For our final episode for this season, we speak to doctor and architect Diana Anderson, who has skillfully carved a unique career path for herself as a “dochitect” – by pioneering a collaborative, evidence-based model for approaching healthcare from the medicine and architecture fields simultaneously.
Dr. Diana Anderson is a triple boarded professional – healthcare architect, internist, and a geriatrician. She is an Assistant Professor of Neurology at Boston University, and a recipient of an Alzheimer’s Association Clinician Scientist Fellowship. She is also a healthcare principal at Jacobs, contributing her thought leadership at the intersection of design and health.
Diana’s website: www.dochitect.com
Transcript
Vaissnavi Shukl
Season Five has been an interesting one to record by focusing on the themes of care, health and medicine. We venture into discourses that we thought were never really approachable from the lens of architecture and design. But then I guess everything can be about design. The season we spoke about plagues and pandemics, menstruation, debt, and memory, mental health and care, disability and tourism. There were other topics too that we had set out to cover in this season, but we were unable to. We really want to talk about supervised drug injecting facilities, funerary landscapes, and maybe even discuss Susan Sontag’s illness as a metaphor, but we couldn’t and in case you know, anyone who can be a great fit for these topics, please let us know and I’d be happy to do bonus episodes. The recognition and support by the Grand Foundation for Advanced Studies in the fine arts also gave us the reinforcement to ask for the questions and tap into for your spirit not before the grant allowed us to streamline flows and make the content more accessible. We are revamping our website right now and we’ll be publishing the transcripts of all the recorded episodes very soon. Today for our final episode of this season. We have with us Dr. And Architect Diana Anderson. We’re skillfully carved a unique career path for ourselves as a dochitect by approaching healthcare from the perspective of medicine and architecture simultaneously.
I am Vaissnavi Shukl and this is Architecture Off-Centre, a podcast where we discuss contemporary discourses that shape the built environment, but do not necessarily occupy the centrestage in our daily lives. We speak to radical designers, thinkers and change makers who are deeply engaged in redefining the way we live and interact with the world around us.
Okay. Diana, we are going to start with a big question, which is about your career and your career path. You chose two professions which are, I mean, I can vouch for one of them the toughest career path, which is studying architecture. And then you also went ahead and bought a degree in medicine. Can you talk a little bit about this collaboration between the fields, this whole Doctor architecture model? I mean, of course, you know, we’ve heard about people you know, studying architecture going into some form of design we’ve heard about people studying architecture becoming chefs, people who’ve studied architecture become something as wild as a lawyer or an aeronautical engineer, but I can vouch for the fact that you’re the first architect. I know who’s gone ahead and studied medicine.
Diana Anderson
Yeah, no, Thanks for thanks for having me on the podcast. I’m happy to talk about some of this. I get this question a lot as you can imagine, you mentioned how did I choose? I guess the first point is, I don’t know that I actually chose this career or set out to do this. As most careers happen. You get these little twists and turns and sometimes it’s a random person who will suggest something that will change your whole direction. It’s not always a big momentous aha moment. But sometimes it’s little things. And you know, when you look back, things really fall into place, I think, but at the time, I guess I didn’t really have a good plan, set out to create a hybrid field. And you also mentioned architects who become chefs or I have colleagues who’ve gone into cinematography and filmmaking from design school. I think what really might set this apart is that I tried to combine two fields and that’s been a very challenging journey, which we can talk about in the next few minutes. But, it really wasn’t a shift from one to the other. It was really how do you blend these two and almost create a new hybrid entity? But I did start out in architecture school intending to become an architect. I think, as most of my architecture student colleagues did. I don’t know how many of us actually do architecture. We do a lot of different things. So it’s sort of interesting. It’d be interesting to go back and do some studies and look at what maybe people have, but it was really this aha moment. For me. I guess it was sort of a big moment on a scholarship trip through Northern Europe and Scandinavia that changed my direction. I’ve written about this and spoken about this on other podcasts, but we were going through Finland and the Pioneer sanatorium, which was a very famous building by Alvar Aalto, designed for the treatment of tuberculosis patients prior to understanding the pathophysiology of the disease. And really at that time, architecture was used as a form of treatment. So outdoor time, rest, natural sunlight and air all of these things were felt to actually improve patients and treat them and so the architect was really tasked with designing a hospital that would foster that and foster healing and having walked into that hospital and it’s still used as a healthcare facility today. It is a World Heritage Site and I’d encourage anyone to go and visit if they’re over in that part of the world. It was really a moment where I walked in and I didn’t feel the way at all was felt in hospitals in Canada where I was brought up your hospitals all this came with very unpleasant and noxious noises or smells, sort of chaos around you or sensory deprivation with almost nothing around you and walking into this building. In the countryside and a pine tree forest with yellow walls in some cases, plants sunlight, communal dining, furniture and patient rooms that was designed by the architect so the architect not