Avoiding the Architecture of Fear

Wow.  My post on the limiting beliefs of architects grew legs, stood, up and ran out the door. It was being chased.  While I never expect that readers of my blog will agree with me wholesale, reactions to this post fell very strongly into two camps.  The camp that agreed with me and said "Right on,  we need to overcome these limiting beliefs," made me feel that I had written about a meaningful and timely topic.  The camp that threw cold water on the very premise of the post confirmed it.  I noticed a very specific pattern that emerged among the naysayers.  It was fear.  Fear of being irrelevant,  seen as extravagant or uncooperative by clients.  It is this very fear that is being manifested as a reality in our profession.  Therefore, I have taken these comments, condensed them into some major themes around fear and share them with you today.  Since most of the discussion was generated on the American Institute of Architects Linked In Group, you can visit this page if you want to see the comments and discussion chain firsthand.

Fear: I will play into their worst stereotype
This one is tricky because no one wants to be typecast as the black clad ideologue with funky glasses who is using their client as a vehicle for their own artistic license.  Many comments I received were concerned that architects are our own worst enemy and that by pursuing a higher level of design, we were alienating our clients, showing them that we weren't listening to them and running up the costs.  It wouldn't be a stereotype if there were not some grains of truth here, mostly born out by Starchitects and their wannabes.  However,  being an advocate for solving the right problem and innovative solutions instead of being a waitress is not the same as being out of touch.  If anything, it shows you are more in touch and are providing the service they hired you to perform, instead of being a rubber  stamp.

Good design is too expensive, or too risky
Maybe it's because the design magazines are filled with examples of exotic materials and systems.  Maybe it's  because we don't really believe that you can be creative on a budget.  I was astounded at the number of people who lashed out at the very idea of bringing a higher level of design to their projects.  It truly saddened me to see architects with the mindset of a low level developer, believing that they were  providing value to their clients by delivering the staus quo.  Rather than meeting client expectations for adequacy, meet their expectations for a truly amazing space that meets needs they were heretofore afraid to state. Good design is carefully considered and responsive, and can absolutely be done with basic materials and on a budget with only the premium of creativity on your part.  A better thing to consider is how much you are paying to play it safe and add to the already bulging inventory of unremarkable buildings.

The profession can't afford this
Talk about fear-based thinking.  These commenters thought they were taking the high road by adopting a lofty, philosophical position about risk management and responsible architecture.  No wonder our profession is struggling.  What a limiting mindset to meekly take a backseat,  hoping to just be of some usefulness.  This only buys into a developer driven mentality and frankly, shows you already believe that architects are obsolete.  What the profession cannot afford is a bunch of synchophants who are afraid to be creative.  I had to chuckle that the most controversial comment in my post was a quote, "If you know it will work, it isn't creative,"from Tomas Chamorro-Premuzic.  This quote to me captures the very essence of creativity: being unafraid to take on a new challenge, to think outside of the box, to stop recycling ideas from past projects.  Isn't this what our profession needs most?  Yet, many took that comment to mean that taking a risk meant abandoning functionality.  True, form should follow function, but how to best house that function is what the act of creating architecture is all about.  It's called a practice because it is an experiment.  Otherwise, we are just drafters.

To me, these fears underline the reason so many of us feel we are in a career crisis.  We have accepted the premise that we are lucky to have work and therefore we had better not rock the boat.  We are playing it so safe that it becomes doubtful that we are actually producing architecture at all.  I can empathize with my post-dissenters because I have worked for firms that propagated these fears and the limiting beliefs that spawn them.  I felt completely demoralized in my work during those years because I felt like I was not making anybody better as a result of the projects being produced in these conditions.

There is a better way and I have made it my mission to help other architects find it.  You can choose to follow along with my blog posts and facebook community, but if you are looking to get on the path to career transformation, you need to look at a more immersive experience.  I invite you to consider one on one career coaching, or to take part in my new telesminar series.  Based on my book, Career Crisis, the teleseminars will explore themes of finding your passion, understanding where you are in the creative cycles of your life,  and how to best position yourself to work in the way that is most fulfilling to you.  It is time to stop practicing an architecture of fear and move forward into producing meaningful, enriching spaces that allow us to work at our highest creative potential.

