Welcome to the Architecture for Health Lecture Series 2026.

Today we have David Allison from Clemson University.

Joining us, David is the Alumni Distinguished Professor of Architecture and the director of graduate studies in Architecture plus health or a plus H at Clemson University.

The A+ H program at Clemson is nationally recognized for the quality of its curriculum and consistent emphasis on design excellence within our field.

Professor Allison is a licensed architect in South and North Carolina and a fellow of the American Institute of Architects.

He is also currently the president of the.

Of the president.

Past president.

President.

Okay.

His past president of the American College of Health Care Architects.

ACH.

So please help me welcome David to the podium.

Thank you.

Roxanna.

And it's a it's a great pleasure to be here at Texas A&M.

We at Clemson think of A&M as a sister institution and sister program.

We go back a long way.

And I'm going to I'm here talking today a little bit about our program, but also embedded in that as the philosophy of what we think makes for an architect for health.

Okay.

Does that make sense?

Again, the two programs go back, have a long history together.

There were at one time two George's George man who you all know and George means at Clemson University and who started our program.

Our first graduate was in 1968.

So we're two of the two oldest programs of our kind in the country, and we go back and have a long history together.

And so so I'm going to talk a little bit about what we're about and how that makes how the philosophy we have for for producing future health care architects and architects that are interested in concerned with the study at the intersection of architecture and health.

So the first thing is about people in place.

You have a strong family here.

I think Texas A&M has a strong tradition of of of collegiality and family oriented.

And we've gotten some of your students into our graduate program.

And they always think of Clemson as basically a small A&M.

It's a very similar thing.

So what makes us who we are as the people in place, the people we work with in the place in which we work.

So that's a really important part of it.

And at Clemson, we're blessed to have a cohort of faculty that have complementary skills that teach in our program.

So myself, Doctor Dina Batista, Doctor Anjali Joseph, Doctor Lindsey Deaton, and now Scott Rawlings, and we have a postdoctoral fellow, Fernanda Goulart, who's now with us as well.

So we have a cohort of people.

They teach in different courses and different things.

They bring different areas of expertise, different backgrounds and and so we try to balance our research enterprise with our professional education enterprise at Clemson.

Of course, what makes us who we are also is our students.

And if you can imagine how difficult it is to get all these people in the air at one time working as a team, collaborating.

And so we we, our students are really about who we are.

And then we draw from and send our, our graduates out and our faculty from all over the world, just like you do here at A&M.

So it brings a diverse group of people with different backgrounds, different skill sets, different knowledge, different experiences, both life experiences and practice and educational experiences together.

And we all learn an incredible amount from each other because of that diversity.

The other thing we believe in is that our first role is to produce future practitioners, future licensed architects.

So we think of ourselves as both a generalist and a specialist program.

So our first role is to produce you as future architects who become licensed and enter the practice and can practice architecture at the broadest possible level.

But then we also layer onto that this notion of specialization.

So we think of of of that.

So we want our students to be able to not only do what is focused in health care practice a lot of planning, but we want them to be able to take projects all the way through from conception, all the way through the technical and detailed resolution, along with understanding the planning.

And this is just some examples.

We touch on everything from healthy community planning and design and site design down to different levels of thinking.

Of course, the other thing that we think is a hallmark of our program is being comprehensive and consistent, because we are a concentration of the 60 credit hours that a two year master students will take.

39 of those credit hours are devoted to the study of architecture and health.

And so and that all that study is focused around what we believe are some of the key forces that drive the health care industry.

Obviously, we want to produce students who understand that health care facilities, first and foremost, have to be operationally efficient and effective, right?

So, I mean, health care providers and organizations are under ever increasing pressure to do more, better, faster, with fewer material and human resources, right.

So we have to produce facilities that are good places to deliver care and effective places to deliver care.

And then, of course, we have to produce places that optimize health outcomes and human health and environmental impact for the individuals that have to occupy those facilities and environments, to the communities in which they're located and globally through their environmental impact.

And then we want to produce practitioners that can understand how to optimize the ability to accommodate change.

