Are you an Architectural Luddite?

Do you cling to the comfort of the way things are “supposed to be” as you compulsively align the objects on your desk?  Are you made uncomfortable when new practice paradigms are introduced, choosing first to disregard, then criticize them, only grudgingly adopting them when your clients say you have to?  On the innovation curve spectrum  you would rank as a laggard.  But you probably don’t see yourself that way.  You think that you are being smart by not jumping ahead as an early adopter of the latest trends.  You grouse about how the market is changing and everything is so much more competitive.  You really have no clue how to survive in this changing market, so you double down on the old way of doing things, you stay in your comfort zone and maybe feel really clever that you are making the same old presentations and decisions, but using digital technology.  Like the Luddites  resisting mechanization during the Industrial Revolution, you are futilely fighting change.  Is the new the predator of the old, or simply its evolution?  

The emperor has no clothes

Skills are transferable, habits and routines are not.  A creative mind set free knows no limits.  So ask yourself, are new paradigms that challenge your comfort zone really bad, or are they threatening to expose your own fears that you aren’t creative enough to handle the change?

A small reward is better than none

Sure in a red-ocean, highly competitive environment, there are still winners and losers.  In fact that’s the point- to eliminate competition at all costs.  But that also diminishes you because it undercuts the overall value not just of an old paradigm, but of who you are and why a client should work with you at all.  The next time you feel the urge to smugly declare “winning,” just think of Charlie Sheen.

It’s the new normal

This mindset, now pervading our culture, is just pathetic.  To think that you have to settle for living up to less than your full potential (and by transference your work and the effect it has on others) shortchanges society as a whole.  It becomes a self-fulfilling prophecy of a future that doesn’t have to happen.  If you find yourself just settling, it’s time to start asking why you are holding on to processes and paradigms that are clearly not serving you.  No one can be innovative if they aren’t passionate and accepting a bleak fade into the abyss is hardly inspirational.

A great piece by Thomas Fridstein for Design Intelligence, “Adapting for Success in the New Practice Environment” exhorts us to embrace the opportunity that comes with change.  His tips for blowing up the old way we practice involve evaluating everything we do with fresh eyes:

1.      Look at the context of practice much as we would analyze the context of a project site

2.      Adapt for success by being, creative, client-focused, competent (and yes even with new technologies or design methods, Fridstein specifically mentions sustainability and BIM), cost-effective, collaborative and global.

3.      Design the design firm by looking at ways you can serve clients better while inspiring and nurturing your employees more.  Last century’s model with its pretext that you are lucky just to be working doesn’t cut it anymore (yes, he does bandy about the term “the new normal” to express the fact that change is here to stay.  I am choosing to forgive him for that because otherwise it’s an insightful piece).

As my friend, life coach Jane Scott Ashley once told me, “Life isn’t what’s happening while you cling for dear life to the trapeze you’re on.  It’s what happens when you let go so you can reach the next one.”

Aspiration vs. Inspiration

Most of us are not unfamiliar with achievement.  On the battlefield of office politics, project expectations, and ever shifting work paradigms, we focus on scoring small victories daily.  We are also not without ego.  We want to do amazing work and have that work be appreciated and recognized.  But, with so many metrics by which our performance is judged, we can’t possibly dance to all those tunes.  How many times do you find yourself settling into a single mode, putting on, say, your sustainability hat to the neglect of managing things, or your manager hat to the detriment of thinking outside the box?  Let’s not even go to lean thinking, silo-busting, or ROI.  We’ve been conditioned to aspire, and that soon becomes our undoing.  That’s because aspirations are external motivators- other people’s ideas of success.  Attempting to please everyone muddies the waters and results in mediocrity, especially when the goalposts keep moving as new metrics get developed.  Aspiration is a treadmill, not a path.  It’s time to hit the off switch on these bad habits:

Exceeding Expectations
Implicit within this lovely catchphrase phrase is the idea that the expectations were clearly communicated and that they contained some threshold for clearly measuring success; which is not really in fact what will be considered success as you should have exceeded it.  In this economy, our clients cannot succeed if they pursue mediocrity and they hire us to access and facilitate fresh thinking.  Transformational projects never arise out of metrics.  They arise out of questioning existing patterns and habits and freeing ourselves from expectations.  Stop handicapping your vision. Instead of asking, “what now?”  ask “what if?”

Expectations are also tied up in emotion.  The fear of not meeting expectations leads everyone involved to play it safe.  That isn’t inspiring to anyone.  Instead, try pulling back to a more logical viewpoint, one that justifies thinking big by providing a path to get there. Focus on the solution and the trials and tribulations of the process will seem less onerous.