Games of Chance

It’s a buyers market out there in any way you want to look at it.  Got real estate to sell? Good luck.  Need a job?  Remember to rub your rabbit’s foot before you submit the next application.  Trying to win over a client?  Hedge your bets.  Trying to attract patients?  Wait.  That one wasn’t supposed to require the beneficence of Fortune.  Yet that is exactly what consumerism has brought to the healthcare market.  It’s a huge gamble for all involved- the newly empowered (or perhaps desperately overwhelmed) consumer being wooed by every stripe of service provider, the institutions looking to hit the jackpot of market demand and patient satisfaction.  This could be good news for those of us providing design services as institutions race to up the ante on one another.  It could also mean that we are forced to take on bigger risks to deliver better outcomes.  So who’s playing?

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According to Deloitte Center for Healthcare Solutions, there are six types of healthcare consumers out there, each with their own behavior profile.  This might sound like a problem for hospital marketing departments, but you, architect can win big by understanding these behavioral profiles and providing designs that respond to them:

They are the cheapskates- Casual and Cautious consumers aren’t sick and don’t seek out care.  They also represent the largest chunk (34%) of healthcare consumers.  The design challenge for this group is to draw them in with services they are interested in- wellness programs, farmers markets, acupuncture and massage therapy, classes on things like stress relief or weight loss.  Maybe even a little retail therapy.  These are the people that need to have the line between healthcare and the rest of their life blurred as much as possible to get them in and get them engaged in their well-being.  The challenge?  Their loyalty to any given healthcare brand.

Content and Compliants are the true blue consumers.  They like the way they currently receive healthcare and tend to resist change.  This block, which is 20% of the healthcare population tends to follow care plans and regularly seek out care for maintenance of their health.  What do they need in a space?  Comfort and clarity.  Don’t overcomplicate with too many bells and whistles, make it easy for them to get their care and be on their way.  Think about multiple access points, convenient parking, one stop “shopping” opportunities that allow them to cluster multiple clinical visits, diagnostics, and testing and really intuitive wayfinding.

The Online and Onboard are not necessarily dissatisfied with their care, they just tend not to settle for said care as the definitive word on their well being.  This 17% of the population are avid researchers looking for alternative therapies or emerging technologies to supplement their care and won’t hesitate to bring this information to a visit.  They need to have a space that showcases the array of options offered by a provider and makes it easy for them to interface their technology- think lots of places to sit and access the wi-fi, wellness amenities highlighted with QR codes, a storefront approach to the care environment, so allow them to take in the array of offerings at a glance.

While they only comprise 14% of the healthcare population, Sick and Savvy individuals are the  biggest consumers of healthcare products and services.  This group prefers a collaborative approach to their care decisions, involving their doctor, spouse or other family member.  They need spaces that accommodate that second or third person comfortably and a format that encourages conversation and exchange of information.  This group would benefit from a consult-room rich environment that would allow their care team to engage them on a very personal and intimate level.

The “cocktailers” of the bunch, Out and About consumers are very independent and like to assemble their own combinations of services ranging from traditional to alternative therapies.  This 9% of healthcare consumers will judge you, and move on if they find anything lacking.  What they need is strong brand identity and differentiation of services. 

Price is paramount to the 4% of Shop and Save consumers out there.  They have loyalty to value alone, and are willing to put in a great deal of time seeking out their health bargains.  This group is a big user of things like retail clinics, and customized health plans that reward their thrifty ways.  Facilities that allow care to be streamlined (and therefore delivered at a lower cost) are key to compete with others working to attract this market segment. 