only did the core and shell of the building and the interior planning but also designed everything down to the chairs the sink basins, and really went into understanding the pathophysiology of the illness at the time. So understanding that it affected the lungs. So the famous pioneer chair is designed so patients can recline at an angle that would be comfortable to breathe, handwashing sinks in patient rooms. So we’re very avant garde, I think for the time being about infection control, but a separate sputum basin. So you’re not spitting lung secretions into the sink where you’re washing your hands, so very detailed thinking raising patient wardrobes off the floor and millwork off the floor so that the floor could be cleaned in its entirety and you didn’t have corners, which could become dirty. And so some of these things I feel like we’re really advanced so really this that it was fascinating to me that the architect could really delve into the medical side and design for the entire process of healing and sickness. So that was a big aha moment. I used that experience to transition to my thesis work in architecture to design a very big hospital that was going on at the time in Montreal for McGill University, and was sort of met with traditional architectural comments. In my very traditional school, saying a hospital isn’t an architectural thesis project. It doesn’t have anything to do with design, you should really pick a museum or community centre housing development, didn’t want to do that and won some money from the AIA in the US to travel around and start looking at hospitals and interviewing people of course now when I look back at some of my sketchbooks and I don’t know that I really developed a great understanding, but I did my best at the time. And that was a time when evidence based design was really just picking up pace, I guess, where the whole idea of studying the effect of the built environment on health outcomes was transitioning and there was a whole field of healthcare architecture that was coming to fruition right now. It’s a very well established field, but it’s not that old. The first sort of evidence based design paper came out in the mid 1980s, you know, in the field has kind of grown since then. So that was really how I got into the interest in hospital design, but I felt when I travelled around looking at different hospitals I went to New York, I went to Boston, I went to Texas to California to places in Canada. And I was really starting to become fascinated with the practice within the building. So it always had an interest in the practice of medicine. But having gone the architecture route, I didn’t feel that I was prepared enough in the Pure and Applied Science. Right. So actually to transition to medical school, I had to do some courses in that area while I was doing my thesis. So that’s another discussion for another day, but that was a rough, rough few years. But right from architecture school, I went to medical school, and I have to say and maybe your listeners will agree once you’ve had the architectural design education, you can never really take that hat off. And I think it informs everything that we do. So going to medical school and being shoved into emergency rooms that were, you know, void of any daylight there was chaos in terms of noise where the planning was confusing. I kept thinking what is going on here? And why aren’t we thinking about this from a design lens? And so sort of began the whole idea of wearing these two hats, and combining them for sure at different phases of my career. I’ve had to really kind of do a deep dive and practice medicine where I didn’t have much time for architecture because that 100 hour week was happening in intern year, that kind of thing. But really I’ve never let go of one or the other and if you look at the career path, I sort of did my core schooling architecture undergrad architecture, Masters medical school, and then I didn’t go right to my medical residency. I took time to go into a fellowship in Texas in healthcare design, and I took time to stay in an office and gain the hours you need and the exams to actually licence. I think it was very important to me to gain the professional stature of an architect and to actually be able to have a seat at the table with other architects and have that qualification. It’s obviously a long road with painful points. But it was important to me. I don’t necessarily think that everyone has to go that route. And maybe I’m shifting a little bit when we talk about healthcare design and when I talked to a lot of early career professionals in health care, their interest in design isn’t really architecture in its purest form, and that’s okay. And so I’ve really kind of think a lot about that design exposure and then what we get as architects but I don’t know that everyone has to be a licensed architect to have that design lens to bring to different fields and circumstances. So many of my clinical colleagues want to think about design and have some training, but I don’t know that they need to go through, you know, eight years to be able to get an architecture licence. So I think we need to separate architectural design and then more general healthcare design. So anyway, I took various moments. It took three years. I did my licence, then I went to medical residency. Then I worked in an office again, I sort of flip flopped back and forth. It wasn’t easy, really to culminate in what I’m trying to build now. And what I do is where I can do a little bit of each every day which is challenging. I think that the clinical practice of medicine is not very well established for people who want to find different types of work. There’s a very robust model for the physician scientist where part of the week you see patients part of the week you do your bench research research, that’s well established. There are models where physicians will do you know, four days a week in an academic centre and one day a week of private clinical practice. There are those models, it’s more difficult when you start to bring in other fields, especially if you want to start conducting research, which I do and you need funding for that. It’s been a challenge to develop the hybrid model.
