Episode 26

Putting the Person in Person-Centered Design

Healthcare and senior living design firm Boulder Associates explored the challenge of measuring the impact on the person from human-environment interactions and then visualizing that data as a journey map. Meredith Banasiak and Jenny Hastings share their research into mood mapping a cohort of remote workers to evaluate impacts from their environments and activities.

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Imagine if - we could measure our stress based on the space we are in. We could use this information to understand how the spaces we design increase or decrease a user’s stress. And we could ultimately improve the design of spaces and processes to lower stress and optimize wellbeing. Meredith Banasiak, Director of Research, Boulder Associates Architects


CCB: [00:00:00] Welcome to the ONEder podcast. This is your host CCB, and I am delighted to introduce another one of our 2020 ONEder Grant Award winning teams today. If you don't know what the ONEder Grant is, I'm going to take one second and explain that we launched the ONEder Grant program in 2019 to support and celebrate thought leadership in the architecture and design community. And what we really wanted to do was empower our design colleagues to develop unique research about a topic or an interest that they have a great passion for. So in 2020, one of our award winners was Boulder Associates and I'm delighted to have Meredith and Jenny from Boulder Associates on the podcast today to explain their particular ONEder Grant project. Jenny, introduce yourself, if you will, please, and Boulder Associates.

Jenny Hastings: [00:01:01] Ok, I am Jenny Hastings. Hello everyone in podcast land. I'm an interior designer out of our Sacramento, California office and one of the principals in that office as well. I've been at Boulder Associates seventeen years and when I got into our firm. So Boulder Associates is a firm that is 100% health care and senior living. And when I started that Boulder Associates, I didn't know much about health care design. I'd come right out of school, and I realized very quickly that I loved designing spaces that had a really powerful impact on people, and especially in health care, in the way that people heal and in the way that their families are able to go along on their health care journey with them. And so I went along for many years at the firm working on projects, and then at some point, maybe five or six years ago, I had the opportunity to work on a couple of projects that allowed us to dig a little bit deeper into really doing some cool work with a couple of clients around involving patients in our design process and really trying to be more rigorous in the way that we, as designers and architects approached our work. And so with that, we were afforded the ability to bring Meredith onto our team as our Director of Research. And I have gotten to work alongside Meredith since she joined our team. And it's just been a really incredible journey. And so she's the champion of this grant and our effort. And so I get to, I consider myself lucky to have her as my colleague to do these types of projects with and again, better the work that the firm does in supporting our health care clients. And she's part of our team, a part of a team that we call BA Science. And I'll let her explain a little bit more about BA Science.

CCB: [00:02:49] Excellent. Meredith, join us.

Meredith Banasiak: [00:02:53] Thank you. It's great to be here. Jenny, thank you for such kind words. I, feel lucky to be part of Boulder Associates. My background, actually, my undergraduate degree was in Classics and Archaeology. So I like to say, kind of, studying archaeology is sort of just doing architecture in reverse because you look at artifacts and kind of the building, whatever is left of buildings to try to understand people and cultures. And in architecture, we just kind of do that in reverse. We design spaces and artifacts to support people and cultures, When I finished my professional degree in Architecture, I started working with the Academy of Neuroscience for Architecture when it had just first launched. This was back in 2005. And at that time, we were trying to understand sort of how people's brains were responding to space or impacted by space. And so that sort of human environment interaction piece has always framed my work from that point on, going forward. Being a part of Boulder Associates has been amazing because Jenny has helped lead this effort to launch what we call BA Science, which is we consider the innovation arm of the firm. And it brought together kind of what was previously silos. So, we had our evidence-based design kind of research group that Jenny and I are a part of. And then we also had our Lean Process Improvement Group kind of working independently and our sustainability leaders. And so, BA Science kind of rolled that all together so we can work together on projects which really helps us understand environments more as a system of spaces, of relationships between people, and of processes and operations. So that's kind of the lens that that we're looking at this.