These insights into how healthcare consumers think and act begins to paint a picture of what the healthcare design of the future could look like.  What I see is that it’s not a one size fits all solution.  Different building types, (urgent care/storefront clinic, outpatient community center, and mothership hospital) that serve different purposes, and incorporation of amenities that are not typically associated with healthcare into healthcare spaces all need to find their way into our programming efforts.  In today’s competitive environment, we need to help our clients balance costs with services and provide true value.  While we take great pains to understand how clinicians and equipment interface, we haven’t put much effort into understanding healthcare’s consumer preferences.  In today’s market,  unless we can produce designs that respond to their expectations and needs, all we are doing is rolling the dice on the outcome.

Winning the Battle and Losing the War

It’s the rare client who has the foresight to truly master plan- rarer still the one who authorizes a capital project based on forecasted need instead of waiting until renovations/expansions are way past their due dates.  When everyone’s working conditions are obsolete and overcrowded, the very way work is done is affected.  The workplace becomes the war zone with erstwhile staff in the trenches every day just trying to keep things functioning.  No wonder it’s so hard to think differently about space.  In healthcare design, we can no longer afford to keep with the status quo “adapt and react” mentality when it comes to buildings.  This mindset brings about a shortsightedness that satisfies an immediate need at the expense of truly solving a problem.  I recently had an opportunity to hear a presentation from Debbie Gregory, Senior Clinical Consultant at SSR and Nursing Institute for Healthcare Design (NIHD) Board member.  Debbie also has a background in interior design, so she understands healthcare design from multiple viewpoints and I enjoyed listening to her insights regarding what healthcare clients are looking for from their architects.  Some thoughts from the battleground:

Avoid conflation
Sometimes an expansion is definitely in order.  Others, reorganization of space is the better option.  While healthcare facilities are getting bigger in part due to larger room sizes, more equipment and the need to have more adaptability built into units, there is also the tendency for clients to ask for (and get more ) of the same space they had before just 30% -40% bigger.  All the same work habits and processes are baked right into the new space. Right size based on criteria related to flexing acuities, innovative technologies and equipment or increases in volumes, not to accommodate inefficient processes that have arisen out of the current physical features of the space.

Beware of collateral damage
Just as teaching to the test leads to peril in the classroom, designing a delivery of care model around scoring enough HCAHPS points is disastrous.  The point of metrics is to measure performance, not how well you can game the system.  If you are providing the best care, you don’t need to worry about metrics, just as a great teacher never needs to worry about how her students will score.  Learn to recognize well-intentioned policies from infection control, facilities or the C-suite as intentions that may not apply to the unique needs of your particular situation and work with them to develop a solution that meets the “spirit” of the law, not just its “letter.”

Know your enemy
The biggest enemy of innovation is the routine.  It’s very hard to break out of the way you are used to doing things, or to question why you do some things at all.  One thing I think we fail to be taught as architects is how to help our clients re-frame the problem.  Sure, we know how to turn an idea on its head, but we may not be attuned to all of the issues related to care.  We also tend to spring these “breakthrough” concepts on our clients, often to mixed reception.  What we really need to be doing is to help them walk through the process and think about what they do and why every step of the way.  Don’t create tomorrow’s problem with today’s solution. Mockups, done at a conceptual phase of the project can help to right size an element like a patient room, which will drive overall program and square footage needs.  Debbie strongly recommends that you conduct the initial viewing of the mockup as a moderated discussion in order to keep department stakeholders focussed and make sure that everyone’s voice is heard, not just the squeaky wheels or department leadership. 

Break ranks
It’s not about keeping the building as we know it, but rather making the building into what we need it to be.  As conduit for healing- the healing environment has a big role to play in patient outcomes as well as staff satisfaction.  With greater emphasis on providing value being placed on today’s healthcare providers, we must think about how buildings contribute to that equation.  The value proposition should include links of design elements to measurable outcomes, such as reduced injuries, hospital acquired Infections or satisfaction scores; recommendations related to achieving the lowest life cycle costs, and agile planning and infrastructure solutions that will respond to emerging needs instead of requiring costly and constant additions.


None of these strategies are about adapting or reacting, they rely on a great offensive strategy where the patient doesn’t end up being the casualty of our planning effort.