And change happens in health care facilities in a variety of ways over the life of a patient stay.

So a person might enter into a health care facility, very sick and very incapacitated under great stress and duress.

And then by the time they leave, they're in a different state.

Okay.

Does that make sense?

So so the life of a patient encounter, you know, we need to be able to accommodate that.

And then so whether that's changing the ability of the environment to change for their particular needs as their needs change over time or, you know, and take on a different atmosphere, and then we want to optimize the ability to accommodate change over the life of the facility.

When we're designing health care environments, they are facilities that that are going to outlast us.

We still have health care facilities in the United States that are working 75, 100 years after they were conceived.

And if you think back how health care was delivered 50, 75 years ago, it was fundamentally different than what it is now, and we can't even imagine what it's going to be like at 50 to 75 years out.

So we have to provide environments, their ability to accommodate and flexibly accommodate the changing needs of health care environments.

And to do that, we have a structured, this structured curriculum of 39 credit hours.

So all of our students take the same cohort of required courses within the the general Masters of Architecture degree.

So they're taking technology and professional practice courses and with with all of the students in the master's program.

But then they're also taking they have to take a whole four studio sequence in architecture and health, supported by a series of seminar courses.

All of our master students have to take a research methods course.

It's not a doctoral level research methods course, but it is.

It is a course that helps our future practitioners understand what research is, understand different research methods, and understand how to interpret and use research.

Okay.

Does that make sense in their professional practice?

They have to take an architectural programing course that deals with defining the problem.

A&M is the home of Willie Pena.

Problem seeking.

You might all have read that that book and understanding how to how to how to do the pre-designed services that most health care architects find themselves doing.

We teach them.

We offer them a history and theory of architecture and health.

So we're looking at the historical context of how we got to where we are today, so that we understand how the design of healthcare environments throughout history, from antiquity to today and future trends, is influenced by the culture of that time, influenced by the medical practices of that time and the scientific and technological advances of that time and how they're involved.

And that along the way, we sometimes lost some of the strengths of things, lessons that Florence Nightingale might have taught us about access to daylight and connections and fresh air.

But that so so you think those are important lessons to retain.

And then there's the health Policy Planning Administration court, which introduces them to the contemporary context for the practice of health care architecture, to helps prepare them to understand what their future clients are thinking, what the language is that they're using, how they're and what informs their decision making in terms of what they build and why they build it.

Okay.

Does that make sense?

And then finally, we offer a seminar on health facilities planning and design that dives into the general overall campus and facility design, planning and design of health care facilities, but then tunnels down deeply into the into the design of critical common departments like surgery or imaging or emergency or inpatient care.

Does that make sense?

And then that is supplemented by the studio sequence.

So several of these courses are co requisites with studio.

The health city planning design seminar is correct with the hospital studio.

So we do a vertical studio.

We have a cohort of eight students each year where they work together.

So 16 students are working in vertically organized teams, and the upper class are taking this health facilities planning design course, and they bring that expertise into the team and serve as team leaders on that.

So in the fall, it's always vertical and it's always dealing with the design of a hospital.

And it's also dealing with issues of urban design and healthy community planning and design.

So one year they're doing it as a as an urban hospital in an urban context.

And the other, they're doing a small community or rural context, a smaller scale project.

Then we the other studio is really a selected a small project studio where we allow students to go deeper into the development of the project, and then they have to either do a comprehensive studio in their final spring semester.

That's an issued problem.

They have to take it to the level of technical resolution.

That's our NAB accredited requirement for comprehensiveness and integration or in architecture and health.

And it's the only place that Clemson in the master's program where you can do a thesis.

We have a thesis option.

And in that case, students take a thesis research course in the fall of their final year.

They identify a topic, they do a literature review.

They they do case study precedent research.

They develop a series of design guidelines.

They have to develop a program for a facility that supports the thesis.

They have to then identify site selection criteria that supports the thesis, and then they have to select a site.

So by the end of the fall semester, they have defined their own problem.