CCB: [00:05:03] That's fascinating and fantastic and unusual, I think for a firm of your size, I would say, in an interesting way. So, given that, and given the ONEder grant opportunity, what drove you to put this particular project forward as a proposal?

Meredith Banasiak: [00:05:28] Oh, gosh, so we had been doing these kinds of patient or kind of occupant journeys for a lot of our projects, and we have as part of understanding or documenting the journey, we would ask different groups of patients, being one of them, kind of about different stress they felt at different parts of their journey. And stress was really hard to quantitatively map or to benchmark in these journeys, like were we actually making a difference in redesigning new spaces or operations and changing their stress. So we just always had this kind of anecdotal evidence from these groups we were talking to. So we came across this kind of ring, which said that you could measure stress and we said, wow, what if we could measure stress, not just hear from people what they thought their stress was, but actually measure stress and see if when we change design or we change process that it’s actually making a quantitative difference. So that was sort of the impetus and, you know, how do we measure stress and correlate that with location and activity along somebody's journey?

CCB: [00:06:55] Jenny, do you have a comment about that?

Jenny Hastings: [00:06:59] Yeah, well, I think that the part of the reason, too, that we wanted to explore this is. Meredith talked a little bit about BA Science being this kind of innovation engine for the firm. And I think the exciting part to us about submitting for this grant, is that it afforded us the opportunity to just dive a little bit deeper. And obviously we experimented on our own staff but to dive a little bit deeper into some of the things that we're trying to do on our work within the firm. And I think that's where, as a firm that's going on forty years of being one hundred percent health care and senior living, we obviously have knowledge that we have about our clients and about spaces and about the way that we assume people respond to our spaces. But what we were able to do on this project that we can hopefully carry through, is just dive deeper into really validating certain things that we might assume as designers and architects about the healthcare spaces we design and if not, challenge that and hopefully bring back some new findings to our teams. And that's, I think, what a lot of the BA Science group is about. It's about challenging the perspectives of the firm, the “how” we approach our work and challenging our clients and others to elevate healthcare spaces.

CCB: [00:08:09] So, now you've made the proposal for this particular project. And I will tell you, last year we received about twenty-five different proposals. And we have an independent and blind judging process where all of the proposals are reviewed and ranked by a number of different judges against a certain set of criteria, which is fairly broad. But clearly it popped up. Your proposal bubbled up to the top. And I will also say that there were a very large number of amazing proposals. So we intended to award six grants last year and we actually awarded seven because there were so many just solid and unique and valuable proposals. Valuable to the design community and to the human experience within the built environment. So that being said, your proposal - so you developed a methodology, if you will, incorporating that ring. Could you walk us through that particular process?

Meredith Banasiak: [00:09:21] Yeah, so the intent was kind of yeah, we had this conceptual idea and with the proposal, it was, alright, how do we actually go about doing this? How do we actually correlate human stress with location and then also activity? Because we knew activity was going to have some sort of interaction as well. And so we did use the rings to measure the stress. We used a kind of Bluetooth--it was a Bluetooth low energy system of sensors and beacons. So the participants wore a beacon kind of on a lanyard around their neck or in their pocket, if they didn't want it around their neck. And then they had sensors at their office and home workstation. And that had sort of a twenty-five-foot range that could detect where they were. And then we also used an experience sampling methodology which essentially just sent text to their mobile device throughout the day asking them three questions. And we wanted to know where they were, what they were doing, and how stressed they were. Because we wanted to again understand if there was any sort of relationship between their perceived stress and what the physiological stress measures were. So that was the three components in our system. Because everything was timestamped, it allowed us to kind of connect the dots between the different data streams and put them into kind of a single canvas or spreadsheet and look for connections.

CCB: [00:11:08] And it goes without saying last year was the onset of COVID, which I'm sure had some impact on your study. So you want to talk about what impact it may or may not have had and what did you do to pivot? If you did.

