Antecedents

I recently attended the Young Designer’s Core (YDC) sponsored presentation, “Antecedents: Evolution of the Architectural Plan for Health and the Authors” by George Marsh Jr., FAIA. I’ve been working closely with George for the past year, and can tell you that his passion for healthcare architecture knows no bounds. He is an avid reader of everything architecture, and is always giving me books on healthcare that he’s recently finished reading. Anyone who knows George will tell you that he is quite the story-teller, and seems to know just about everyone in our profession. This presentation was a forum for George to tell his stories and spread his great wealth of knowledge in the process.

George started his presentation with Florence Nightingale’s “Notes on Hospitals”, which discusses how the architectural plan for health is improved by increasing ventilation, adding windows, improving drainage and increasing space. He then got into the meat of the presentation, which revolved around the key physicians, nurses and architects who influenced the architectural plan for health, and how this plan changed with the invention of air conditioning, the elevator and advancements in better hygiene practices. 

During this part of the presentation, George told stories of various PAYETTE projects.  With these anecdotes, he was able to transport the audience back to the time when these projects were still just ideas on paper.  Other senior staff in the audience, such as Bob Schaeffner and Jim Collins, added their commentary to these stories to help paint the picture of what Tom Payette and others were thinking while developing these healthcare projects. 

At John Hopkins Hospital, Tom Payette designed a prototypical patient care cluster which is an improvement over the labyrinthine corridors common in clinics. The clusters provide patient privacy in lieu of long, impersonal corridors.

With these stories, we, the audience, were taught basic planning and design strategies through the lens of the forces that typically drive healthcare today: Optimizing Operation Efficiency and Effectiveness; Optimizing Health, Health Outcomes and Patient/Staff Safety; Optimizing Patient, Family and Staff Satisfaction; and Accommodating Changing Needs Over Time. 

George concluded with a discussion on how weaving nature (daylighting, views of nature, thermal comfort, natural ventilation, etc.) into hospital design is critical to achieving a successful architectural plan for health. In architectural discussions at PAYETTE, George will always push healing through nature as an important guiding principle, whether it’s designing a courtyard into the heart of a hospital, developing a winter garden as a part of the public amenities or creating beautiful landscapes that create a dialogue with the built environment. This goes hand in hand with our passion for sustainability at PAYETTE, and how we integrate our Building Science Group into the early stages of the design process with nearly every project. The final slide of George’s presentation was a drawing of the XiangYa Fifth Hospital Project courtyard, which depicts the concept of ‘Evergreen’ – as George titled it – as a beautiful balance of nature and architecture, creating a remarkable place for healing.

Courtyard Design for Fifth XiangYa Hospital

I was inspired by this presentation, and — as someone who is still fairly new to PAYETTE — was appreciative to learn more about the history of our firm. Tom Payette developed a strong foundation for our healthcare practice, and we continue to reflect and build upon that foundation with the various healthcare projects that pass through our office. I’m excited to continue working on healthcare projects at PAYETTE, but now look at them through a lens influenced by our past and George’s concept of Evergreen.