And then they develop that as a comprehensive project in the spring as a comprehensive thesis project along with and they have to write a thesis manuscript.

So, so that we have that option.

And then of course, we we help place all of our students in summer internships over the summer.

Of course, you all go to I think you're all going to PDC.

Are you all going or many of you are going to PDC?

We take our students to healthcare design every, every, every fall.

I think some of you have met some of our students there.

It's always great to get the A&M and Clemson students together.

In fact, if you look in this class, there's a few what we what George has come to term clashes, which are, you know, have gone to both A&M and Clemson for their their educational career.

The other thing we believe in is that as a health care architect, you really should be balancing both the art and science of what we do.

Of course, health care environments are highly technical environments.

They demand a lot of rigorous process and methodology.

They should be grounded in evidence.

But at the same time, we we want to promote the art of architecture that we think that our students work and the work that they go on to do in practice should be able to stand up critically, should be able to be recognized for design awards, whether or not it's for health care or any other building type.

And we want our faculty in the School of Architecture to appreciate their work at a level at which they may not understand on the health care side.

So we we use this term multivalent so that work can be appreciated at multiple levels simultaneously.

Does anyone know where that word came from Charles Jencks.

And so, you know, we expect our student work to be not only works of art and architecture and technically sound, but also inspiring and moving places for people.

We think that future health care architects should transcend, be able to transcend the roles of designer, medical planner and technical expert.

And so we want them to be able to work at all levels of scale and development that we don't.

We ideally are our best graduates.

We want them to be people that can transcend the role of designer and medical planner.

Many of you, and many of them, will go off and be titled with the role of medical planner.

If they're a medical planner, we want them to be a medical planner who thinks like a designer.

If they're a designer, we want them to be a designer who thinks like a medical planner.

And so, because what makes less and satisfactory health care architecture is when the design and the medical planning don't, don't align, right, and they're not technically resolved.

So again, this is an example of a comprehensive project, just a cross section of some of the work that goes everything from site design down to the technical resolution of the building.

And then the thesis option.

This was a student who wanted to explore the idea of a mass timber health care facility as a as a carbon carbon reduction strategy.

We want our students and graduates to go out and be able to work across scales, from the level of communities to buildings to landscapes and spaces and details, and we try to introduce them to design problems along the way that cover all those levels of scale.

And so, like I said, every fall we offer a project that's themed building in the city building.

As the city, we fundamentally think that large, complex health care facilities are fundamentally urban design problems, that if you get the infrastructure right, we know they're going to evolve and change like a city does over time.

So we we think about healthy community planning, design as an urban design approach.

But then we also put urban design strategies towards the design of, of of health care campuses and buildings.

And so they have to start off doing a master plan for the health care campus.

This happens to be in Charleston.

And then ultimately they'll tunnel down and design a health care facility.

At the other end of the spectrum, we tunnel down, sometimes into individual spaces.

This was our patient room prototype project, where we revisited that over numerous iterative cycles with different teams of students where we we we designed it, we build it, we evaluated it, we learned lessons from it.

We went back and redesigned it and build it again and learn more lessons from it, and went back and redesigned it again and ultimately came up with with a futures version of it.

And in that patient room prototype, we basically wanted to.

Transform the health care patient environment.

Institutional clutter was one of the things that we found in our research that no matter how well you design the environment, they're going to come and put a sharps dispenser, an alcohol wash dispenser, a toilet paper dispenser, a paper towel dispenser, a soap dispenser, you know, all kinds of equipment on the wall.

And then when that equipment has to be changed out, they just pull it off the wall.

The screw holes are left there, and they put the new piece somewhere else.

And so we were trying to find a way to reduce the institutional clutter for the patient to make it a more therapeutic and health supporting environment within their field of view.

So that was one of the drivers.

We wanted to reduce unnecessary clutter in the room, get all furniture that didn't need movable furniture that was unnecessary or unusable out of the room.

So we eliminated the bedside table, which is useless when you're sitting up in a in a hospital bed if you've ever been in one.

And and so we were trying to deal with that.

