Designing for Health: Small Space, Big Message

More Photos

The Problem
At Children's Medical Center Dallas, an organization of more than 3,000 people and 200 departments, three groups were to be co-located in a new space: Engineering, Safety, and Planning Design & Construction. The three groups, totaling about 50 people, had never shared the same floor or even the same building.  Each brought their own work processes and culture.  Due to spatial constraints, the new space would require a shared open-office setting. This would be their first project under a new way of working, as they developed a vision for their new environment.

The Approach
The user group wanted the space to embody a new way of working for the three departments. The space should be a projection of their values and the changes already underway – changes in their staff, roles, and focus. The space would literally be a message: This is who we are. The message is to be promoted internally to their own staff and colleagues, and externally to visitors and consultants.

In a healthcare environment, Engineering, Safety, and Planning Design & Construction needed a space that would unite them as it educated the greater organization on the value that they provide. When implemented, the design will help the three teams to speak with one voice. In this way, the space will be both a tool for change and for in-house marketing.

In developing a strategy for change management, the leadership opened a discussion to the users. Through a democratic process, all stakeholders had a voice. As a result, Children's was able to incorporate lessons from across disciplines. The users, many of whom are designers, project managers and standards managers themselves, took ownership of ensuring that the space would adapt to their work styles.

The Solution: Principles
A part of the change management process was an exercise to develop a core list of seven principles for the three teams: Stewardship, Sustainability, Patient Focus, Service Excellence, Innovation, Collaboration, and Safety.

Those values informed the design process, such as a desire to establish a collaborative working culture.  In writing for Harvard Business Review, Professors Anne-Laure Fayard and John Weeks attribute successful collaboration to the 3 P's: Proximity, Privacy, and Permission.1 In this space, these goals were realized through a balance between public and private amenities: smaller conference rooms, flexible furniture, and touchdown stations. For private offices, larger sidelights encourage visibility and accessibility.

"Stewardship is another core value," observes Judson Orlando, Director of Planning, Design & construction at Children's. "It's an important concept in today's healthcare environment, so challenging ourselves to be creative but decrease our overall costs is a story we wanted to shine through in the solutions." 2 Just as the users are tasked with making informed decisions about how to allocate the organization's limited resources, the design of their own space would be no different.

The Solution: Practices
To ensure that the design was true to the working styles of the team, they determined the design practices that they wanted to employ in this space as a reflection of their core principles. The list of specific initiatives ranges from vinyl-free materials to a construction waste management plan, but each strategy can be categorized according to these six general practices: Recycling, Energy Savings, Solar Power, Water Conservation, Human Health, and Time and Money.

The space became a lab.  Building-standard materials and assumptions were challenged.  Re-selection of products and materials were based on four criteria: life cycle cost, sustainability, maintenance, and future integration. The acknowledgement that this space would serve as a test lab for future work in the hospital alleviated some fear of taking risks with the design. It empowered the team to experiment. This too was a manifestation of their core values. Each critical design decision could be filtered through these lenses. In some cases, the boost to the sustainable culture or the probability of future use helped to justify a higher first cost product.

The new space will serve as a living example of space functionality that could be leveraged as a marketing tool for future Children's projects. Industry partner Herman Miller finds value in fostering change.  "Good change management… builds change adaption skills so that the next change is easier," the company said in a recent research summary.3  

Another tool for promoting brand was the use of architectural graphics. The imagery was developed from both the principles and practices. They record the story of the space – how it was designed, the goals pursued, and what they achieved in the end.  It celebrates success.  But the graphics also serve as a reminder to themselves – what they hold dear, why they do what they do, and how they want to achieve it.  The graphics are part of the progression through the space.

There is a hierarchy to the graphics:
1.    Large-scale silhouettes provide an overview of design solutions and values
2.    Large-scale words list the seven principles
3.    Small-scale decals highlight individual design solutions

Each graphic has been thoughtfully placed based on visitor and staff workflows.  As a nod to the Stewardship principle, the Children's Planning Design & Construction team opted to print and install the majority of these graphics in-house. "We wanted the artwork to embody the design intent and vision of our departments and the organization's mission.  We worked to develop inexpensive flexible solutions through use of oversized graphics, vinyl appliqués and signature stamps that each help tell the story," Orlando noted.  "They inspire not only those who live in the space, but others who visit." 2

 On the whole, the space is a story of change management.  It embraced a user-driven process to identify who they are as a new group and where they want to go.  This drove the design.  In the years ahead, the design will help them stay focused on those goals.

Emily Shea Beck, LEED AP, is an interior designer with the Dallas office of Perkins+Will.  She can be reached at

Jordan Thompson, AIA, NCARB, LEED AP, is a project manager with the Dallas office of Perkins+Will.  He can be reached at

1 Fayard, A. L. and Weeks, J. (July-Aug 2011). "Who Moved My Cube?" Harvard Business Review, pp. 1
2 Interview with Judson Orlando, CHFM, Director of Planning, Design & Construction, Children's Medical Center Dallas.  Dallas, Texas.  December 19, 2013.
3 Herman Miller. (2012). "How Change Management Makes You Good at Change." Herman Miller Research Summary. Herman Miller, Inc., Zeeland, MI.