furniture moved to the side to create an open space for walking around the virtual model without bumping into physical objects that can’t be seen with the VR goggles on. Team members can give feedback based on what they are seeing, including the “feeling” of the room using the true-to-scale nature of the software. Using IrisVr’s Prospect software, we can cycle through preset locations for doing multi-room reviews, add markups to the model, draw in space, and take snapshots for sharing these notes with others later

These VR design reviews also help to eliminate the distance between our offices and allows the opportunity to get feedback from our diverse group of designers across the country. Using our high speed network and multiple VR headsets, teams in Texas can review a project in New York and share comments based on their own recent work.

With Our Clients

In addition to reviewing the our work as a team, we also conduct VR design reviews during typical meetings with our clients. We recently used this during a final design development review at Elliot Hospital, with multiple users from different departments. We gathered feedback on equipment locations, casework configurations, outlet quantities and furniture arrangement. The perspective from the goggles is duplicated on via projection for everyone else to follow along and continue to offer feedback. Once the group gets past the initials fears or hesitancy to try them out, they often forget they are still sitting in a conference room. The technology has been a great facilitator of discussion with users of all kinds including doctors, nurses, administrators, facilities staff and more.

Find out more about our VR capabilities.

The 3P Workshop

In architecture school students are introduced to Louis Sullivan’s modernist mantra ‘form follows function’. This mantra follows a strict two-step chronology:

  • First, the function of the space is defined, vetted and communicated. Here the needs of the client and the space are outlined. Traditionally, this step is completed by the client with or without outside consultants.
  • In step two, designers are invited to explore the form or how the established function is spatially organized.

While this two-step process is widely accepted as the logical progression of a design, today many architects are being invited into the first step: defining function.

Often, our clients come to us questioning the needs and processes of a facility or department. The hospital has an interest in exploring a change of function, but the new requirements have not yet been defined. For example, we are often asked to examine metrics collected by a hospital and translate patient population projections into spatial requirements. Other times, when a department is interested in exploring a new treatment methodology, we are asked to explore the consequential spatial impact. We appreciate these requests as they seek to engage us in the entire process of defining both the form and the function.

To further provide services in line with our clients’ growing needs, several of our architects and designers have been trained in Lean and Six Sigma strategies. Lean is a process designed to reduce waste and increase efficiencies. Its principles and tools have been widely embraced by the business and planning professionals within the healthcare industry.

One Lean exercise we have found particularly useful is the 3P (Production Preparation Process) event. In these three to five day events both the process (function) and design (form) of a facility are carefully examined. The event is unique in its inclusion of all key stakeholders and users. It is not just healthcare executives making decisions regarding the future state of care delivery, but also physicians, nurses, support staff and patients. At each event current and future state flows are outlined and design solutions vetted across disciplines.

Our Lean Design Team recently hosted a 3P event for Lifespan Health System in Newport, RI. Across three days, more than 70 attendees informed the schematic design of a new 13,100 SF Emergency Department at Newport Hospital. The facility incorporated state-of-the-art strategies for emergency care, increases the number of treatment bays, expand triage capacity, expand waiting room and entrance space, and host a dedicated Rapid Treatment Area, Clinical Observation Unit, and Behavioral Health Suite.

Food in Healthcare

seedlings-rows

There is a growing trend in healthcare to make hospitals more hospitable. One element of this trend involves hospitals cooking up food that doesn’t taste like ‘hospital food’, but instead restaurant quality fare.

Many restaurants across the country have embraced the ‘localvore’ movement (cooking with locally sourced ingredients). Chefs find that the practice is healthier (requiring fewer preservatives and processing to the foods), more sustainable (necessitating less travel distances and decreased carbon footprint) and more neighborly (purchasing directly from nearby farms and companies).  Hospitals are taking note and have begun to look local for food sourcing.