Marching into the Abyss
Of course we would like our next project to be user-centered, efficient, restorative, and transformational.  Of course we want to collaborate with the project team to leverage expertise and find innovative solutions that are faster to build, more cost effective that the traditional ones and save even more money over the life of the project.  Of course we want to attract and retain the best staff, satisfy our patients, residents or customers, and generate positive marketing. That some enterprising souls have found ways to codify these things (LEED, Lean, Evidence Based Design, organizational management, BIM, etc.) should make it easier for us - right?  Eh, not so much. 

When you try to add project expectations and tools together like a layer cake, you don’t get much real benefit from them.  Moreover, you drive yourself and your project team crazy chasing rainbows.  LEED, for example, can actually hurt the project’s overall quality *gasp* not because LEED is inherently evil or that sustainability shouldn’t matter, but because you aspired to be sustainable instead of being inspired to provide a better environment.  When we lose focus on why we are building in the first place and get distracted with “measuring up,” we start doing things that are not in alignment with the project goals or our personal ones.  We miss opportunities to enforce these goals in ways that would probably blow the doors off the LEED scorecard.
 
Chasing Proficiency
Scattered energy impacts nothing.  Trying to follow all of the buzzwords and metrics is more than just exhausting, it obscures your clarity.  Let go and start practicing with purpose.  When you know what you are all about and pause to plan how to express that in your work, you suddenly find yourself passionate, energetic and clearly communicating your vision to others.  Your inspiration leads them to be inspired as well.  This alignment of purpose and passion creates the focus that allows us to achieve the seemingly impossible. It is this distilled message and effort that leads us to mastery over mediocrity.  Mastery is what our clients crave and seek out, what the market rewards. Achievement is not about ego, which is limited by aspirations of what “should” be.  Instead, it is about having a consistent philosophy that can be understood by others. When you are functioning as your highest self, others will see you that way as well.

Simplify and pare down instead of frantically rushing to adopt whatever trend you recently read about.  Focus on the things that really matter to you and design on purpose instead of by default, allowing all the checklists, codes, technologies, requirements and strategic alliances to limit your vision then using that as the excuse for why the project wasn’t better.

Aspiration is playing into the expectations of others, inspiration is following you own path.  Do you want to get somewhere or not?

How Does your Garden Grow? The role of Therapeutic Landscapes in Design

What does landscaping mean to you?  Most likely, not nearly enough.  Too easily, we view it as decorative, a “nice to have” part of a project.  However, as we learn more about salutogenic design and the effects of the environment on wellness (everything from healing to better job performance), landscape starts to become a critical element, one which should form the basis of design.  With this in mind, I asked Naomi Sachs, Founder and Director of the Therapeutic Landscapes Network (TLN http://www.healinglandscapes.org) to share some insights on the power of nature.  Naomi is a landscape architect and recognized expert in therapeutic landscape design, and part of the Center for Health Design’s Environmental Standards Council working on expanding the Environment of Care section of the 2014 Guidelines for Design and Construction of Health Care Facilities.  Rather than helping afflicted people to feel less bad, her goal is to use landscape to make them feel good:
Usually, when architects think about landscaping, we think about outdoor rooms or ways to enhance areas like building entries or parking lots. What are your suggestions for getting more landscaping inside of buildings?
Nature needs to be viewed as a part of the built environment.  While being out in nature is best, bringing it indoors with interior gardens, atria, or even potted plants is the next best thing. A great recent example of nature incorporated within the building is the Stoneman Healing Garden at Dana Farber’s Yawkey Center for Cancer Care. Providing windows is an excellent way to allow visual access to nature, which is especially important when people can’t go outside. Allowing for views out also lets natural light in (one study found that patients in east facing rooms who were exposed to morning sunlight did better than other patients), and “advertises” the garden, which then encourages use.  Research has also shown that while images of nature, like artwork or videos, do help people, they are not as effective as views of nature through a window or – best yet - an experience of real nature. Using natural materials (wood, stone, etc.) is another way to “bring nature in” to an indoor space.

In terms of facilitating access to the outdoors, transitions from one to the other are critical: Architects must design to minimize barriers (providing flat thresholds, doors that are easy to open, etc.) and allow for transitional spaces, such as a paved area with an awning where people can enjoy the outdoors close to the building, even in inclement weather, and can get a sense of the space before they venture out into it.

