Hospital of the Future - The 1% | ASID

Hospital of the Future Architectural Nonprofit / MASS Design Group Interior Design/ CAMA Incorporated

An on-going series of case studies that feature projects by ASID members participating in the 1% who are making pro bono service an integral part of design practice.

PRO BONO CASE STUDY / Nº8

DIALOGUE NONPROFIT / INTERIOR DESIGN

© PUBLIC ARCHITECTURE AUGUST 2015

An on-going series of case studies to make pro bono service an integral part of design practice.

Project Hospital of the Future Architectural Nonprofit MASS Design Group Nonprofit liaisons Michael Murphy Interior Design and Evidence-based Design Consultant CAMA Incorporated Design team Rosalyn Cama, FASID; Edward S.K. Bottomley, FASID; Elizabeth Oshana, Allied ASID; Anne Barthelemy; Michael Murphy; Alan Ricks; Amie Shao, LEED AP; David Saladik; Tanya Paz; Monique Guimond; Claire Lubell Area and Cost Scheme A – 153,625 SF / $27,771,251 Scheme B – 136,288 SF / $46,124,069 Scheme C – 291,347 SF / $119,087,559 Estimated pro bono hours: 1500 Collaborator Turner Construction More info www.massdesigngroup.org www.camainc.com www.turnerconstruction.com

Interior Design /

Architectural Nonprofit /

I first met Michael at the Center for Health Design awards program. Michael and I kept showing up at same nonprofit activities over a very short period of time, so we got to know each other.

CAMA and MASS were both shortlisted for a competition to design a hospital in Westchester, New York. It was pretty fortuitous that Roz asked us to partner with her interior design firm. She knew us as well from the Contract Magazine Designer of the Year Award in 2012, as she was on the jury that gave us that award. Roz has years of experience with healthcare interiors, so it was extremely helpful to collaborate with someone who knows the industry so well.

Rosalyn Cama, FASID, President and Principal Interior Designer, CAMA Inc.

Then I got a call from a hospital that was looking to repurpose their building. They put together a competition and asked if CAMA would submit.

When they realized that we were an interior design firm, they asked if we would partner with an architectural firm. I thought, “This could be really interesting.” So MASS and CAMA put together our team and submitted our qualifications.

The competition was for a hospital in Westchester, New York. The basic premise was to repurpose a community building and ask what it means to the people they serve. They asked for three scenarios.

We put ourselves into a think tank situation and developed three possibilities for the competition.

PRO BONO CASE STUDY / Nº8

Michael Murphy, Co-founder and Executive Director, MASS Design Group

The project brief asked for three approaches to the intervention: minimal, mid-range, and aspirational. It forced us to look holistically at what was wrong with the hospital from a systems design perspective. How had it evolved and what was not working within it? Our process uncovered several problems in the hospital design, which we developed into theses around how designers understand hospitals and the construction of medical facilities.

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An on-going series of case studies to make pro bono service an integral part of design practice.

Interior Design / The first stayed pretty close to code and proposed how the hospital might renovate their building and meet some of their objectives. The second level was to include more community-based health and wellness programs over and above the standard level of care. The third was to think outside the box. We applied MASS’ south to north thinking and that is what got the publicity. The hospital wasn’t prepared to see where we took the project.

The hospital was an older building that had structural limitations and poor mechanical and electrical, which needed to be upgraded. Turner Construction was part of our team, so they helped price these phases and included a cost analysis.

Our concept took the masonry structure off the building to lighten the load, which allowed us to add two more floors above the building. We also created a double-layered skin that would act like a chimney to heat air. The chimneys would create a negative pressure for air to flow out of open windows. Restrictive building codes may be binding, but they created a challenge and an opportunity for disruptive innovation through mechanical engineering.

As a competition, the client wasn’t there to get nervous and stop us. The short time period helped us get to a place that the client couldn’t have gotten to otherwise. The project gave me a beautiful example to take to other clients as a model of what can happen if they’re willing to go far out on the innovation curve line, using new evidence and some know-how from other buildings, and other cultures to build in a sustainable way. We’ve used the project to liberate the fear of what it would take to be truly innovative in the design process.

The competition was three years ago. If our design had advanced, the building would likely be opening now. The design would have needed to keep pace with the changes in health facilities over the last three years or it would be a little bit behind. No designers can go into a brick and mortar project anymore without figuring out the impact of new technology and the changing practice of delivering care. You have to look at the total picture and constantly tweak your program and your design solution.

PRO BONO CASE STUDY Nº8

Westchester Hospital Aerial © MASS Design Group

“The project has given me a beautiful example to take to other clients as a model of what can happen if they’re willing to go far out on the innovation curve line.”

— Rosalyn Cama, FASID

“Our process uncovered several problems in the hospital design, which we developed into theses around how designers understand hospitals and the construction of medical facilities.”

— Michael Murphy

I am a consummate volunteer, but at the end of the day, I run a firm and I need to make money to put the key in the door. Yet, we still manage pro bono projects like we manage every project. I urge my employees to volunteer, if not in the nonprofits that I’ve been involved in, then in local community efforts. We find the issues that are aligned with who we are and what we believe in. I bring that richness back to my studio and my collaborative team effort. We are forever changed because we continue to work in that way.

