Those who fail history are doomed to repeat it

2H asks a good question in his comment on yesterday's post, which is this:

I’ve seen two philosophies to design:
One says that you create a master plan, an overarching idea that is evident from 30,000 ft. and that macro idea guides the thinking down to the selection of the shelf pegs. The opposite approach says that you begin at the micro, find some aspect of design or space that is clear at the intimate, human level and allow that to guide the concept for the macro. Does the fact that you are doing individual rooms make as statement about either approach, or is master planning for facilities and the design of individual spaces two completely independent things?

Good question.  The short answer is that me building these rooms is about both approaches, both macro and micro.  The long answer, as usual with me, involves more detail.  The macro scale, the 30,000-foot view, as 2H calls it, involves a long-time commitment that Alex (my main big boss at DA) as well as many of the associates working for him have had towards building a central library of all healthcare design knowledge.  On some levels, the technology wasn't where we needed it to be in order to compile databases of information or really good floor plans, ceiling plans, and interior elevations (drawings showing what happens on each wall of a room).  Another major factor was the personalities involved.  It seemed like every time well decided to make a "standard" for our healthcare team, one project manager or the other said "feh" and dismissed the new idea, thereby making every new rule into a "rule".  Yet another reason for not establishing this be-all end-all library is the fairly inexcuseable lack of denouement on decisions.  We'd go over and over something--an exterior wall system, a finish system, whatever--and there would never be any real solution.  No one would just say, "Okay, people, that's it: the insulation goes here, the vapor barrier goes here, it laps over the parapet cap, and the air space is x inches wide.  Done."  So, there was lots of discussion but not a lot of resolution.  Much to my joy, Jann recently expressed frustration with this system of doing things.  "I just want resolution on something!" she lamented to me.  Perhaps that's why she set me to task on this, in the hopes that I, a world-class high-expectating finisher, would provide something tangible after all is said and done.

The factor that is most in play right now is time.  For most of my days at DA, I've been comfortably to insanely busy.  It's only been the past three to four months that I haven't had a lot to do.  Many of us (the highly-experienced licensed and mostly-licensed healthcare design staff) are pretty unbusy now, and it's finally left us with the opportunity to get these important-but-not-urgent things done.  So, Jacqueline is working on the healthcare design and code requirement differences between all the states, various people here and there are working on specs or construction system standards, and I'm working on templates for each type of room in a healthcare facility that will allow people with or without a lot of experience in a type of design (surgery suite, labor/delivery/women's care suite, imaging, whatever) to accurately space plan for the department as well as show the department's users something as a starting point of design.

On the micro scale, each room type--OR, LDRP, CT scan, PET CT, exam, toilet room, etc.--brings with it its own set of problems and issues and questions that need to be asked.  For example, on MHRC's radiology suite (note: for the most part, the terms radiology and imaging can be used interchangeably), the doors for some of the rooms had to be extra big only to get the equipment in the rooms.  This reeks, because where a 4'-0" wide door would have easily worked for every patient coming in and out of the room, a 4'-0" door with a 1'-0" smaller door had to be put in because the imaging equipment needed a 5'-0" opening to go through in order to get to its final resting place.  And because imaging equipment vendors have to work in a dust-free, finished area, we couldn't just leave a big hole for them to roll the $1+million equipment through and then nail up some extra studs and drywall and the 4'-0" door later.  So, one of the questions/things to consider that will be listed along with my room layouts is "do you have a wide enough path to roll the equipment through?"  That's just one of many several-thousand-dollar questions the architect should ask their client and the equipment vendor.

As I build these rooms, I zoom from macro to micro and back again.  I think of the best ways to use my time.  For example, I wondered if I should build the CT scanner as a 3D model, and then I decided that yes, it would be best to do so.  After all, having a big chunk of equipment actually in the room template will help a newbie to imaging design understand just how much room this thing takes up.  Architects think in 3D, so it makes sense to draw in 3D.  I think of the best ways to use the software.  For example, I give extra consideration to how I build each thing I put in the room templates--the CT scanner, a paper towel dispenser, a mayo stand--because too much detail makes the model eat up memory space on your computer, but too little detail and you just have a room full of abstract boxes, which helps no one.

At any rate, the goal of my endeavors is to build a big, single-source database of healthcare architecture knowledge that incorporates lessons learned from past projects.  I'm slowly getting away from feeling like I'm totally wasting my time to feeling like we might actually finish one of our lofty goals at DA and do something right.  We will if I have any say in the matter.