How do you explain the link between nature and wellness?
Biophilia – our innate attraction to life and living things - is intangible, but research is working towards measurable results. The book Healing Spaces: The Science of Place and Well-Being, by the neuroscientist Esther Sternberg, addresses the role of nature not only in reducing stress, but also in eliciting positive psychological and physiological responses.  For example, Sternberg documents how seratonin receptors in the brain, when exposed to positive sensory stimuli, light up. She posits that being outside creates multiple positive stimuli (and therefore more seratonin) because it’s a multi-sensory environment.  You can hear the birds, feel the sun on your face, smell flowers or freshly mown grass.  Being outdoors also enables exercise, and tends to facilitate social connections because people are more relaxed. At the San Diego Hospice, the nurse leading my tour of the facility observed that people shared more about themselves and their situation when outside. 


Kuo and Taylor have published several studies that measure the positive impact of green settings in reducing ADHD symptoms, and the correlation of trees in a neighborhood to reduced domestic violence, lower crime rates, and higher self esteem.  These studies show, empirically, that people in environments with nature do better.  Research by Whitney Gray presented at Greenbuild 2011  focused on sick building syndrome.  Gray looked at sick days, turnover, stress, and ability to concentrate; when access to nature was provided, there was a measurable improvement in all of these factors. Debajyoti, Harvey, and Barach showed that nurses who had a view of gardens over those who just had access to natural light, or no windows at all, were better able to concentrate and had less long-term stress. When you think abut the fact that it can cost around $60,000 to train each new hire, the economic benefit of providing access to nature is huge. (Full citation is below)

Maintenance is always a concern when it comes to landscaping- I’ve actually worked with healthcare clients who wanted nothing but grass in the areas they “had” to landscape for ease of maintenance.  What kind of recommendations can you make to landscape skeptics about using plantings?
Access to nature just makes good business sense. Studies by Roger Ulrich, confirmed by others, have demonstrated less need for pain medication, improved patient satisfaction, faster recovery rates, and many other examples of improved outcomes for patients and staff. When you really look at the benefits of providing access to nature, the return on investment (ROI) justifies the initial cost and lifetime maintenance.  Hospitals need to see landscaping as a strategic investment in the same manner they would the purchase of a new MRI.

Sure, a lawn is better than no landscaping at all, but when you consider the benefits of gardens and more designed landscaping, you can make the argument for the cost of maintenance. A study by Matsuoka showed that students viewing just lawn vs. a more varied view that included trees and shrubs performed better. Access to a lawn is often restricted; it may be wet or uneven, and wheelchairs cannot travel on it.  Lawns are best as one element in children’s play areas, since they – especially visiting children - need to run around and blow off steam. [In case you want the full citation: Matsuoka, Rodney (2010). “Student Performance and High School Landscapes: Examining Links.” Landscape and Urban Planning, Vol. 97]. Incidentally, lawns actually take a LOT of money to maintain: They need regular irrigation, fertilization, mowing, leaf-blowing, etc. Facilities that are using alternative landscapes such as native meadows and rain gardens are finding significant savings after the initial investment. And at the same time, they are sending a very positive message about their commitment environmental as well as human health. It’s all related.

That being said, the landscape architect needs to know the resources and capabilities the client is willing or able to put into the project – up front and for the future - and design around that. Your typical “mow and blow” crew is not qualified to handle anything more than routine maintenance, so there needs to be a funding strategy in place for an annual maintenance budget. It’s also a good idea to create a maintenance manual for staff or an outside landscaper to follow.
Some healthcare facilities, usually those with a horticultural therapy program,  integrate gardens into physical and occupational therapy.  This is a great way to provide benefit to patients while keeping the garden expertly maintained. The gardens at Legacy Health, in Portland, OR, are excellent examples of this strategy.
Healing gardens can be easy to raise money for because they are “warm and fuzzy.” The institution can also use the space for social events and to generate PR (promotional materials, events, press releases, etc.). The likelihood of assisted living facility resident referrals has been shown to increase with the quality of the grounds.


What is the difference between landscaping and a garden?  Is it only about habitation?
In general, I would say that a “landscape” is any outdoor space, wild or designed, and a “garden” is a designed space. A restorative landscape is simply an outdoor space that makes you feel good when you’re in it. To me, “landscaping” implies decorative elements like a lawn, shrubs, some trees, and is not necessarily intended for interaction.  A therapeutic (or healing) garden is a space designed for a specific population (children, cancer patients, people with Alzheimer’s) and a specific intended outcome (stress reduction, positive distraction, rehabilitation). This is not to say that landscaping isn’t important. Well-designed and maintained landscapes communicate to patients and their families that they will receive a high level of care, and this can happen from the moment you cross the property line.  Even areas such as parking lots can utilize landscape to provide and reinforce the overall image and mission of the facility.

