Six Design Principles for Complex, Multi-Stakeholder Institutions

Andrew Lewis was recently published in The Chronicle, a publication of the Southern New Jersey Development Council (SNJDC), about best practices for working within complex organizations like healthcare systems or institutions of higher education. With so many different stakeholders to account for, it takes special sensitivity to balance competing priorities and deliver great design.

Continue reading below for more details, or read Andrew’s article in The Chronicle.

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Six Design Principles for Complex, Multi-Stakeholder Institutions

Andrew Lewis, AIA, Fitwel

When people think about architecture, they typically think about physical spaces like buildings and the interiors within. At large institutions  such as healthcare systems and universities, however, an architect must be able to not only design spaces, but also sensitively navigate a complex, multi-stakeholder organization.

Healthcare spaces in particular are often extraordinarily complicated, serving many different types of people and their needs, which is why a critical skillset of the architect is actually building interpersonal relationships. To ensure an institution gets the highest value from a project, it’s important to consider a few principles:

Get the Right People at the Right Time

Getting the right input from the right people at the right time — and then responding to that input appropriately — is a skill in itself. Often, different stakeholders have needs that conflict with one another or with project constraints such as budgets, timelines or space requirements. It need not be, however, a zero-sum game: varying viewpoints and needs can often be the productive friction that drives more inventive outcomes. Which is why the next principle is so important...

Genuinely Listen

A good designer reads between the lines to uncover deeper motivations and opportunities. At Mercy College, for instance, we realized that a simple renovation could expand to serve an even greater need for space in nursing education by repurposing an underutilized gym and inserting an entire new floor within its volume. This quadrupled the program area for Health Sciences from the original project scope without increasing the campus footprint or displacing other programs, an outcome possible only after sustained engagement revealed the true drivers of the project.

Build Trust

Architects occupy a privileged position: as outsiders, we offer a fresh perspective, and we can also elevate good ideas within an organization that might otherwise get lost. Personally, I work hard to build trust with project managers, planners and facilities departments. Their work is demanding, and they are often the figurative ping-pong ball being bounced between administrative and user needs.

Learn from Other Disciplines

Institutions often have significant real estate tied up in large, private offices that are rarely used, or in storage and other “forgotten” places that accumulate excessively, but incorporating best practices from disciplines like workplace design can help reclaim space for other emergent needs. We’re working with one Philadelphia health system to reduce their administrative office footprint by optimizing the balance between focused work areas and more flexible, collaborative zones.

Increase Utilization

Using Lean principles of waste reduction, many healthcare spaces can be utilized more efficiently, but this requires designers to also engage with institutional operations and culture. That Philadelphia health system is working hard to understand its workplace needs of the future, as a direct result of Covid-19 having substantially altered how its staff work today. What non-critical functions can be decanted from the hospitals? Can technology, such as room scheduling software and occupancy sensors, assist by increasing utilization of spaces? Clinical spaces too, from exam rooms to operating suites, can be used more frequently with operational improvements — if the institution is willing to sustain them.

Increase Flexibility

Spaces can operate more frequently when utilized by multiple departments, but only when their design supports multiple flows and operational requirements. Achieving this flexibility requires listening to all stakeholders and incorporating their concerns. This is also a great way to spend capital dollars more effectively. Whether at a large institution or a small one, that’s just good design!