Meredith Banasiak: [00:11:29] Yeah, well, Jenny and I had a lot of discussions early on. Again, we knew we wanted to do this in our kind of healthcare settings ultimately. And so it was kind of how do we do this with patients or with staff? But staff were wearing gloves and washing their hands all the time. We didn't feel comfortable with patients, we took that off the table early on. And so it was, well, what's a different mechanism we can use to sort of test this out pilot it and see if it works maybe before jumping in with healthcare occupants? And so, just it felt that our own staff and as you mentioned, kind of during pandemic, this whole, there are so many questions globally about the work from home versus office-workplace culture. You know, and even prior studies before the pandemic, as you know, which tried to evaluate this, were all kind of thrown out the window because it was such a larger movement that had to be restudied from the ground up. So that's when we said, well, let's look at our own employees and see if there's any differences between stress when they're working in the workplace, the office workplace, versus stress when they're working from their home environment.

CCB: [00:12:58] And Jenny, you're shaking your head, what is there something that you'd like to contribute to that?

Jenny Hastings: [00:13:03] When we were talking about, you know, using staff, you know, you say, OK, what people will be on board? Will people be wanting to do this with us? And it was really cool to see, like, how, you know, people whether or not they signed up to be participants in the story, I think there was a lot of excitement around this. We've had people that have asked afterwards to want to wear the rings to just to look at their stress. But I think, you know, part of what we try to do is talk again about the firm of our size trying to infuse this behavior of questioning and challenging into the firm. And so, I think that was also an added benefit to running this internal to our firm was just to get people thinking about having maybe a broader natural curiosity for looking at exploring things a little bit deeper. And so that was definitely an advantage that I didn't see going into this when we decided to do this with our staff was just how excited people would be about it. And then even with the sample set that we had, people were interested in seeing what happened afterwards, what the results were reading. I've heard people that didn't participate in the survey, but I read through it, talking about it, talking about some of the things that we learned from it. So it's been, that part was also pretty exciting to do. And it afforded us the ability to get some of our folks at Boulder Associates excited about the endeavor.

CCB: [00:14:21] That is I mean, that's so fantastic to hear because we love hearing what the by-products are of the work that the ONEder Grant teams are engaged with. And we do hear numerous unintended byproducts or results that have kind of positive nature. There was a question I know when we did our webinar, about was there any handpicking or was it really random selection of participants and did that have any, do you, Meredith, see any impact on results as a result of, you know, who the participants were?

Meredith Banasiak: [00:14:58] Yeah. So one of the things that came up during the webinar, I remember, so we said, you know, we didn't control for individual differences. And there's other research out there which says absolutely, individual differences will contribute to someone stress in work from home setting or a workplace setting. So, you know, things like personality, generation, what their home environment setting is, like do they have distractions, their family, roommates, do they have social interaction from home, all those kinds of things. So, you know, so the question came up. You didn't control for that. Why? One thing is, well, this was during the pandemic. So we are kind of a medium-sized firm. So, we didn't have a huge sample to pull from. And then we said you have to work at least twenty percent of the workweek from home one day and at least twenty percent of the work week at the office. And so that also limited it. And so we took every single person who wanted to participate. We didn't have a lot of because of that exclusion criteria right there, we were really limited to who was eligible. So everyone who wanted to participate participated. But that really prevented us from doing sort of a controlled study looking at these other factors. And it was a small sample size. It was only a size sample of seven. total.

CCB: [00:16:42] So with the results that you received, what was the most surprising or what was the most reinforcing on opposite ends of the continuum of thoughts that you had or were considering?