What is landscaping’s role in wayfinding?
This goes back to the importance of views outside from indoors. As a wayfinding tool, a garden stands out as a strong landmark, something people notice and remember.  Plantings - indoors and out - can also provide visual cues or themes for a space.  Again, when well-integrated with design, views to a garden can also act as advertisement for that space.  So often, gardens are underutilized because people (even staff!) don’t know they exist.  Signage can help, but creating direct views to the garden is the best way to ensure that people use it.

Landscape is a blanket term that includes plantings, water feature, site furniture and hardscape elements like pavers and walls. How does your ideal therapeutic garden utilize these elements?
My ideal garden would focus on the needs of the user population (patients, visitors, staff) and would be designed based on evidence, but also with a heavy dose of empathy and inspiration. As with any good design, there are parameters, but we can never just tick off boxes on a checklist. All landscape elements – overall layout, paths, seating, hardscape, plantings, water features – should facilitate health and well-being. Two useful theoretical frameworks are Ulrich’s Theory of Supportive Design, in which a space supports the users by reducing stress; increasing a sense of control; encouraging social support; and facilitating physical movement and exercise. And Stephen and Rachel Kaplan’s theory of environmental preference, which calls for an emphasis on coherence, complexity, legibility, and mystery. I would add that especially in the healthcare environment, outdoor spaces must be safe and comfortable, and should provide a marked contrast to “the hospital,” which is often perceived as a very cold, alien, intimidating environment. Finally, all of the elements should contribute to that positive multisensory experience we talked about earlier to help people feel not just “not bad,” but instead “good.” That is true salutogenic design.

How does this play into prospect/refuge theory in biophilic design?
It is really important to design with this in mind.  People like to survey the space from a protected vantage point.  Creating transitional space like a covered patio at the entrance to the garden is important, especially for elderly people who may not feel safe going directly outside.  Those with certain psychiatric issues, including autism, like to be “read” a space before immersing themselves in it.  Good designs create transition spaces throughout including shade to sun and walking and seating areas, and “nooks” or nodes where people can feel a sense of security and even privacy.   

It’s not unknown for a project to get landscape elements value engineered out due to budget concerns. What’s your advice for architects regarding how to work best with landscape architects and really integrate their work into the design so that the landscape elements become less expendable to the client?
Bring the LA in right away! Landscape architects are valuable members of the interdisciplinary project team [or A/E team] and they need to be included in the conceptual design phase. LAs have so much more to offer than simply “putting the parsley around the meatloaf.” Their site planning expertise can be a great asset to preserve open space, maximize views, create walking paths, take advantage of existing natural amenities, and to create that “healing experience” that starts at the entry drive, not just in some tucked-away “healing garden” courtyard. They can assist in design of the building to maximize visual and physical access to nature, both indoors and out. They can also best address EPA standards and maximize LEED and Green Guide For Healthcare points and help make sustainable measures like stormwater management or green roofs into design features.

It is important to use a landscape architect trained in healthcare design for healthcare projects (the TLN has a directory of designers and consultants who specialize in this field). They know the research and requirements for each specific user population; they have the experience in this particular area and so they know how to do pre-occupancy evaluations and talk to the various stakeholders: Healthcare providers, facilities and maintenance staff, the C-Suite, board members and donors, patients and community members. They can be allies in your design efforts because they have the experience, examples and precedents to share with clients regarding the sustainable or evidence-based value of a design decision.

Can you talk a little bit about the book you are working on with Clare Cooper Marcus?  What kind of issues are you looking at?
Healing Gardens: Therapeutic Benefits and Design Recommendations (Eds. CLare Cooper Marcus and Marni Barnes, with eight contributing authors including Naomi Sachs) was published in 1999 and is still considered to be the "bible" on this topic. Our new book, to be published by John Wiley and Sons, NYC in 2013, will be a shorter companion volume with different material and format, and will address many of the issues we’ve talked about in this interview. The heart of the book will be design guidelines that are applicable to all patient populations and settings, as well as guidelines for specific users (hospice, cancer care, children, etc.). We will be drawing on many examples of built works to illustrate theories and practice. Other chapters will focus on history, theory, and definitions; the interdisciplinary design process; funding; planting design and maintenance; sustainability; and more. Clare and I are both very excited, and from the feedback we’re getting, others feel the same way.


I encourage all of you to explore the wonderful resource that is the TLN site (http://www.healinglandscapes.org). You don’t have to be a landscape architect to take advantage of the TLN as a springboard for your sustainability and evidence based design research or as a resource for finding a great landscape architect specializing in healthcare.  How will you harness the power of  landscape and gardens on your next project?