Vaissnavi Shukl
No, this this ties very well into what I was into what I was going for with actually asking how it works out in your day to day practice, as both the doctor and and the architect because I can imagine that as an architect, you’re able to look at the design of hospital in a certain sense, but I wonder if ever in your practice, as a physician, the architectural training kicks in and if at all, how so how do you spend your time between between the two professors and are there are there boundaries whether to kind of cross over where you blur the line between the two or two, they still, to a certain extent stay compartmentalised in the in the way you approach both.
Diana Anderson
Yeah, that’s a good question. I think maybe we have to unpack it a little bit, and I have to do some thinking on my toes to answer it. But an important question, I think, certainly there are many times in sort of a clinical setting where I think like a designer or design issues come up and many physicians and clinicians in general need to think about that or want to or see potential, you know, a couple of examples that I’ve written about is you know, examining the patient from the right hand side, which is really convention taught in medical school, I encountered many clinic rooms where I would go in and the way the configuration of the room was I couldn’t approach the patient from the right hand side and that sort of threw off my practice took longer had had so many impacts in terms of patient care delivery. There are examples from colleagues I’ve heard more recently. In very cluttered operating rooms with lots of screens and equipment, where staff have bumped their heads enough to get a concussion because the screen was in the way and then they’re out of work for a month. And that’s definitely a design issue. So I definitely think about that a lot. I think how we enact change and healthcare has been the most challenging. I do think architecture and medicine are two professions where change is very hard, and maybe that’s the case in all professions. But we have seen a shift in nursing in law in ethics towards empiricism, towards the use of evidence based practice. Towards the use of data applications. I think that has maybe come easier in some professions and that’s that’s come easy to medicine right. We never recommend treatments or procedures without thinking about the evidence out there and the science behind it. I think architecture and these are just opinions but has been very late to the game and there’s been a lot of apprehension just because of the nature of our field where there’s a huge artistic design and creative component. And I think there’s a general fear or concern that that will be lost if we turn towards data application. I don’t necessarily agree and certainly within healthcare architecture, I think we have a moral imperative to use data that exists and if we don’t, that we can create harm through our buildings, and I do see a lot of healthcare spaces that create a lot of harm, not just for one person moving through them but for generations and decades of people using the space right we have we have such a huge potential to impact 1000s of lives at the price of architects because these buildings stand for so long. So I also did a fellowship in bioethics a few years ago, and at the time, my family said a third career and I said, No, no, there’s really a strategy there. And I really use that as the glue to kind of bind the two professions. together. And now I think a lot about the practice of healthcare design with a bioethics lens, and sort of our higher obligations as architects and interestingly, there’s sort of an emphasis on professional ethics and healthcare design, misconduct and legal proceedings and all of that. But what about sort of the ethics around practice and the lives that we impact and the utilisation of this data? Maybe this needs some examples, but for example, I also trained in internal medicine in my residency, but then I went to specialise in geriatric medicine and most recently finished a fellowship in Cognitive Neurology, so really focusing on dementia care of older adults. The reason I picked geriatric medicine is I really enjoy working with that demographic, but I think that’s the place where design can have the most impact on everything from Quality of Life health outcomes. You name it. I mean, we don’t have drugs for ageing in a sense, right. It’s sort of a part of life and there can be a lot of suffering and a lot of complex chronic conditions. But design has a huge impact. We can impact people’s brains through design, we can impact the medications they take or may not