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A Design Vision

Planetree program certifies patient-focused design practitioners

By Kimberly N. Montague, AIA, LEED AP

Planetree, a not-for-profit membership network focused on transforming health care by considering the health care experience from a patient's perspective, recently recognized five architecture and design firms as part of the new Planetree Visionary Design Network. Albert Kahn Associates, Inc., Earl Swensson Associates, Inc., HMC Architects, Huelat Parimucha Ltd., and Kahler Slater were honored at Planetree's 2009 Annual Conference held in Baltimore October 4-7.

These charter members of Planetree Visionary Design Network were recognized as fully embracing Planetree's philosophy of building and designing healing environments that provide the greatest opportunity for caring of the body, mind and spirit from the perspective of the patients, families and caregivers who utilize the facility.

Recognition by the Planetree Visionary Design Network establishes firms as specialists in evidence-based health care design in alignment with the Planetree philosophy and its core components of healing design; such as welcoming a patient's family and friends, creating synergy between human beings and technology, enabling patients to fully participate as care partners and fostering a connection to nature and beauty.

Taking in the sites

As part of the certification process, a health care design project from each firm was visited. The facilities toured included Loma Linda University Medical Center (LLUMC) East Campus in Loma Linda, California and the Aurora Women's Pavilion in West Allis, Wisconsin.

At LLUMC, HMC Architects integrated the new building addition within the existing context and provided single-bed rooms for the patients and their families. Additionally, the new facility design incorporates light wells that allow daylight to filter into the interior spaces and provides a comfortable garden area for staff and patients alike.

Kahler Slater worked with Aurora Women's Pavilion to design an experience where health care is delivered in a nurturing, collaborative way while preserving the dignity of the patients. The holistic approach to care is comprehensive, not only healing women's bodies, but their minds and spirits as well. The desired patient experience is one of refreshment, inspiration and restoration. The facility houses comprehensive services, both inpatient and outpatient, that address the needs of women of all ages, from birthing to mid-life and surgical services. It also features a resource library, education center, retail and a spa.

As part of Planetree's efforts to continually promote healthy, healing and supportive environments for patients, families and visitors and staff in hospitals, clinics and continuing care facilities, Montague established the Planetree Visionary Design Network and Advisory Council in June, 2008. Members include architects, interior designers, landscape architects, wayfinding and artwork consultants, as well as dedicated partners in the design industry, each bringing their passion and knowledge to the creation of efficient yet beautiful healing environments. The mission of this group is to further the art of healing design and develop a broadly-based network of design professionals who share a passion and commitment to the Planetree design philosophy.

"The Planetree Visionary Design Network creates an affiliation and an environment for recognized leaders in the health care design field to share their challenges and experiences of success, inspire growth, support standards, and ultimately, develop strategies and mechanisms of communications with other designers and stakeholders which will increase the collective pool of knowledge, and subsequently, the evolution of healing design," says Advisory Council Member Karrie Frasca-Beaulieu, IIDA, of The S/L/A/M Collaborative.

Over six months, the advisory council developed the criteria for certification around the fundamental characteristics of a patient-centered approach, evidence-based design principles, sustainable practices and community outreach, with the goal of establishing a level of consistency in the details for what it means to create spaces that support the Planetree model of care.

"Planetree Visionary Design Network recognizes design firms that reflect the philosophy of Planetree, have the skill set to develop and execute, with their clients, Planetree environments. A Planetree facility design should reflect the culture of caring, nurturing and a patient first philosophy," says Phyllis Goetz, EDAC of Nurture by Steelcase, a member of Planetree's Design Advisory Council.

Certification requirements

Firms applying for Planetree Visionary Design Network certification submit an application which is reviewed by Planetree. Following acceptance of the application, a self-assessment tool is submitted, and an interview is held with firm leadership to comprehensively explore details of the organization's commitment to healing environments, evidence-based design, sustainability and principles of design excellence and innovation. The final step is an on-site tour of a recent project.

In the application firms are asked to complete seven sections: approach to design of healing environments, involvement with Planetree, evidence-based design, sustainability, certifications, publications and portfolio. To showcase a portfolio and how the Planetree model was integrated into design, a maximum of four projects may be described and five photos per project may be submitted.

A self-assessment tool is provided for firms and is comprised of a series of questions along with requests for documentation to determine the depth and breadth of a firms' experience. To evaluate vision and design process, a firm must articulate how its mission or its representative design team is reflective of the patient-centered philosophy; how community needs and patient perceptions are incorporated into planning and implementation; how hospital staff is involved and the integration of design and operational activities. The firm is also asked how it attempts to implement the Planetree model regardless of affiliation with the network, if it has participated in a Planetree Annual Conference and if the firm supports the advancement and communication of patient-centered care within the health care community.

In the evidence-based design section firms must demonstrate how they keep abreast of research and how research is comprehensively utilized relating to healing environments including the psycho-social as well as spatial attributes. Information related to this topic should include design work that includes the engagement of all the human senses considering mind, body and spirit of patients, families and staff. Also, are any of the firms' staff EDAC accredited, or involved with any Pebble Projects with the Center for Health Design?

To demonstrate commitment to sustainability, organizations should evaluate how green practices and methodologies are addressed with clients as well as within their own organizations. Applicants are asked to outline green practices which may incorporate a number of tactics including utilization of the Green Guide for Health Care and intent for a project to become LEED certified.

Finally, firms are asked to showcase their awards and recognition such as AIA Design Awards, VISTA awards or other local recognitions. Each firm is also encouraged to submit copies of any recent articles that have been published in architecture journals, health care magazines or related publications, in an effort to demonstrate their commitment to information sharing in the design industry.

Demonstration of knowledge base and a cultural assessment of the applicant firm are the key components for firms selected for the next step, an on-site visit. Once the interview is completed, each firm selects one project for two representatives from the assessment team to visit and evaluate the physical environment as it relates to the Planetree model of care and key aspects of a healing environment appealing to the five senses. During the visit, a detailed tour of the facility highlights each component, and the client is asked to comment on the relative success of implementation. A separate discussion with the client is conducted to review their satisfaction with the applicant firm's process and approach to creating healing environments.

Subsequent to the visit, a report is prepared by the assessment team, with recommendations and requests for additional information that may be required to complete or solidify the submission. Additional questions may address patient focus group data, design vision or intent or clarification of component integration. Firms are given a time frame within which to respond. As all information is received a comprehensive report is prepared by Planetree and submitted to the Advisory Council for review, along with recommendations for certification.

Benefits of recognition

Certification assists hospitals that are planning construction or remodeling, especially Planetree members, in finding a firm committed to the same patient-centered care philosophy. "As health facility architects, we have a huge passion for the design of patient-centered healing environments, and being certified by Planetree is the highest honor imaginable. It also informs our own staff what we believe to be most important, and that we expect all of our professionals to create only the best patient-centered care environments," says Albert Kahn Vice President Robert F. Sharrow, AIA, ACHA and LEED Accredited Professional.

The firms were acquainted with the Planetree network by being recognized in front of a large Planetree audience during the annual conference and they were also featured in the Planetree magazine and on the Web site. "Becoming certified by the Planetree Visionary Design Network benchmarks our firm's mission of "improving patient outcomes through design," says Joe Parimucha, Architectural Principal at Huelat Parimucha Ltd.

Design firms interested in pursuing certification by the Planetree Visionary Design Network can access the 2010 application and self assessment tool on the Planetree Web site, www.planetree.org.

Kimberly N. Montague, AIA, LEED AP, is director of design consultation services for Planetree, Derby, Conn. She can be reached at kmontague@planetree.org.