*Citation: Debajyoti Pati, Tom Harvey Jr., Paul Barach (2008). “Relationships Between Exterior Views and Nurse Stress: An Exploratory Examination.” Health Environments Research & Design Journal, Vol. 1, No. 2, pp. 27-38.
Exterior views of nature decreased stress and increased alertness in pediatric nurses.
Abstract: 
Objective: Examine the relationships between acute stress and alertness of nurse, and duration and content of exterior views from nurse work areas. Background: Nursing is a stressful job, and the impacts of stress on performance are well documented. Nursing stress, however, has been typically addressed through operational interventions, although the ability of the physical environment to modulate stress in humans is well known. This study explores the outcomes of exposure to exterior views from nurse work areas. 
Methods: A survey-based method was used to collect data on acute stress, chronic stress, and alertness of nurses before and after 12-hour shifts. Control measures included physical environment stressors (that is, lighting, noise, thermal, and ergonomic), organizational stressors, workload, and personal characteristics (that is, age, experience, and income). Data were collected from 32 nurses on 19 different units at two hospitals (part of Children's Healthcare of Atlanta) in November 2006.
Results: Among the variables considered in the study view duration is the second most influential factor affecting alertness and acute stress. The association between view duration and alertness and stress is conditional on the exterior view content (that is, nature view, non-nature view). Of all the nurses whose alertness level remained the same or improved, almost 60% had exposure to exterior and nature view. In contrast, of all nurses whose alertness levels deteriorated, 67% were exposed to no view or to only non-nature view. Similarly, of all nurses whose acute stress condition remained the same or reduced, 64% had exposure to views (71% of that 64% were exposed to a nature view). Of nurses whose acute stress levels increased, 56% had no view or only a non-nature view. 
Conclusions: Although long working hours, overtime, and sleep deprivation are problems in healthcare operations, the physical design of units is only now beginning to be considered seriously in evaluating patient outcomes.

The Architect Brain- and How it Holds Us Back

We are trained as architects to be hyper-focused on detail.  We scrutinize relationships among elements, fret over details of code, think about every device that will be installed on a wall.  We draw finishes and juxtapositions of materials to the nth degree.  This same level of, well, obsession, gets applied to the way we operate.  Although we outwardly say that it’s a practice and that we can’t be held to a standard of perfection, we hold ourselves to that standard and react (at least inwardly) with shame when an error or omission occurs.  We condition our clients to expect perfection and implement all kinds of safeguards and quality control measures to “guarantee” mistakes won’t happen.  But the bottom line is that it’s about control.  We think that if we monitor every action of our staff, clients and contractors that we can swoop down like a hawk as the least sign of indiscretion and right the wrong.  That’s exhausting.  Furthermore, when was the last time it actually worked? 

If we were building the same building on very similar sites over and over again, we could just about perfect it over time. But most of the time, what we are doing in design is creating something from nothing.  We have developed a schizophrenic architect’s mind that allows us to be creative (embracing change) yet detail –oriented (resistant to change and looking for a right answer that can be applied formulaically).  Unfortunately, our creative mind does not win out often enough.  We ask of clients or superiors, “what do you want me to do?” and train our interns by saying, “this is how you do it.”  Then we become controlling about every detail of performance, documentation and implementation.

In an industry defined by disruptive change, we can take a cue from several recent neuroscience studies about how to deal with it creatively instead of procedurally.  Because architecture is really all about ideas.  A recent article in Strategy and Business magazine  by David Rock and Jeffrey Schwartz gives some really great insight into how to let go of fears and start making amazing buildings.  Here’s how to deal with taking the leap:

1.  Command attention by eliminating distractions so the entire project team is focused on the information being presented.  Engaging your audience makes them stakeholders in ideas as they are developed.
2.  Create a compelling vision of the project and why certain design characteristics make a difference in how the building will support its users.  The authors call this mental mapping, and it shapes the expectations and attitudes of our audience, allowing them to have moments of insight that forge new neural connections.
3.  Sustain the focus.  Keeping creative or innovative approaches in the consciousness of the project team (daily is recommended) helps the new vision to become “the filter through which every decision is made.”  Isn’t this our dream for every project- to lock into the owner’s vision and support it with an amazing design that makes the lives of all who experience it better?  Think about why this so often breaks down (or fails to even get started) on most projects.  Now think about how you can articulate and sustain focus on your project.

The devil is in the details
It’s time to perform an exorcism.  Our obsession with detail sets us up for both madness and failure.