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The annual Academy of Architecture for Health Summer Leadership
conference, held July 17-20, 2008, at the Drake Hotel in Chicago,
drew members from more than 31 states, a record-breaking
attendance. The two-and-half day conference started with
provocative insights from the keynote speaker, David Dranove,
Ph.D., author of "Code Red: An Economist Explains How to Revive the
Healthcare System without Destroying It." He spoke about the
history of modern U.S. health care, and from there segued into how
to fix a broken healthcare system. Presidential candidates John
McCain and Barack Obama have each talked about fixing the
tax code as one way to reduce escalating health expenditures, a
move Dranove supports. The current system means the shift in
outpatient care will continue, and any inpatient care will need to
be flexible. "Cardiac and cancer wards are dying concepts," he
said. Building design will be an instrumental part of the change,
with beds becoming information spokes, and nurses becoming
information hubs.
Dranove was followed by Blair L. Sadler, past president/CEO of Rady
Children's Hospital, San Diego, and current Senior Fellow at
the Institute for Healthcare Improvement, who stressed the
value in research-influenced design. He said hospitals face greater
transparency around patient/workforce safety/quality issues, and
"progressive architects can achieve measurable improvements and
operating savings through evidence-based design." The goal should
be an error-free hospital, not a bigger hospital. "Winning
architects and designers will add value by showing evidence-based
design interventions which will help them succeed in the
marketplace through decreased operating costs and increased
satisfaction scores," he concluded.
Russell Perry, AIA, who leads Smithgroup's corporate sustainable
design efforts, discussed the value in sustainable design during
his talk. One must first consider the local climate
for the project: the building must be oriented to
be most energy-efficient and to make the most of
available solar energy. Green roofs will absorb storm waters,
and the use of regional materials, including certified wood, is
recommended. Portand Cement, which contributes to greenhouse gas
emissions, should be replaced with fly ash/blast furnace slag, and
hospital rooms, not outside streets, should be illuminated in
order to reduce light pollution.
The 2008 AIA National Healthcare Design Award winners are:
- Shenzhen Third People's
Hospital, Shenzhen, China. TRO Jung/Brannen designed this suburban
hospital near Beijing. The primary challenge was to
incorporate Chinese knowledge with "what we in the West can
do," according to the architect.
- Peter and Paula Fasseas Cancer Clinic at University Medical
Center, Tucson, Arizona. Designed by CO Architects, this
state-of-the-art clinic was finished in January 2007. The
architects were proud of bringing the project in under
budget, at $21.4 million.
- CHA Hospital for Women and Children,
Bundang, Korea, by KMD Architects. Called the "Prada of Hospitals"
by Contract magazine, this
hospital was a challenge because planners wanted to introduce U.S.
birthing concepts such as a LDR room, water birthing and an
improved NICU, which met reimbursement under the Korean health care
system.
- Designed by Polshek Partnership, Weill Greenberg Center, New
York City, combines state-of-the-art medical education,
ambulatory care and clinical research in one unit. The facility's
mission is to put a new face on healthcare.
Col. Thom Kurmel, U.S. Army, Chief of Staff, Office of the
Assistant Secretary of Defense for Health Affairs, addressed how
AIA members can "help us give better value" in his session on
"Learning from Your Medical System." He stressed that his work is
"about the building," and treating the urgent health care needs of
critically wounded soldiers. His department envisions a world-class
health system that supports the military mission by fostering,
protecting, sustaining and restoring health. The U.S. government
will spend $11 billion in the next five years to build new military
hospitals. Toward that end, construction has started on the new
Walter Reed Army Medical Center in Bethesda, Maryland.
There was considerable discussion in the Academy update, led
by Ray Pentecost, AIA, the Academy's President-elect, about the Guidelines for Design and
Construction of Health Care Facilities, now that AIA and FGI
have parted ways. Neither the AIA nor the ASHE logo will
appear on the 2010 edition of the
Guidelines, and copyright on the contents will be held by
FGI.
The update was followed by a spirited discussion on the value of
Integrated Project Delivery, focusing on contracts. Attorney Mark
Frielander favors one contract signed by all parties. "We can
return the architect to the role of master builder," he said.
He contends that this can save costs, cut down on change orders,
and increase overall project satisfaction. Other panelists,
including Jim Young and John Pangrazio, FAIA, were skeptical. "This
requires a lot of cultural transformation," said Pangrazio, and
Young argued that "value is whatever the client says it is." Col.
Kurmel noted that he cannot sign these kinds of contracts because
he is governed by congressional appropriations. "I can't
afford to watch over you," he explained. "It's not fair to the
taxpayer." Frielander optimistically predicted that Integrated
Project Delivery will eventually become popular, and stated
that "the contract is not as important as the attitude
of the parties."
The conference ended with two tours, one of John H. Stroger
Jr. Hospital Emergency Department and the other of Prentice House
Women's Hospital.
1. Open since 2002, John H. Stroger Jr. Hospital Emergency
Department is considerably smaller than the 3,000-bed Cook County
Hospital it replaces. In fact, the old hospital is being
demolished, and only the facade is being saved for an unspecified
future use. Tour host David Levine, M.D., talked about the
political challenges he and his colleagues faced when the hospital
was being designed. If he had to do it again, he would have pushed
for a bigger overhang in the emergency vehicle area, more storage
space, and wider hallways. The hospital has no major future plans -
just improving wayfinding by installing plasma signs similar to
those in DMV facilities.
2. Prentice House Women's Hospital, Chicago, has been open less than a year, but the
36-bed hospital has been a hit with patients, according to James
Bicak, AIA, Vice President, Campus Development. "There are bigger
rooms, more space for families," he explained. Unlike other
hospitals, Prentice officials promised that they wouldn't open the
facility with untested technology. That was a challenge, and the
jury is still out about whether this was an effective design
approach. Bicak plans to sit down with staff later this year for
their input on the new building.
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