take, we can impact their mobility, which has a direct health care link. We can impact their goals of care and what they want in their life in terms of how they want to age. So we can actually do all of that through design. It’s fascinating to me the literature is not very robust, but there’s some interesting evidence. So an example maybe for the listeners is just a series of papers out there that look at how we can prevent people from leaving different locked facilities with dementia, right. So as you demand people can develop behaviours like being very agitated or aggressive or wandering and just wanting to wander away and we don’t want people to hurt themselves. So we locked doors to try to keep people in units. We’ve used alarms, we’ve used chemical restraint like sedating people with medication, we’ve tied people to beds to prevent them from wandering, a very interesting series of studies looks at just using the interior architecture, and looking at layout but also just painting horizontal stripes on the floor in front of an exit door. If you do that, with people who have certain types of dementia, they will not approach the door. You can paint a black square in front of an elevator. And the literature says that people interpret that as a hole in the floor. And so nobody really wants to walk into a hole in the floor so they’re not going to approach now there’s a whole ethical side of whether that’s okay. Does that create fear in people or really scaring people to not exit and that’s another topic but these are simple techniques. If you turn those horizontal stripes 90 degrees and paint them vertically in front of the door, people go right on out. So it’s that sort of link of how do we tie our knowledge of what’s happening with the visual centres of the brain and dementia and what we’re doing with the interior design of a facility? And can you actually change behaviour in a less harmful way through architecture? And that’s sort of my example of what I mean by turning towards empiricism and data. There’s data there’s a great paper out that looks at lighting in nursing homes, right and if we maximise wavelengths of light for day and night appropriately and circadian rhythm, we can decrease fall rates much more than we can if we installed a very high tech AI robotic fall prevention system, up to almost 43%. Almost half of falls can be prevented. This doesn’t only have a health impact but a cost impact right we know that every fall in a nursing home costs a certain amount. I think it’s 50,000-60,000, whatever it is injuries, hospital use, pain and suffering. So you can actually just get a cost back to what you might save with better design utilised at the beginning of a project. Some of the things I’ve become very passionate about I write a lot about using evidence in design. I have lectured at architecture schools and I have had some feedback from students to say that hospitals are really not an architectural building where we need creative design and I would wholeheartedly disagree I think, you know, the practice of medical planning of understanding space adjacencies understanding throughputs of different patients and how staff utilise space. It’s extremely complex in hospitals, and that’s where we need our design knowledge the most. Right I think as architects, we’re very good at learning how to problem solve and how to come up with a number of solutions for one problem. Right and a hospital is very complex for that. Actually, I read a really interesting piece that I wanted to mention to your listeners if that’s okay, because I had that a few comments throughout my career and maybe maybe people who’ve done architecture and then shifted careers have had this to saying, Well, you’ve trained in medicine, you really have a responsibility to see patients for your career because all this money has been invested in your training. I thought about that a lot in recent years and felt that I agreed, but a recent commentary in a medical journal actually made the case for a different viewpoint. So doctors like architects are trained to problem solve to take large amounts of data and to funnel it in your mind and come up with or differential diagnoses. Communication skills are a big thing. And the article basically made a case for it’s okay if people who are trained clinically don’t practise but take that skill set to something else. Right, take it to policy, take it to the government, take it to law, whatever they’re going to take it to, and I started thinking about architecture in that way as well. And to me, I felt it was a great general education that teaches us a lot of skills that we can then use in other fields.
