Mary Phillips is a licensed architect who’s spent over 25 years working with the University of California San Francisco (UCSF) Health. In her current role as Project Manager of Interiors, she oversees interior design materials, furniture, art, signage, and the patient experience with UCSF Health Major Capital Projects. UCSF also recently launched the Standards Program, a new effort to create a consistent feel and experience across every location.
When we kicked off the Mission Bay Hospitals project several years ago, we realized we did not have formal design standards. This was a massive project that spanned three hospitals and an outpatient facility, and we wanted to create a welcoming and healing design with consistency across the board. Our goal was to create a brand that unified the project when it came to look and feel, maintainability and infection control. Many of these design decisions were the foundation of our current design standards as well as the many lessons we learned along the way. Let me share a few.
Creating standards might feel cut and dry or a straightforward activity but in practice, it’s quite complex for a large medical center and university. We began by thinking from the standpoint of the users –– the patients, families, providers and staff –– and how the designs we choose would impact them.
To help, we got hands on. For interior products we gathered large samples and evaluated the products. For furniture we set up our own furniture showrooms with selected options and invited diverse groups of users to evaluate our selections. These workshops tested various furniture pieces each with different requirements and within each of the different spaces including exam rooms, patient rooms, and lounge spaces. What might be good for one person or location isn’t for another. Having a variety of people evaluate our choices hands-on, helped us gather the human input we needed.
Standard doesn’t mean the same. While we wanted all the buildings within the project to speak with the same voice, we also wanted them to feel unique –– like their own place. By unifying the major design elements, we were able to add in extras and accents that tied everything together while giving different areas their own look and feel. This balance is very valuable. For example, a children's waiting room versus an adult outpatient cancer waiting room might have a very different look and feel. And they should, but they should also have consistency within the maintainability, durability and the infection control components of the finishes and furniture. So, what you really need are standards that have a majority of unifying fixed standard components as well as open-ended flexible components.
If you’re undertaking a standardization program, budget will play an important factor. Standardization increases design efficiency helping the budget, and the ability to maintain the design long after the building opens. Identifying what can be purchased in quantity and developing a set of standard details and elements creates economy of scale. This helps with first costs and ongoing maintenance costs.
It’s important to thoughtfully plan how the unifying elements and custom elements come together to create the best design for a large project, identifying locations for a higher price point and economizing in other locations. For example, there are many chair types in a project. Workstation task chairs are a high priority and are important for staff safety and satisfaction. Patient and family comfort is also a high priority in lounges and clinical spaces. Other chairs that are used with less duration and frequency are an area for economy. Understanding the different quantities and goals of each piece allows savings without sacrificing quality.
It’s been fascinating to see how the standards we’ve built have influenced other decisions. We do our best to learn from experience, learn from our UCSF and industry partners and educate others too. There may be spaces that aren't patient centric, but it's still valuable to have certain durability and infection control qualities for the wide variety of users. We must recognize that there’s no one size fits all, and we keep going back to the idea that there're some things that are set and some things that are flexible. It’s an ongoing process of sharing, evaluating, and learning.
There's so much to learn and bring to the next project. And what's important about standards is that they, out of necessity, need to be continually evaluated and updated. Ultimately, standards aren’t rigid stipulations written in stone, they are a tool; the culmination of information, perspectives and human-centered testing and validation.
When you’re creating design standards for a space, it’s easy to lose sight of the most important factor –– the people inside of it. In our case, it is the patient. We wanted to do the right thing for them. The key is integrating all design standards - finishes, furniture, art and signage to work together. We want to create a place where our patients feel welcomed and cared for, in an often-stressful moment of time.
Even today after the project has been open for over six years, some of my best moments are walking around the buildings and really seeing people use the space in ways that you wished them to. And then sometimes you see them using it in other ways that you never thought of. But at the same time, that is a lesson learned for the next project. It’s amazing and rewarding to be a part of this process.