And so this was the original design prototype where we were looking in within a standard chassis.

The idea that we thought of that, that patient room is a sham, like an automobile chassis that could accommodate different body styles, different interior outfitting, different features and stuff like that.

And they would be plug and play.

So we were trying to make it adaptable and changeable as well, and we were trying to maximize visibility to the patient.

So it could be acuity, adaptable either as an intensive care or an acute care environment.

So we were trying to look at how we could have an inboard toilet that maximize views to nature and connections to the outside, but in a high acuity environment.

So we wanted to make sure that our room could optimize views.

And so the idea that the patient could see who was entering the room have a sense of control over that environment.

And also the staff would have a good sense of visibility and access to the patient.

And so, again, the idea that we would design the room with a very under that could accommodate different stages of use.

We wanted to support family rooming in, because we knew from evidence that that improves health outcomes in the environment, and we wanted to clearly define work zones and separate the family from from the staff work process, and that this was this notion of reducing institutional clutter.

So this was the view the patient would see from the bed of the head wall that we would introduce acoustical properties where we could, that we'd positioned the mirror so that you could see into the room, walking down the hallway, the reflection of the thing with the inboard toilet.

And in fact, I think maybe that's let's see, you see the mirror there so you can see that.

So it's positioned so that you could do that.

Let's see.

And then the room could transform over different uses.

So when you have your family in there when there's not caregiving that the atmosphere is, is calming and and supports family interaction that that we know that in some for some families and some cultures, they bring a lot of people into the room.

So how can you accommodate a lot of people in the room and still not interfere with the caregiving process?

So we designed this bench bed area, this Pullman bed where several people could interact with the patient and then but also support caregiving.

And then and then you could flip down this Pullman bed very easily.

If you had a code, you could flip it up very simply and get all and get everything out of the room.

The only movable furniture in the room was the over bed table and the patient chair.

So so you could position it around the room and then again, you could sleep overnight there as well.

We designed a head wall to get all that medical gas stuff out of view of the patient.

And we made it a light box so that but it was more accessible because instead of reaching through all the poles and IV pumps and everything you could, staff could actually get behind it.

It was organized within the ergonomic zone for the staff, things like that.

And then you could use that as a way.

We didn't want to colorize the room.

Well, the room should be blue, the room should be green, the room should be beige.

Whatever.

We wanted to allow the patient the opportunity to to colorize the environment based on their particular needs at that particular point in their care giving process.

And then there would be a default where the staff could hit a button at the front door, and it would bring full spectrum lighting into the room for appropriate patient patient care.

And so during the day, it might just suddenly alter the environment of the room.

Oh excuse me.

I read something wrong there.

So in the day it could be, it could, but at night you could really alter the environment.

And the beauty of that was some of our graduates then went off into practice and actually implemented these ideas and actual facilities.

And so a couple of our graduates went and did this at Children's Memorial.

Now the beauty of that is at night, then the hospital becomes a reflection of all the personalities of the patients that have to be occupying the room.

It would have a dynamic quality in the facade of the building.

So this gets to this notion of art and science.

That's all grounded in evidence, but then it has a dimension of art to it.

Does that make sense?

Another thing we believe is in serving communities, right.

So, you know, we've done projects, service learning projects.

I know George introduced that.

I know Roxana is doing that now, where you're working with real clients and real communities for real problems and stuff like that.

That's that's a big part of what we do.

We've done it in our own small college town that's undergoing incredible pressures of how to make it a healthy, walkable, transit oriented community with incredible growth and pressure from that, where we then worked in developing a process for creating a health community, we work with the community and to design a series of design guidelines and strategies for how how they could they could begin to implement and make our community a little healthier.

And we did that by having workshops with community residents and the city staff planning staff.

To do that, we built full scale models of downtown and work with them to brainstorm.

We've also worked with health systems locally.

Watauga wanted to create a health district adjacent to the hospital, and they want to create a healthy campus that the hospital campus would be more than just a place to go when you're sick, it would really be a civic anchor in the community.

