The first edition of Design That Cares grew out of a quest for information about the design-related needs of patients and visitors. In 1980, when we were hired by the University of Michigan Medical Center to act as what would now be called “customer-experience advocates” during the long, complex, expensive process of designing a huge replacement hospital, there was almost no useful information available about health facility design and its effects on patients. The design needs of family members and visitors were barely on anyone's radar. In the absence of this information and with a commitment to evidence-based decision making, we began conducting our own research. With the existing hospital and its patients as our laboratory, and the fast-moving train of design decision making as our engine, we conducted nearly three dozen distinct studies focusing on patients' and visitors' needs and preferences for health facility design features. Six years later, when the new hospital was complete and we had done our best to use our data to influence scores of design decisions, it was time to publish the information. In the meantime, we had been on the ground floor of a new field. There was finally a nascent body of health facility design literature based on empirical research.
This book was always intended to be different from the vast majority of architecture books and journals. Design That Cares is not a compendium of completed projects. Though such publications are useful in order to show designers and design students what has been accomplished across the United States and around the world, they tend not to emphasize the reasons why design decisions were made or how each feature was intended to function. By their visual nature, they emphasize aesthetics over function. Good design, of course, reflects aesthetics, function, and a host of additional considerations and requirements, such as corporate culture, marketing, capital costs, codes and regulations, environmental impacts, operating costs, long-term maintenance, and other requirements.
We wanted Design That Cares to consider design from another vantage point: emphasizing function (designing for the needs of patients and visitors) and encouraging creativity on the part of planners and designers. There are endless possibilities for how designs can look while at the same time satisfying functional criteria.
We are delighted that our hunch about the usefulness of this approach has proved to be on target for more than 30 years. As we began writing the third edition, we were gratified to see that the situation we faced in 1980, of having virtually no useful evidence-based information, is long past. There is now an active, productive, prolific community of researchers, designers, and others exploring numerous issues pertaining to patients, visitors, and health facility design. Research has expanded from an exploration of preferences to measures of a variety of physiological effects. The once-radical notion—that health facilities affect patients and visitors and should be designed with their needs in mind—is now an accepted paradigm.
However, paradigms are not enough. We offer this edition of Design That Cares to current and future design decision-makers with the hope that its nuanced, evidence-based guidelines will inspire the creation and long-term functioning of health facilities that care for and about their most vulnerable users.
An instructor's supplement is available at www.wiley.com/go/Carpman3e. Comments about this book are invited and can be sent to publichealth@wiley.com.
Janet R. Carpman, PhD
Myron A. Grant, MLA
March 2016