Bringing Policy into Medical Education


George Washington University Medical School is taking full advantage of its neighbors. Less than a mile from the highest offices in the United States government, George Washington University Medical School has begun to integrate public health policy into the curriculum through hands on practice. Recent projects include pitching ideas for managing asthma to city health officials and making suggestions for AIDS and HIV policy to the national AIDS czar at the white house.

The following article from NPR introduces how medical students are shaping the way policy makers look at health – and learning a lot about public policy issues along the way. Read the whole article on NPR: This Med School Teaches Health Policy Along with the Pills

E4H is excited by the idea of being a holistic partner in the pursuit of public health. We are encouraged by the innovations and ideas coming out of medical school campuses across the country. #Changemakers

How E4H is Organizing Knowledge


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.

How Tall Buildings Touch The Sky


Yesterday afternoon, in a quiet moment as I was staring out of my office window in midtown south, I was thinking about the skyline and how tall buildings touch the sky. Louis Sullivan theorized that the skyscraper (the new building form in his time) should be designed like a column, with a distinct base, shaft and top or capital. If you look at many late 19th century buildings in NYC, this directive seems to have been widely adopted.

Other architects, at the same time, took this in another direction. Drawing inspiration from Gothic architecture, they seemed to think that tall buildings should pile up and up in ever narrowing masses, culminating in points like those of the spires of a cathedral reaching toward heaven. All around us are examples of this design thinking. Then there are the modernist boxes, which disregard all of this previous thinking, and replace it with geometric repetition, sometimes with vertical elements to emphasis the height and sometimes with horizontal banding which often ignores both height and scale, piled repetitiously one of top of the other.

From my office I can see examples of all of these schools of thought as well as other idiosyncratic buildings, which seem to adhere to no particular theory. I see Raymond Hood’s Radiator Building on Bryant Park (peeking up out of anonymous masonry masses) ending in vertical spires, masonry buttresses and arched windows, gilded and glistening in the sunlight, piling up around an octagonal element (does it enclose a water tower?) spilling out white streams of smoke or steam into the blue sky around. Directly behind it is the WR Grace Building, an SOM geometric box, which rises in horizontal concrete and black glass bands to a banal flat band. Down the street, 200 Fifth Avenue grows in multiple masonry increments pushing itself in vertical limestone and brick ribbons upwards to a lovely pinnacle, which unfortunately is now held in place, silver boxes of air handling units. Peaking through a slot between fussy repetitive orange brick 1970s boxes is the glory of the Chrysler Building, shining in silvery arches pushing back into itself through to its iconic needlepoint. This building does not so much scrape the sky as inoculate it with Deco cadmium splendor. Lower down, squatting on top of multiple receding piles of masonry are those wooden barrels, variously hued, NYC water towers.

What a composition this cityscape is, so full of diversity and complexity, reflecting the imaginations and hubris of various ages, reaching upwards and upwards as if after some constantly receding prize in the sky! What a joy to look out upon it and to live and work in it.

Author: Jaques Black

Applying For A Job In The Design Field


A week or so ago, I took part on a panel for the IIDA Knowledge Forum. This is an organization that holds several informational events every year for students in the design field as well as awarding scholarships for prospective interior design students in the NYC area. The majority of students participating come from Pratt, FIT, Parson, SVA and the NYSchool of Interior Design. I had been recommended to the organizer by an administrator at one of our most important clients, actually, a person I would never have expected would even think of me. Anyway, this gentleman from Gensler Associates contacted me several months ago to see if I would be willing to serve on this panel. So, I volunteered. I was not however looking forward at all to the actual event. Though I had calendared it, it had gone out of my mind and I thought seriously of canceling, not something I ordinarily do. I am generally pretty moralistic about commitments. I suppose this is in part due to being an Eagle Scout and Assistant Scoutmaster all through my teenage years. Anyway, I went to 200 Lexington the night of the event and I participated on the panel. And I am so happy that I did.

There were four design professionals on the panel, two from Gensler, the largest design firm in America, one from a NY design firm that specializes in restaurant design and myself, an architect who specializes in health care design. Prior to the event, we had sent ahead our resumes and some information about our firms, which we then used as a general introduction. Then the two moderators asked us questions about the process of applying for a job in the design field, what to submit, how to format letters, resumes and portfolios, what employers are looking for in an applicant, how to dress, what to say, and generally how to present yourself when you are looking for a job. I looked out over the audience of about 50 people, most of whom were young students of all ethnic backgrounds, the majority young women, and I thought,” How amazing that some organization is doing this for you and how smart of you to be attending this event!” As we talked and looked at various examples on the screen of letters and resumes and portfolios, students busily scribbled notes, asking pointed questions and generally showing an amazing amount of enthusiasm and real interest in this process of applying for a first time job in the design field. How I wish somehow that I had had access to such an event when I was graduating from Columbia School of Architecture. Though I did have real work experience working in the Westchester County DPW Engineering Division for 3 summers, I still had no real idea of how to go about getting a job. When I graduated in a class of about 17 persons, it was during a major economic recession and only 4 or 5 people in my class had actual job prospects as we attended graduation. This type of seminar would have been most useful to me as I started my summertime search for a real job in the field of architecture. As I explained to the students present, I sort of fell into my current field by mere happenstance. I got an hourly job in the Planning Office at Columbia College of Physicians and Surgeons and after working there for 3 years got a job in a small architecture firm doing mostly health care design. Not exactly a blueprint for a well thought out career plan.

I talked for quite a while after the actual presentation with several students from various types of backgrounds. Most were concerned with the specifics of what to include in their portfolios, what will make the best impression. I advised one young woman who had been a pharmacist before deciding to go back to school for a design degree to include any materials that genuinely express her own personality, even yellow trace sketches or freehand drawings. “Most of all try to be yourself,” I said. ” Come across as a real person with real interests. ”

All the students seemed to have enjoyed the event and are eager to proceed with their job search once they graduate. Such enthusiasm coupled with a desire to use the design talents they have so diligently acquired in their time in school will go a long way to help them in their search. I told one young man that the fact that he was there at this event already put him ahead of most of his classmates. I hope that they all find great jobs with great firms where they can continue to grow into their chosen profession.

Author: Jaques Black