Meredith Banasiak: [00:16:56] So there were not clear-cut results that said workplace is stressful or work from home is stressful. It wasn't black and white. And I again, I think that had we controlled for individual differences, you would have seen more of those kinds of effects because other research coming out has is kind of showing that. So just because our study didn't show that, I want to be clear to say that doesn't mean it exists, because it probably does. But what I thought was most interesting was kind of looking at it as a continuum of their journey throughout a day and throughout a week. And where we saw the most interesting effects was kind of what was happening before and after discrete events or by an event, I mean, either a change in activity or a change in location. So, for example, when a participant was moving locations throughout the day, so if they were going from home, maybe they worked a few hours at home, and then they went to a construction site, and then they went to the office. Those days where they were moving locations were very stressful. And the anticipation of moving locations throughout the day seemed stressful. So if someone started their workday at home, they would be high stress and then they went to another location and returned home. We would see lower stress. So, again, it wasn't just the setting itself, but kind of this moving all the time within a course of a day that seemed to create stress. And we saw kind of site visits as being the most stressful activity, and that certainly could be related to COVID maybe just the fear about sort of having interactions with other people was stressful. But that was kind of clearly the highest stress activity.

CCB: [00:19:13] Was there anything surprising? I mean, that you kind of saw that you didn't anticipate. There doesn't have to be, I just wondered.

Meredith Banasiak: [00:19:23] I hypothesized that driving would be one of the higher stress activities and it actually was one of the lower stressed activities. And again, we don't know if what traffic was or wasn't at this time or anything like that, but it actually seemed like a kind of a transition that allowed for more recovery, almost as much as like kind of afterhours leisure time was the only activity that was lower than driving. So that was interesting.

CCB: [00:19:56] We did a very informal set of interviews around how you were feeling within the work from home environment. And it was more than, let's say we did twenty interviews. More than twenty-five percent of them said they miss actually driving because it's that transitional time from “I'm leaving the office now. I can detox on my way to home.” And there is a piece there of habit when you think about it, of being that separation or that liminal space in between activity. So that's kind of fascinating. So when you think about the process and the tools that you've used, are you doubling down and saying, yes, we will do this again in another environment? And what other things did you learn, you know, that you might make iterations to?

Jenny Hastings: [00:21:02] Yeah, I definitely think that this is something that we would want to continue to expand upon and continue to find the opportunity, you know, especially if we come out of the pandemic to some extent, trying to find ways to bring this into our healthcare projects, whether it's through looking at staff, as Meredith said, staff or patients. I mean, I think that it's something, again, in the spirit of wanting to just learn more and understand our spaces more and understand people's behaviors in existing spaces to inform spaces we design or how our spaces we design perform. I think it's definitely something that we want to continue. I mean, this is a good kind of beta that we got to do it. And so, again, the pandemic allowed us the ability to do this at a level where we try it out on our staff first to make sure that the technology works, make sure that we can sync it up, make sure that it is starting to give us an understanding of how we can leverage it moving forward on projects.

Meredith Banasiak: [00:22:01] Yeah, I think.

CCB: [00:22:02] Go ahead.

Meredith Banasiak: [00:22:03] Well, I mean, the other thing and CCB, you know, your industry has been saying this forever, is like pair the right environment with the right task. And that seems like one that was one of the findings that came out as well. I think the stress map that sticks out in my mind the most was a participant who put all her stressful activity; so her site visits, her back and forth to the office, her meetings on Monday/Wednesday/Friday, and then did her focus work at home on Tuesday/Thursday. And you could see a very dramatic swing in her stress. And those interspersed days for focused work gave her health-wise that ability to recover so much, much lower stress. I think her kind of the time above average on Monday, her kind of stress days were like 80 percent and then her on her focus days was like 20 percent. So a very dramatic swing in her stress levels and giving her that chance to recover. And then kind of just, you know, although a lot has been made about the effect of Zoom fatigue and how stressful that is. And so we also saw some effects of that where it was bookended. It wasn't necessarily during the Zoom meeting, but it was before and after we saw these spikes. So if you're piling on the Zoom meetings, you're getting this cumulative effect of the stress is building, building, building, building. And you're not building in that recovery time throughout the day. So it's thinking about how to schedule different work activities and then also matching them with the right setting that can support those activities. And again, I know your industry has been telling us to do this for a long time.