Architecture for the Everyman

A few weeks ago, I had the privilege of being interviewed by Salomé Reeves for her (x)Architect series.  One of the questions she had for me was something I hadn’t thought about all that much, but clearly should have.  Salomé asked, “Why do you think architects are often conceived as expensive accessories in the eyes of the general public?”  This question gets to the root of a conundrum that many of us have: we want to do exciting designs, but our potential client base is just a fraction of the population of people who wish to acquire, build or alter space, with only a limited subset of them committed (financially and otherwise) to high design.  I wondered: why don’t average people consult an architect more often?

The answer is probably the same as why they choose to file their own taxes instead of hiring an accountant, use online legal services instead of seeing an attorney, apply home remedies before making a doctor’s appointment, and fix their own leaky pipe instead of calling the plumber.  It’s easier, faster and more convenient to take care of things yourself instead of bringing in a professional.  Actually, if we take a look at human history, the idea of being a jack of all trades is far more prevalent than the idea of specializing.  People have been building their own homes for millenia.  In antiquity, architects, when they are so acknowledged, were very high status individuals who worked for the likes of the Pharaoh or Emperor.  Even in the age of master builders, and the emergence of the architect as a professional during the Renaissance, talents were reserved for a client base of the rich, the royal and the religious.  Perhaps the historical status of these patrons as well as the fact that works commissioned by them were intended to inspire awe has gone to our collective heads.  When we see architecture for the masses, it’s often in the form of some grand utopian vision.  It’s no wonder that the masses have soundly rejected these visions and continued to resonate with their traditional understandings of home, neighborhood and city.

The market share of the everyman requires a whole different paradigm on the way we understand design services.
People have always been able to build their own spaces. In today’s world, the developer has taken over for the do-it-yourselfer of the past. Expectations are not particularly high for space because most people don’t know what they don’t have. If your house looks pretty much like you expect a house to look and you have a nice lawn and nice decor inside, you feel good about it. Same thing with your business. A custom architect-designed home is just not something that could ever be affordable to most people - the design time alone would be exorbitant. And as an architect, we would have to take this time in order to deliver a good product.

But what if we didn't?  What if instead of looking at a traditional scope of services, and grousing that we can't do it cheaper, we instead delivered services that appealed to the affordability and convenience of the self-made project? We need to get on the other end of the innovation curve.  If we want people to appreciate our work, we must first help them begin to demand better, then find ways to make our work more available. This may mean that we create a kit of parts and some You-Tube videos about what to do with them and let people play. They’d still be paying us for a product and service, but it would be a whole lot more affordable. I also think that there would be a greater appreciation of design if people had more ability to modify their space to get it to work best for them. They’d stop settling for environments where they actually have to develop work-arounds to function and start noticing how and why other people choose to configure their space in a different way.

I have posted a poll on facebook to allow readers to weigh in on their view of accessibility in architecture.  Please visit  and let our community know whether you think we should redefine who we include in our client base and how to best go about reaching this new audience.

The Skinny on Lean

Forget all that stuff about firmness commodity and delight.  Today’s design drivers are Lean, Green and Clean.  If you embrace evidence-based design, you probably already find your efforts fall into these categories.  Most institutions have fairly robust initiatives related to sustainability and infection control.  It’s the third leg of the stool where things get a little fuzzy.  While every vendor can tell you how their product contributes to your sustainability and infection control efforts, can they tell you how it provides greater value by promoting efficiency and service?  Lean is a concept that most embrace in principle but have no real idea how to put into practice-ask ten people to define Lean for you, and you get ten different answers.  Yet this is such a powerful tool for improving patient satisfaction, outcomes, employee retention, reducing errors and eliminating waste that any design effort that doesn’t take Lean into account is falling short of its potential.