Vaissnavi Shukl
What do you mention about dementia? It’s interesting because earlier today, I was listening to the daily The New York Times podcast and did a one hour episode about something different but about the story of this family, two daughters and their mother who had dementia and how they saw their mother change over the course of you know how progressively bad the dementia began and do they describe how her physical surroundings have changed in the way she used to keep her house how she used to move around. And so as an architect a couple of hours ago, just thinking about how the space changes because of a certain illness. The other common thing I also think is in India, architects lawyers, Chartered Accountants, and, and doctors these are the four professions where you work very closely with people, especially when you look at medicine and architecture. They both are deeply ingrained in terms of dealing with the human body, right. So whether it’s inside the human body or outside the human body, the centre of everything we do revolves around that particular like the physical human body and the way that body interacts with the space around it, whether it’s, it leads to healthy living, or whether that space in their environments need to mishaps, which was then sent you to doctor but that I think, is another commonality. And I think lastly, what architecture education, of course, does and you’re talking about evidence based design, but I also think the big buzzword in Western countries right now is design thinking and architecture actually equips you with that skill set where you’re able to take your your education and your skill set from that education to actually just go out there and apply to whatever right so people get into consulting people get into all sorts of advocacy groups, they work with nonprofits and they’re able to use that same skill set of, as you said, right, looking at a large set of data of problems and to really like funnel it down. So I think that’s something that five-six years of architecture education does, the teachers you spoke to earlier about the time you’re at the sanatorium. But you’ve also extensively talked about the history of ICUs. And if you want to talk about that a little bit.
Diana Anderson
Yeah, and I’m not an intensivist. So I’ve practised in critical care units as a general internist during my training, but I got into writing about ICU design so intensive care unit design with some colleagues years ago, for various reasons, but the Society of Critical Care Medicine is a very interesting, multidisciplinary society that has critical care nurses, pharmacists, physical therapists, doctors, anyone related to providing critical care, and they actually had an ICU design committee that I chaired at one point, but it was initially a member where they asked hospitals to submit renovations or new construction projects for critical care units, and every year we would judge them and give them give a winner and this was a worldwide competition could be paediatric, neonatal or adult ICU. But what was interesting about it is it was a multidisciplinary jury. So we had architects, engineers, doctors, nurses, pharmacists, respiratory therapists, anyone involved and we would sit around a table at multiple locations in North America, there were a number of voting sites and talk about these attributes and we had a sort of methodological matrix to go through so it was sort of standardised between voting sites. And that was really fascinating. And I don’t know of any others for medical society that does that type of emphasis on the unit itself. And I’ve sort of felt that intensivists have always seen this link between the built environment and the outcomes of their patients. So I started writing some textbook chapters after being invited by editors and these are textbooks for intensivists. These are for board certification of ICU doctors, but they asked for a chapter on design, which to me was really kind of bizarre a few years ago, why would they need a chapter on design if they’re going to be treating ICU patients but there has been such a shift in terms of clinicians wanting this design hat or this design skill set. And just like I did a fellowship in bioethics I am not a bioethicist, but I have some understanding of the vocabulary and the practice. Actually I think the future might hold in medical school a course in Design for All doctors to take at one point. So how I got into ICU design writing but I’ve done a lot of papers around it and thinking about how ICUs have changed. One tidbit I wanted to mention today is that there are also ICU design guidelines that we originally came out with in 1995. And we revamped them in about 2007 or eight something around then that were published, but we’re redoing them again. And this time, they’re being supported by the Society of Critical Care Medicine and they are a very robust multi year process. Looking at all of the existing evidence and really collating it to base our design recommendations on what we know about critical care units. So that’s been a huge change in the field. Right, that really supports my goal of data driven design in some way. But also because I think it’s an area where there’s been really robust design guidelines that I haven’t necessarily seen in a lot of other fields of medicine. And there’s been a number of really fascinating anecdotes along the way. I write a lot about this one patient who was in a critical care unit when I was a resident and who improved a lot when we moved her to a window bed because she didn’t have a window in her room, even though that’s really not a robust study. At all. And there’s lots of bias and confounders and you know, it was an anecdote that really led me to write some papers and think about how we could create studies to understand how daylight can impact patients. So that was another thing that became clear, right? I talk a lot about evidence and big papers and statistics, but these little anecdotes, these things that patients say to you that you notice, in a room in a space, they can actually really create a lot of change on a big scale, even though you think they can’t, right. So I wrote to my mentor, Kirk Hamilton after moving that patient and she got better but I said you know this, this is just a story. This isn’t to judge anything. And he said actually, this is the genesis for ideas around confirmation studies that can lead to change. And so for anyone out there I’d say these are important things. I kept a diary during my medical training of things I noticed related to design things that would help things that patients said, right, I had a patient who grabbed my hand when we left the ICU and said, You know, I’ve been in there for a month and I haven’t had a window even even a prisoner gets a window but I didn’t have one. And so I wrote a whole article about the idea of windows and how prisoners have the right to a window but patients don’t. So you know these things that people say are important and they can really change your career direction even so, but
Vaissnavi Shukl
I also feel like technology and the progress of the profession, and an over-specialisation of people who are involved in the making of a hospital. When I was in the US, I wrote a paper on Charles Bulfinch, the guy who designed the Massachusetts General Hospital and he designed this very, very famous surgery room where the first anaesthesia was administered. And you know, it’s almost like a theatre the way the demonstration surgical room has been designed. And now when you look at it a couple of years ago as a practising architect, I was revamping a floor in a hospital and what my role kind of boiled down to was just making sure the room sizes were met because there was another hospital consultant who knew all the guidelines and came into advice on what pipe went where where the oxygen ducts went where this went where that when and so when when the students or the professors kind of ended up telling you that this is not like a final year project. My fear is that it’s because of this hyper specialisation, where hospital design has boiled down to services almost like integrating services and maybe not as much about design which is quite sad, right? When you talk about simple things like Windows, you’re missing out on them, But you provide everything, all the monitors and all your electronics. You’re still not serving the purpose. so maybe that’s some food for thought. I don’t know.