This trend is not new to The University of Vermont Medical Center (UVM Medical Center). Through our ongoing relationship with the health network, both as architects and as patients (many of our employees utilize the UVM Health Network for care), we have come to appreciate firsthand the benefits of delicious locally sourced food. As part of their sustainability initiative, the University was one of the first to sign the Healthy Food in Health Care Pledge in 2006, dedicating itself to, “providing local, nutritious and sustainable food”. As well as supporting local farmers, it maintains a roof garden which supplies the cafeteria with fresh blueberries, kiwi and assorted vegetables, when in season.

E4H has worked with UVM Medical Center to support multiple sustainability initiatives, during our recent design of the Robert E. and Holly D. Miller Building  at UVM Medical Center, representatives from Nutritional Services were a part of the design team, contributing input on how to best address the nutritional needs of patients in the acute care setting. We have also worked with department leaders to achieve LEED Gold Certification for the  newly renovated Mother Baby Unit and Clinical Research Center.

It is also interesting to note that Hospitals & Health Networks recently reported Connecticut’s New Milford Hospital saw its patient satisfaction scores rise from the 30th percentile to the 95th percentile after implementation of its Plow to Plate local food sourcing movement. Serving tasty local food may also be good business.

We are happy to partner with forward thinking companies like The University of Vermont Medical Center and are excited to see the trend of locally sourcing food to spread across the country.

How E4H is Organizing Knowledge

BosOff-16_1000x620

A Community of Practice

Architecture is more than a set of drawings. While drawings are a tangible commodity of practice, the Architect’s most valuable product is knowledge.

For many years our respective offices have produced and fostered knowledge regarding the design and construction of healthcare facilities. Our ability to stay competitive within the marketplace was contingent upon our ongoing generation and distribution of intellectual capital. Stepping out of our silos, we look at E4H as an opportunity to further cultivate our knowledge base through collaboration and cross pollination.

Knowledge and the appropriate organization of knowledge are critical to our practice. In the article Organizing Knowledge Dr. John Seely Brown and Paul Duguid, experts in the science and business of information, contend, “Intercommunal relationships allow the organization to develop collective, coherent, synergistic organizational knowledge out of the potentially separate, independent contributions of the individual communities.” Through organization we seek to cultivate and direct our most valuable resource: our knowledge base.

Know-What versus Know-How

Knowledge may be filed away for reference in an individual’s brain or an interoffice database, but this does not produce organizational knowledge. Such archived information is know-what and it is relatively ineffective without know-how, the understanding of how and when to utilize it. If information is our most valuable asset, but it is rendered relatively useless without know-how, then how do we begin to foster both? Brown and Duguid explain that such dispositional knowledge is best acquired through collective practice – communication with colleagues, contractors and clients. They write, “Collective practice leads to forms of collective knowledge, shared sensemaking and distributed understanding that doesn’t reduce to the content of individual heads.” E4H is organized into communities (aka “workgroups”) designed to foster collective knowledge through collective practice.

Specialized Knowledge

E4H is a 100% healthcare design firm. The benefit of specialized knowledge was introduced by Plato and enriched by the father of modern Economics, Adam Smith. Smith explained in his treatise, The Wealth of Nations, “The greatest improvement in the productive powers of labour, and the greater part of the skill, dexterity, and judgment with which it is anywhere directed, or applied, seem to have been the effects of the division of labour.” Specialized groups are able to produce highly specialized bases of knowledge. The healthcare industry recognizes this fact through increasing demands for fellowship trained physicians and specialty practices. As healthcare design evolves and grows ever more complex, a specialist is necessary for the design of healthcare environments.

Ecologies of Knowledge

We believe the sum of our intellectual capital is greater than its parts. We seek to forge a synergistic community of practice in order to expand our intellectual capital and achieve collective understanding. Brown and Duguid describe the mutually beneficial qualities of interdependent communities, “Such hybrid collectives represent another level of in the complex process of knowledge creation. The outcome is what we think of as organizational knowledge, embracing not just organizational know-what but also organizational know-how.” Our architects and planners are excited to share best-practices and project experience across E4H.  We believe embracing a culture that fosters both know-what and know-how will contribute greatly to our organizational knowledge and bring tremendous value to our clients.