Lean started at Toyota as a manufacturing process.  Apply it to the design of buildings unfiltered and a lot gets lost in translation, for example focusing on efficiency to the detriment of the human experience. The Lean Construction Institute, a non profit organization, is a great resource for helping architects and their clients work together to get a building design that supports its optimal use and generates value. I like to draw analogies to the Leaning Tower of Pisa as a mnemonic device in understanding why we need Lean:  inadequate foundations set in unstable soils and a flawed design led to a failed effort that corrective actions over it’s 177 year construction history (talk about inefficiency and waste) never did manage to put right. Lean processes help us take a step back and consider what we are really doing instead of getting swept up into the chaos of a frantic deadline:

A process about a process
A hospital can hire a Lean consultant and optimize processes without moving a wall.  As architects, our goal is to understand how design can support and even facilitate those processes. If the organization has not already done so, consider hiring a Lean consultant to observe existing conditions and help make improvements.  This allows your design efforts to be focused around the best operating conditions, not a bunch of old habits.  If a consultant isn't something the project can afford, do take the time to work with staff and understand and map the variety of activities they engage in daily to provide patient care.  You can do observations and start to notice the redundancies and waste that is built into the current system. 

Think differently about a solution 
Lean is also about empowerment.  By involving project stakeholders and coaching them through a collaborative process, you encourage them to think about how they could do their jobs better.  You also encourage everyone from the C-Suite on down to filter everything they do through the lens of whether it improves the experience of the patient.  This will inform the design in amazing ways and help you to set project goals that keep the design on track, even during value engineering.

The value proposition
Lean is, above all, a  multidimensional tool for improving value.  Value is a slippery metric.  It is not, as I’ve stressed multiple times in this blog, another word for cost.  Value may include cost, as when the lifecycle of a piece of equipment is measured against first cost and cost savings.  Value can also include intangibles, like improved satisfaction, that may generate revenue.  Still other measurements take into account indirect costs such as reduction in FTE’s or patient length of stay or lawsuits/non-reimbursement due to errors.  

Frank Zilm, Jody Crane and Kevin Roche have produced what I view as the most concise and understandable breakdown of Lean for Healthcare in their article for the Journal of Ambulatory Care Management “New Directions in Emergency Service Operations and Planning”   In their article they cite five key components:

Creating Patient Value
A value stream is a patient’s path through a set of services during a visit.  A facility will need to define value streams for all of the typical services they offer by department as well as by acuity level.  Departments then work collaboratively with leaders to identify ways to provide more value (such as shorter wait times, more amenities for family members, ease of access to the facility) or eliminate things that take value away (such as long waits for the transport team, inability to sleep well due to noise and interruptions) for each value stream they identify within their department.
Eliminating Waste
The next step is to categorize each element in a value stream as either value-added or non-value added.  The article suggests that non-value added items are one of eight forms of waste traditionally defined by Lean:

1.  Transportation – care delivery is delayed by the transport of patients, supplies or equipment
2.   Movement- staff should have supplies close at hand to their work areas, which should be proximal to the tasks/staff/patients they need to interface with. Think: right amount, right place, right time.
3.  Inventory- overstocked inventories represent capital that will potentially be wasted
4.  Waiting- this is wasted time for all involved.  In healthcare, this means less silos and territories and better utilization of resources such as exam rooms or OR’s.
5.  Overprocessing- doing more than the patient needs because of overlapping protocols
6.  Overproduction- generation of reports or materials that are not used
7.  Defects- errors or incomplete work that must be subsequently re-done.  Often there is waste generated by a lack of communication or even problems with wayfinding.
8.  Lack of human creativity- the ability to problem solve and improve processes

Promoting Flow
Study of service responsiveness within a system.  This uses tools such as queing theory to map flows from arrival through service delivery and exit, with a focus on responsiveness and system capacity.  Other ways to study flow include “spaghetti diagrams”  which track the movement of individuals through a system to identify where flow is impeded or non-linear (too much retracing of steps involved in a process).
Continuous Improvement
This is a quest for perfection that is embedded at every level of an organization.  By clearly identifying what will add value to the patient experience, staff at every level is empowered with the tools to suggest ways to improve performance. 
Developing People
Unlike traditional top-down leadership hierarchies, lean encourages a bottom-up organization that recognizes that those doing a job have the most insight into the processes involved.  By empowering staff at all levels, a more collaborative work environment is formed with a focus on delivering value over beauracracy. Resources for improvement are provided while obstacles are removed.