Diana Anderson
I mean, hospitals have a huge design component. I mean that so we have specialists called medical planners, right, that our federal vignette, all of the room types in hospitals and how those pieces go together, there’s a huge design component and I think a great thing to do is to get architecture and medical students together in one room, get them a big piece of paper with an outline of a floor plan, and we used to do what we call gaming chips cut out little coloured pieces that represent all the different rooms, and you know it’s.
and how their dialogue changes that design. But you have to have an understanding of how patients move through the space and how the operations work. So you mentioned sort of technology and gases and services. I think the complexity of hospital design is also that we can design a fantastic building that’s evidence based, that looks great, that heals, but then you have to put the operations into that and how people work in it. And there’s often a gap there. And so yeah, we really have to understand so what’s standardised design is one example. So there is some talk in long term care to standardise nursing home design. So there’s a recipe book and a developer or somebody can take one and just plop it down wherever and it’ll work. I don’t agree with that. I don’t think that can work. I think the term standardised design scares me although I do see potential for sort of like guideline informed design standards, right minimum standards that we should all have. But the idea of sort of a cookie cutter floor plan for a nursing home or hospital scares me a little because the operational aspect is different in different areas for different patient populations for different staff. And so not only do you have to think about the adjacencies of the rooms and how the hospitals are put together, you also have to think about the operations of it. But then you also have to think about the digital environment. And so that’s a piece we always kind of leave out or we tack on at the end but the built environment, the bricks and mortar, is one thing, but now we have to think about the technological environment. And how that integrates with the bricks and mortar and we have to think about it from the beginning. Not when we’re in CDs and you know, ministration phases it has to be right at the beginning with schematic thinking I think but you know in medical in my medical school training a while ago, not gonna say years because it’ll date me but we had a course called the social determinants of community health are the social determinants of health and at the time, people made fun of that course. We talked about things like public health issues, diet, exercise, socio economic status affecting health, and people thought this is hokey. Why are we learning this right? Why are we learning about the cells in the body? But now we know that the social determinants of health are hugely important in humanity’s health, right, and it’s a well established robust field. So we know even after the pandemic, that isolation and loneliness if you look at the publication of papers on that topic prior to COVID There’s a few and now there’s just 1000s, right? Because we know that if you are lonely even in your middle aged years in your working years of 30s and 40s that puts you at a higher risk for dementia later in your life. We know that the architecture design of cities and the design of communities can impact how people feel in terms of being lonely, or their social network around them. And so social determinants of health are very well accepted in the realm of health science. What hasn’t really been quick to take off is the physical determinants of health . We spend 90% of our time indoors in North America, buildings are all around us. It’s very intuitive that they would affect how we think, how we feel, how we behave. But we don’t, I think intuitively, have the research to really gain that evidence to apply that to our future thinking. The other thing that we should be thinking about as architects is not just healthcare, so this applies to everything housing commercial buildings, communities, it should be measuring how successful our buildings are, right? So I’m referring to something called post occupancy evaluations or POE’s, but I have strong opinions about them. So I sort of don’t like that terminology, because I’d like to expand it to something different. Maybe I’ll call it like building systems measurement, or something. But the POA traditionally, is building a building, waiting for some time for people to get used to it and then studying how well it’s done. This is often done by the same architecture firm that built the building, which in science, you would, you would never do that there’s total bias and so science or medicine has set up a very robust peer review system where people evaluate each other’s work. So scientific papers, I read a lot of them, they are anonymous to me, and I critique them as a peer