CCB: [00:24:02] Yes, we have. And well, the other thing that you're addressing that is, that is a constant conversation and is gaining momentum is the idea not only of well, you're just talking about it choice and control. You know, that you have choices and that you can control the activities that you perform in wherever the environments are. And the higher the choice and control is, the lower the stress. So you have that autonomy where you kind of can move about. I do think, as I've been sitting here listening to this, I'm struck that your practice is so focused on healthcare and on senior living. And arguably there are higher stressors in the healthcare environment for patients and families and obviously, potentially staff as well, given whatever the activities are. But curious about the senior living and would there be applicability for that environment as well?

Meredith Banasiak: [00:25:12] So I think for sure, because with office workers, I think the concern is chronic stress and too much stress. And with senior living, I think, a concern could be being under stress, because we know stress itself isn't a bad thing, we kind of need that balance between kind of our two competing nervous systems there. And I think with senior living, a lot of times it's there's a lot that under stimulation and sometimes it's the result of the person's cognitive abilities, but certainly the environment plays a big role in that, too. And so I think kind of we would look at kind of that lower end of the scale to evaluate that environment's kind of opposite of what we might be looking at for office workers.

CCB: [00:26:15] Well, I personally am intensely fascinated by all of the research. And if I could go back to school, I would go back in cognitive science and behavioral, just the impact that not only place that's our world, but the impact from all sorts of stimuli. What does that do to us as human beings? And your work with this human environment interaction has just been, I'm going to say, what's a right word, it's been motivating for us as we sat and looked at it, because we have been thinking about “what does your engagement and your affiliation with space do for your affiliation to the organization, to the brand, to the culture”, but also to the productivity that you can derive from the best environment for the activities you’re performing. So, we're delighted that we've had your input. Is there anything else you'd like to share with us before we sign off? Think about our audience of architects and designers and a lot of end users in the healthcare and the learning environments and corporate world. What else might you share and if you have nothing else to share, that's not a problem.

Meredith Banasiak: [00:27:41] Well, I mean, I think like this, there's lots of others who are working on kind of data informed design and kind of dashboarding different environmental and human attributes. So kind of what we're doing is it isn't necessarily novel in that sense. But I think kind of one maybe key difference about how we're going about it is trying to tell the story and communicate the results in still more of that occupant journey. And right now, I think that's kind of a little bit of a mismatch with the highly complex and technical aspects of working with data. But then how do you kind of humanize that to make it usable and understandable and digestible to the consumers of that information, to the designers and our clients?

CCB: [00:28:40] Any last thoughts Jenny?

Jenny Hastings: [00:28:42] What Meredith said! I just want to wrap up by saying thank you so much for the ability for us to go on this journey. This grant was, it was a lot of fun. I mean, it was moments of, I know when you mentioned earlier the pivot, I mean, we had to have an emergency pivot in our project with the pandemic, when one of our offices, our Boulder office, kind of shut down. And so we had to switch gears very quickly. So there was a lot of moments of like navigating how to do this study. But overall it was really exciting. It was afforded us the ability to test this out. And again, I look forward to all the things we can do with it in the future. So it was a bright spot in a year that was certainly challenging. And so I think it was fun. It was nice to have some fun improving our work and again, looking for ways to better our practice in the future.

Meredith Banasiak: [00:29:43] Yeah. I want to thank you again, too, for the opportunity. I think the other types of funding mechanisms that are out there are so heavy on the research. And I felt like this allowed us to explore and innovate and we really, really appreciate that. So, thank you.

CCB: [00:30:00] You are very, very welcome. And I would say that, you know, you could be poster people for the ONEder Grant by virtue of not only the depth of process thinking that you put and iterative work on it, but also the broad application across not only your clients, but your practice in thinking through what did that, what was the impact of the grant itself. So we're delighted that we were able to share that with you. And thank you so much for sharing your work with us. I will let our audience know that the ONEder podcast is available on all of your podcasts, streaming services. And thanks to Jenny and Meredith from Boulder Associates again for joining us today. And we will be back again for another ONEder podcast with more of the ONEder Grant winners. Thanks so much.