By working collaboratively and filtering it through the value process, it is easy to determine which strategies will make people better and which won’t.  These strategies can be reinforced through architectural elements. Focus on the value adds and drop the waste, and you’ll end up with a project a lot more successful than that famous belltower in Pisa.

Alchemy and Architecture: How rich is your perspective?

What’s your point of view? How is it the same as or different from that of the users who will inhabit your design? How is it perhaps still different from that of your client?

In quite a few recent posts, I’ve discussed the idea that architects need to provide a value beyond just our traditional scope of services in order to stay relevant. This value often comes with the ability to harness and master data from its collection to application on the project. However, as we go boldly forward with integrated project delivery, evidence based design and quantifications of value associated with sustainability (green) and productivity (lean), it is all too easy to feel that creativity must emerge in spite of - not because of - these constraints. No, you are not off the hook in terms of shifting your practice model to incorporate the aforementioned value streams. You are being challenged to be more than an information generator and processor (overwhelming and boring). Too much of our time and energy is wasted feeling besieged yet unchallenged and uninspired.

The value of the architect in today’s world lies in his or her ability to synthesize. An excellent series of articles by Jon Kolko for Fast Company based on his book, Exposing the Magic of Design, caught my attention because they address precisely what makes us creative, as well as how we can allow our creativity to get lost in translation by being overly concerned about process and data. Kolko uses the term “sensemaking,” which has its roots in behavioral psychology, even going so far as to term the act of design as applying bias. We’re conditioned to view it as a four-letter word, but it’s impossible for anyone not to process the world through their individual filters. Bias represents the personal perspective of the individual designer, and the more interesting their perspective, the more likely they are to bring an exciting design solution to the table. Neutralizing your bias is the equivalent of dumbing down your work. Allow yourself to value the explorer inside of you, to question the status quo and to feel that pushing the envelope is not just OK but necessary.

Being creative begins with being inspired. Being inspired comes from allowing yourself to ask what if? That’s a scary concept, and when we don’t know where to begin, we start following all the rules of design and allow constraints to eliminate creativity by a depressing process of attrition. We fail to approach the subject with fresh eyes, disgruntled that we are doing “another” (fill in blank) and have clients that only care about getting the most amount of building for the least amount of cost. How could anything innovative ever hope to arise out of this attitude?

While budget is certainly a serious concern on every project, our clients want to build the best buildings they can, not the cheapest or most adequate. They want a solution that works for them and supports the activities that need to take place. They understand the difference between cost and value, but they will also uphold cost as a determinant when design seems too wayward and devoid of value. They are relying on your vision to take a quagmire of facts, needs, data and requirements and start to connect the dots to form a solution. That is the alchemy of architecture, to transform a bunch of information into a design strategy that supports an underlying project mission. To apply your vision and design the spaces that make people better.

Those voices you hear are the angels in the architecture, and you have to let them sing.

Architecture in the Age of Ideas

Now that we've kicked the first decade of the 21st century, it's a good time to reassess how we work, from the generation of ideas to the way we communicate them.  The digitalization of life has spawned an age of conceptualization- a unique opportunity for ideas to be communicated and valued as never before possible. Information of all sorts is readily available to anyone who can use a search engine.  This can lead to frustration on the part of architects, we feel that our clients think they can do our job for us, that our services are being cherry-picked away by owners representatives and contractors.  It makes us want to turn inward, draw a line in the sand and try to create value for our work through exclusivity.  And that would be a big mistake.

Sure competition for what we traditionally defined as our services has increased while perhaps value has reacted in inverse proportion.  But what do those traditionally defined services have to do with being an architect anyway?  Ask any child what an architect does and you'll get the heart of the matter- we deign buildings.  Who really cares that at some point someone created phases of design and structured contracts around those phases?  Maybe they don't make sense anymore.  Maybe we can do better and be more fulfilled if we stop being competitive and instead focus our main reason for doing this at all- designing buildings.