Again, the students got to meet with and present to community groups in a real format.

And again, we started off with looking at creating walkable and transit oriented health district and then looking at at the health campus overall and how to make that, in effect, a civic anchor and a park, a public space within the community.

As health care architects, you will be going and working in, in, in multidisciplinary teams.

And the goal of what we're trying to do is to have the future health care architect help ultimately, very quickly in their career, get to the point where they can lead multidisciplinary teams.

And so that talks about communication, how you work in engage with others and in developing processes.

If you know Pena's work, you know, we're very grounded in some in some of that thinking.

And then ultimately we want to integrate our learning with teaching or theory, research, service and practice.

So we want to work across all those dimensions.

We were recognized by NCBI with a grant, an award for doing that.

We did a community oriented primary care facility for Charleston.

And this is an example of some of the work that, again, dealt with not only providing effective, community oriented primary care, but it was also about being a civic place in its community and environmentally responsible in a highly sensitive, flood prone, coastal part of our state.

And so this is just some examples of that work.

Again, taking it down.

And then ultimately we want to advance the discipline, do that by creating new knowledge and and relationships between architecture, the built environment and health.

We wanted to do it by translating that knowledge into usable formats for design decision making, ultimately, and we want to do it by disseminating that knowledge through publication and presentations.

And then ultimately, we hope that we serve as a national and international locus for the study of architecture and health.

And that's what our goal is at Clemson.

And so by doing that, we do that with the center for Health Facility Planning and Design, which is our research enterprise, which is physically co-located next to our design studio and our and our seminar workspace.

That's the environment that Roxanna grew up well, not grew up, but culminated her educational career in and and so I'm going to share with you two projects that that have come that have been an integration of our research enterprise and our design enterprise, okay, our professional education enterprise.

And the first is, is our Ripcord or project, which was a four year multi-million dollar grant where we had a year of basic research, literature, research, case study, research, and then and best practice research observations.

And and so we did all that.

And then we took all that first years of work.

And we then brought it into the studio, and we had our students design a prototype or ambulatory surgical or building off of all that.

And then we had a workshop where we created with with an interdisciplinary and multidisciplinary workshop.

We created a series.

We had a set of vision.

We had a series of design goals based on evidence.

And then we developed a series of design strategies for how the or could be done.

And then ultimately we worked with that interdisciplinary team.

This was a collaboration with the Medical University of South Carolina through an iterative design process.

We designed it.

We built full scale models or a large scale models, and then we did tape on the floor mockups.

Then we did cardboard mockups and then a series of cardboard mockups.

Higher fidelity.

We had tested it.

We went through simulated surgical procedures with the clinical staff, and then ultimately came up with this room design that had a few innovative features that have now been adopted in a series of or both at the medical university, as well as at several other facilities nationwide.

And one of the things we learned was by turning the operating room table diagonal in the room, we could we could minimize what our research discovery was.

A lot of task disruptions, interruptions that could potentially lead to errors in the surgical procedure happened in conflict with the anesthesia work zone.

And so positioning the anesthesia work zone in the most protected place in the room at the diagonally opposite corner of the entry to the room, and then and then minimizing using that space for the anesthesia team, as opposed to a place where the Pyxis machine or other kinds of supplies might be stored, where you had to either walk behind the anesthesiologist or walk behind the surgical, the sterile field for the surgeon.

We positioned it so that it was in the most protected place, and optimized the travel distance for the circulator around the other three sides of the of the room.

And this was the vision that the students had for what that room might look like.

We wanted to introduce daylight.

The option.

It was again a as a shadowy where when you had the opportunity to have an exterior wall, you could introduce daylight into the room, or you could make it a sterile core on the other side of the room.

So this was their vision.

And then we built a high fidelity mock up with surgical booms.

Again, we tested that in with with a robotic dummy patient and, and surgical teams.

And we went through entire surgical procedures with those teams in that, in that, in that, in that room.

And then the current project we have underway is now we're looking at the mental and behavioral health exam room in the Ed.