I learned a long time ago that my professional work at ASID was my place to get an education at a very different level. Did it come back to me? Absolutely!

Because I engaged myself, I ended up being on the leadership training track and got more training than most people do in large firms. I learned to speak in front of large audiences, how to write strategic plans, and how to negotiate contracts.

The things I learned from my volunteerism have played out over and over again in my work.

This project asked me to think differently about community health and delivery of care, and to build a very different experience for patients and for staff. It was one of my first experiences to completely repurpose a building to healthcare.

The staff at MASS brought innovative ideas of using

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An on-going series of case studies to make pro bono service an integral part of design practice.

Butaro Hospital © MASS Design Group

Architectural Nonprofit / In tackling the problem, MASS used many of the lessons and best practices learned from our Butaro Hospital project in rural Rwanda. There are clear programmatic variations that hospitals in emerging economies can show us about what is essentially wrong with US hospital facilities, and where they’re going. We think a lot about how to make hospitals more sustainable in developing countries.

corrupted over time. The original construction was a 1960’s bed tower which had a lot of really unique design features that could no longer be used or had become inefficient. On the other hand, they were innovative design approaches for that period of time. Returning to the design intent of the original building was such a useful lens to build our research for the Hospital of the Future.

Hospitals in these economies can also provide insight into the sustainability of electrical and mechanical demands on a hospital. A hospital is a very energy intensive environment that produces a lot of waste. To use an example: there is clear value to gain in trying to design new medical facilities versus adapting or renovating existing medical facilities in the US.

Hospitals need to do more for their communities than just provide acute care. Way-finding is one of the major problems in US facilities and it is a complete mess everywhere. For the Westchester project, we turned way-finding into a major success by improving and boiling down the hospital into a zone strategy that provided clarity in the circulation. There was also a challenge with the separation of clean and contaminated materials, such as linens. Redesigning the building along

This project also showed incredible insight into some of the design approaches that had been

PRO BONO CASE STUDY / Nº8

those fundamental parameters is clearly another challenge that every hospital deals with as it grows.

It was so wonderful and informative to partner with an interior designer to work on this Westchester hospital project. With Roz’s expertise on the team, it was especially amazing to approach the project holistically, in terms of how the building was used and experienced.

For my co-founder Allan Ricks and I, there was a clear and primary reason for launching a nonprofit architecture firm. In Rwanda, there wasn’t a market demand for architecture; organizations weren’t using architects. We had no choice but to position ourselves as a nonprofit that could be supported financially through outsiders and third party donations.

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An on-going series of case studies to make pro bono service an integral part of design practice.

“The healthcare industry needs good designers and a lot of good thinking in order to update and improve care delivery and safety.”

— Michael Murphy

Rendering © CAMA Inc. and HOK

Interior Design /

Architectural Nonprofit /

site and structure as a way to impact the interior experience. Through the project, CAMA and MASS built a very lasting relationship. We continue to do interesting work with MASS and this was the trial run. We’re all in it for the right reasons: to do the unthinkable and to design buildings that impact the way we live.

I have two pieces of advice for designers fresh out of school who want to get involved in public interest design. One, I would resist the inclination to label this work as humanitarian or socially-good architecture. I just call it architecture. The social, the humanitarian, and the political are all deeply important metrics that should be evaluated in every project. It’s a disservice to separate them as something else.

Two, undergraduates should be aggressive about finding projects. I recommend looking in your neighborhood and hometown, and leveraging the connections in your own community. Many small towns throughout the US lack access to resources and creative minds. They are reliant on a kind of industry-standard, typical design that isn’t really changing the way that people think about their own community. If you’re constrained by the limitations of the market, try to make your own market.

PRO BONO CASE STUDY Nº8

Even though the Hospital of the Future was never built, it was unique and ambitious. The hospital client brought good teams together and it came out to be a great design. I’d love to work with more healthcare leaders who are making hospitals that are openly and humbly asking for new direction.

Hospitals are one of the toughest architectural typologies and a lot of architects avoid thinking about medical infrastructure because it’s so complex. The healthcare industry needs proactive designers in order to update and improve care delivery and safety. Architecture in medical spaces is both one of our greatest challenges and opportunities, and one of the most important places that we can build.

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An on-going series of case studies to make pro bono service an integral part of design practice.

THE 1% PROGRAM The 1% program is a first-of-its-kind effort to encourage pro bono service within the architecture and design professions. It connects nonprofits with architecture and design firms willing to give of their time. Learn More PUBLIC ARCHITECTURE Public Architecture is a national 501(c)(3) nonprofit based in San Francisco. It engages architecture firms, nonprofits, and manufacturers to commit to design for the public good through its nationally recognized 1% program. Learn More THE SOCIETY OF INTERIOR DESIGNERS ASID is committed to advancing the profession and communicating the impact of interior design to enhance the human experience. Public Architecture supports the Society’s efforts to build awareness and opportunities for members to practice social responsibility and create positive impact through design. For more information, visit www.asid.org.

IN PARTNERSHIP The 1% and the American Society of Interior Designers and its Foundation salute the Society’s members on staff at design firms who contribute over $10M in services annually to the most vulnerable communities through The 1% program.

All Graphics, Unless Noted Otherwise, © MASS Design Group and CAMA Inc.