What our clients need more than anything is someone to take the overwhelming amount of information that exists out there and distill it down to apply to their situation and solve their problem.  They need fresh thinking and innovation- someone willing to synthesize seemingly unrelated issues into a cohesive whole. No owner's rep or contractor can do that.  I challenge everyone not to hoard their knowledge, but to share it.  Make it free and easy to access your ideas, knowing that the more people are aware of them, the more powerful they will become.  Change the world.

Design Power

I recently read and loved this post.  It really gets to the heart of the power we have as designers, especially architects, if only we will believe in ourselves and innovatively and fearlessly use our abilities to problem solve.
quoted from dinet

Design thinking ... carries a conviction that there is always more than one way to solve a problem http://bit.ly/fUqZ7U

Is Your Ocean Red or Blue?

Have you ever thought about how architecture is practiced?  Why so many architects are just not very collegial with one another and our professional organizations serve more as a source for legal documents, status, and continuing education instead of as a true collaborative resource?  Maybe you just naturally assume that you have to compete, after all work pays the bills.  Our profession has accepted the premise of a business strategy called Red Ocean (think blood in the water),  that assumes at its core that we can only win if everyone else loses.  Our work becomes a product or commodity and offering more of it for less is the only way to stay ahead of the game (sound familiar to how we undercut our fees and lose money on jobs to keep or get a client?) 

A more recent strategy to emerge turns that premise on its head.  Called the Blue Ocean strategy, it asks us to rethink the idea of beating the competition and instead examine that for which we are actually competing.  In other words, is the prize really worth it?  Are we decimating ourselves just to win?

By looking at who we really are and what we really want to do; we can, according to Blue Ocean thinking, define a new market that we can serve with the full force of our individual talent and passion.  It seems almost too good to be true.  I am transported back to my days as an idealistic student full of dreams and ambition, not the soul-crushing professional environment that awaits said student ideologues.  

Of course, there is a catch: you have to actually be innovative (and not too risk-adverse either). In a Blue Ocean paradigm, the focus is on the value of what we have to offer and finding a market that is actually seeking that value.  No building industry, creating niche markets requiring hyper-specialization is not the point, it's about innovation.  Innovation that also takes into account utility, price and cost in an attempt to make competition irrelevant.  That's something that we have a hard time with, because we want to keep designing buildings, and so do all the other architects. Also,blue ocean is an ideal that may not prove lasting. Mohammad Jamil of the Change Management Community is his article "Red and Blue Ocean Strategy" argues that the two strategies are in fact interdependent and cyclical, with blue oceans driving innovation, which in turn drives the red ocean competition that will eventually spawn more innovation.  I think that what matters most is that we realize that we are not constrained by the "way things are" and instead start asking a lot more critical questions:

1. What are you really trying to achieve and why?
2. To whom will it matter?
3. Can you abandon old habits and dependencies?

Stop swimming with the sharks and chart a course to peaceful waters.  When survival isn't the primary issue, it's amazing what you can achieve.

Money Makes the World Go 'Round

Yeah, no one really likes to think about money- being materialistic offends our design sensibilities.  BUT, nothing gets built without incurring cost to both design and construct.  And if there is no money to operate the facility, that isn't going to help much either.   Fortunately, most healthcare projects have donors.  Donors can actually be a powerful tool if you can involve them in the design process and really get them excited about the ideas that are the basis for the design. The dreaded grim reaper that is value engineering can be kept at bay for more cherished ideas if they have a dedicated source of funding and if said source is really excited about seeing those ideas in action.  I have worked with thrifty hospitals who gave naming rights to every room in a new dapertment just to keep the design features they wanted in the project in a time of major construtcion escalation.  But to realize the bigger ideas in their full glory, start working from the beginning with your client to pull onboard some donors whose personal experiences/links to the organization will be a goof fit for your project and design approach.    They may even be able to bring some greater insights and buzz to what you are trying to accomplish. Cha-ching!