And I know some of you are doing that as a part of your project.

This, this this this semester.

Is that correct?

And so, you know, we learned that particularly for pediatric populations, mental behavioral health patients typically present first and foremost at the emergency department okay.

The emergency department is about the worst place you can possibly imagine to be in when you're in that, in that state.

But that's where people present.

That's where law enforcement might bring you.

That's where you might you might go when you're there, but then there's no place to discharge you, you know, if you need if you can't be sent back home, there's no place for the hospitals to discharge it.

The beds upstairs in the psychiatric ward are full.

There's very few facilities.

We don't support mental health care in the United States very well.

And so sometimes children spend extensive periods of time, days, weeks in the worst case scenario, months in an exam room, in an emergency department without access to daylight, without a bathroom, in a, in a highly clinical environment.

And so we were trying to find a way that we could take a typical exam room in an apartment and make it easily convertible and more suitable for patient care for mental and behavioral health patients, make it easy to turn over, make it ligature free and things like that.

So that was that was one.

And so again this this talks about some of the different issues that we discovered in that process with the with that environment and that population.

And then again it was this has been a multi year project.

We did a lot of research to the the center for Health Facility Design and Testing with my led by my colleague Doctor Joseph, as she did with the Or.

And then there was five parts to that larger research project.

And then we took the part with the built environment and said, we're going to bring that in into the coursework.

And so we created a directed studies course where several of our students then had to develop ideas for how they could make that environment a better place.

And so we identified what would be the common barriers in that environment.

Okay.

And then we, the students came up with four solutions.

One was built environment and solution for the Ed exam room.

One was a respite space for staff who in the Ed have are under high stress but can't get away.

So we wanted to take a module within the Ed that could be converted into a respite space.

A quiet space for them to get away, to cry, to, to, to gather themselves, to maybe make a personal phone call, but not be far away from the Ed.

I'm going to focus on on the exam room portion now.

And those were the four basic projects.

So what we call that respite space was called micro for the staff.

The Eden Room was or convertible exam room.

And then we had a technology solution as well that could be used that we then brought in as well.

Again, we started that process like we did with the Or by design, but defining the vision and a series of design goals and then a series of design strategies for that environment.

And so the Eden Room.

So like I said, they're not safe.

Exam rooms in the Ed are not safe places for patients.

They're not therapeutic places for patients.

They they're hard to convert.

It's very time consuming to take a room that is designed for clinical care, with all kinds of stuff mounted on the walls and things like that, and make that ligature free.

Okay.

And then it's also very institutional place for someone who's really struggling.

Okay.

Does that make sense?

And so we were trying to address all those all those concerns.

We looked at it at a couple of various configurations of the first step in the iteration.

We did this through virtual virtual mock up.

We created a digital mockup that the staff could work with headsets and visualize the room.

And we studied really two configurations that would be typical in a need either the either the bed perpendicular to the corridor or parallel to the corridor.

And we looked at it in the end that that that series of simulations directed us towards the perpendicular arrangement, because the the parallel arrangement of the table provides allows the staff to potentially be trapped behind the bed, it creates places that aren't necessarily visible and creates some conflicting workflows in terms of delivering clinical care.

So by being perpendicular to the corridor, it gives you equal access to both sides of the of the of the of the of the bed we looked at.

Then what happens after the initial medical evaluation?

Or if you're in there for a longer stay that you could you could push the the bed to to one wall so it would be a more environment friendly.

We also looked at issues of writing space for family members to be able to be in the room, yet out of the way of the clinical processes, or for the patient to be able to escape to a more comfortable thing than a than a typical Ed gurney.

Okay.

And how that could be.

And then we provided a closet in that room to take as much of the equipment on a cart and put it away in a closet to be secured.

And then we put the medical, the head wall behind into cabinets on the head wall so that it would be closed off.

And so all the gases, all the ligature prone items could be concealed within that.

In that environment, we introduced different lighting ideas in terms of how to control the atmosphere of the room from, again, the need for bright uniform lighting for clinical examination, but then also atmospheric lighting for different states of things, from sleeping to to just calming environments.

And that could be accommodated.

And then, of course, dealing with the issue of visual control that for mental behavioral health patients, you need to have eyes on them all the time.

And that and yet you want to be able to have some sense of control over the environment from the patient's standpoint as well.

So we dealt with all that.

We provided a virtual window skylight in the, in the, in the ceiling, a digital skylight.

We we provided a screen that the students could use that was built into the wall.

I'll show you that in a minute.

We went again when you could have access to the daylight.

We looked at clear story windows over the head wall element when you had the opportunity to do that.

But again, it was a kind of plug and play chassis.

We then collaborated with our colleagues in the general program who had developed this, what they called simply a modular plywood fabrication system.

And we thought, well, this would be a great thing to be able to build for a mockup.

It allowed us to prefabricated all the component parts for the mock up in a shop, outside of the outside of the operational parts of the facility.

This whole system, if you think about a 3D jigsaw puzzle, it's all assembled without fasteners, except it fits together.

And then we use metal zip ties to anchor it all together.

So we erected this mock up in this space in about six hours.

So to minimize the disruption in the clinical environment, we could we could we could do all the fabrication outside, all the dust, all the stuff outside of the environment.

And then we we basically built this, this, this mock up in about six hours using that simply system.

And that's what the final mock up looked at.

And so as you can see, the head wall had had doors that that hit all the medical gases behind the doors, stored all the stuff that would typically be mounted on the head wall.

All they have to do is close the doors again, there's a closet off to the side.

And then we were trying to optimize visibility into the room.

And so again, everything could be put away there.

And then we evaluated that with again the clinicians and with actors acting as the patient and going through a series of simulated scenarios for delivering patient care, from medical screening initially to the transition to a longer term stay in the environment, and then mental and behavioral health consultations.

So so we did all that and then we learned some things.

The swinging doors were not ideal.

So we looked at then sliding doors.

So now we're going back.

We've made some modifications to the thing.

We were trying to then get the room down to a more reasonable size.

So we were trying to get it within the same typical depth of an exam room, because it started out deeper and we were trying to get it so that you could do within the space of three traditional ten by 12 ed exam rooms, you could create actually for you could create three of these rooms, but without disrupting the overall design of the Ed.

So we reduce the size, we reduce the closet, we reduce the depth of the bench bed to optimize visibility of and minimize hidden hidden corners in there.

And then we change the doors.

We added the second observation alcove and we moved the sink at of the out of the Ed exam room itself.

So it was outside in the hallway because that that was we found that to be a task disrupter for delivering clinical care in there.

And so that's kind of, you know, outlines our process a little bit and how we how we do some of our research and things like that.

And I know Roxana wanted me to limit this to maybe about 20 minutes so we could entertain questions.

Does that make sense?

I think we were doing great on time.

Okay.

All right.

So I wanted to give a lot of time for questions.

We can go back and and go over any of that.

But I really want to make this as interactive as possible with all of you.

Does that make sense?

Well, thank you so much, David.

Wonderful presentation.

I'm a Yankee, so I talk fast as well.

So I hope I didn't go too fast for you guys.

Any questions for David, especially from you guys.

You did the mockup simulations.

You love the LED mock up simulations as well at Texas A&M.

Do you have any questions regarding the wonderful projects that David just talked about?

Danny Denny did two of the simulations and mockup buildings at Texas A&M.

Well, thank you for the presentation.

I wanted to know if you've heard from graduates from y'all's program, which aspects of the overall curriculum was most impactful and most helpful to them?

Oh, well, I think they value it all.

I mean, you know, obviously they they you know, one of the things we try to do is and I know that you do here too, is you have first have to learn the language.

So you're going into a healthcare environment and they're talking a whole different language than you are.

Right.

So so that's clearly understanding the terms.

Again understanding what motivates people to make decisions.

So you know because we know our graduates, they're still just beginners.

In two years we cannot produce a highly advanced practitioner.

But we the feedback we get from the firms is that our graduates, if they're going into healthcare practice, they're operating at a 3 to 5 year level of defense standing, responsibility opportunities that they're doing.

So the learning, the language, learning, understanding the forces.

And then that that Health facilities Planning and Design seminar, we set that up so that they're producing at the end of that course, basically a planning document so that different teams do different departments.

Then at the end, they can all share that information with each other, and they have what is a planning and design resource for them to go out and actually go into practice and begin to actually operate in the design of health care facilities, in a way.

And so we're bringing in we bring in national experts like you do here, like we're doing today.

So they're getting access to the best minds in the industry there and best practices whether.

And one of the things we've tried to do is open it up more internationally, because we know that they do something better than we do here in the United States outside of the United States.

Right.

So particularly when it comes to access to daylight and connections to nature more consistently in health care environments around the world, and then understanding how culture influences how we think about the design of health care facilities.

So, again, the notion that we're we're iterative, you see it, you touch on it multiple times.

You might be introduced to it in a seminar course, but then you're going to be exploring it in design studio, and then you're going to be exploring it again in a different way with a different problem in the design studio.

So, so I think I think that's what I mean.

If you ask our graduates, I think that's what they would tell you.

Does that make sense?

Yeah.

Thank you.

And we have Francisco.

I'm going to walk over there.

Okay.

So last Friday we had a presentation with Doctor David Pepper.

He was a physician, and he spoke a lot about the freedom that these patients receiving.

I really like how you talked about the light choices they received.

That's a kind of freedom.

So my question is how what other options of freedom do you design with, again, basically control over your environment.

I mean, first of all, one of the first things I tell our students, if you're designing a patient room and you give me, for example, a room where that door to the room is on the head wall, and you realize when a patient sitting upright in a, in a bed, in a patient bed, in a patient room or in a gurney, they're about four feet off the wall.

Okay.

If you put the door to the room on the head wall side of the of the corridor, they can't see who's coming in there.

So you saw that picture where the patient, from the patient's point of view, they could see the staff member.

The staff member could see them.

It's inherently an insecure.

Positioning of the of the patient when you do that.

The other thing that we learned with a patient room prototype is when you have an outboard toilet and you put the outboard toilet on the foot wall, then you have a window and you have a family alcove, but the patient can't see out the window.

Okay.

And then if you're if you're looking from the entrance to the room across the patient and the windows behind the patient, guess what?

They're in silhouette on a sunny day on a south facing exposure.

So, you know, those are kind of things where you were trying to give control over the environment.

Obviously technology, I mean amazing things that can be done with lighting.

Now that we can colorize the environment with light, we can give them choice.

You know, the idea I don't know whether you'd picked up on it, but in the patient room prototype, we had a tablet that could be set on the on the over bed table that they control the light, the thermal environment, the privacy environment, right.

As well as their entertainment.

They can order food, you know, like DoorDash, right.

And not not relying on that.

So, you know, to give them as many options and choices to be able to have control over their lives in a, in a situation.

I mean, I think the one fallacy is to think, don't think about a health care environment is trying to create a home like environment because the situation you're in when you're in a hospital or a health care environment, it's not home.

Your bedroom is your most private space in your lives, right?

Okay.

That's not the way in a house care facility, a staff member can come in any time of the day, you know.

Right.

And so again, being able to see who is entering the room, have a preview of who's going to be coming into the room, being able to see what's going on outside your room.

Those are all things about givin really important.

So we don't think about home like because it's not home, you're never going to create home there.

But to the degree within an institutional setting where inherently control is taken away from you to give you as much of that back as we possibly can through the design of the built environment and to then through the design of the built environment, influence the culture of the place.

So that the staff is actually has intuitive sense of, of giving that control back to the patient.

Does that make sense?

Well, thank you so much for the questions.

Thank you so much, David.

We have to wrap up this session right now.

And of course David will be here for the assignment reviews in the studio.

So you guys you can join the studio and we're going to come over very quickly.

But thank you again, David for joining us.

It was a wonderful presentation.

Thank you for being here for sure.