reviewer. I believe architecture needs to set up that type of model so we can work hard to blind people right. You know who the architect is because it looks like their style. So it’s hard to maybe blind a building and anonymize it. But we need some sort of robust peer review system where we can go in and study each other’s building or there needs to be a separate even government or private entity that will come in and study the success of buildings to eliminate that bias. And traditionally, architects are not trained in research methodology, right? We don’t know how to analyse statistics and set up complex studies. So we often go in and ask people questions in the lobby. Do you like this space? Are you happy today? We’ve got a POE. Well, that’s not very scientific. How do we know that this one person represents 1000s of people who use this lobby? So I’m sort of on another crusade to sort of say how can we measure the success of our buildings? Because if we’re going to cookie cutter 60,000 new nursing home beds with one floor plan, do we know it’s going to work and help people or is it going to harm people on a big scale? So those are some kind of food for thought. But we’ve done POS in housing industries in commercial sectors. There is some very robust data around measuring design success, social housing, so it’s not just healthcare, I think it spans a number of different designs sectors.
Vaissnavi Shukl
So the last question, this is our season finale. And we are wrapping it up with this episode. If you want to share something that you’re working on and maybe talk about what’s next for you as you continue on this tool path of being Dakka Dakka how so
Diana Anderson
I’m doing a few things currently, but I am undertaking my first grant funded study that’s multi year. So it’s three years long, and I was very grateful to the Alzheimer’s Association for funding this research. Because healthcare design is not such a robust field. I think it’s hard to just ask for money and get it and I’m very grateful for the funding support to be able to do this, but I thought I would look outside the hospital as a change. Because most people are not living in nursing homes. Right. Most people are not living in hospitals, they’re in their communities. And so community architecture and housing design is really important. So for older adults, I am looking at communities and their homes and thinking about what I’m calling transitional spaces, which are sort of indoor outdoor spaces that connect people to the world beyond. So in the home, it might be a porch, a backyard, a bay window, and at the community scale. Maybe it’s a garden, a park, a street bench, and really understanding how those spaces can impact older adults who live in the community and affect their social health. So things like depression, anxiety, their mental health, isolation and loneliness as well, and then also their cognitive health. Can this actually affect the brain and cognition? People who have mildly demented access to these spaces improve that or not? Does it help their cognition? And so this is going to be looked at over several years. But to me, it was important to shift my thinking outside the sort of acute care setting and really go into the community and see how we can think about housing and community design. So that’s one project that I’m working on. And I would say to the listeners, I guess, in closing that I get a lot of emails and calls, mostly from medical students, some from architects and architecture students about how they can blend the two fields. I often find I don’t necessarily have a roadmap that everybody’s different. But I do think that this is a field that we’ll continue to see grow. And I don’t think you need to be a full on physician and a full on architect and do all the school and all the exams and I won’t tell you how many exams I’ve taken, but it’s a lot to have that skill set in each and so I’m very keen to set up hybrid courses and fellowships that can have some of that skill set and you can take it from one profession to the next but you don’t necessarily need to be a full on architect to appreciate design and have design thinking but I would say hybrid careers are definitely possible. I’ve lots of examples of people who’ve done really cool things and have combined the craziest topics together. So don’t let that intimidate you. And you can always find somebody who can be inspiring and really I think the world is at a time when hybrid fields are popular and well respected. And we understand that there are complex problems in the world like climate change, health care, and politics, and we need collective minds to solve them. And we need sort of unique combinations of skill sets. And so it’s a very good time to think about hybrid careers and hybrid models. And so I think anything is possible at this time. That’s
Vaissnavi Shukl
A great note to end this. Thank you so much for sharing your work, your life with us and good luck with that land.
Diana Anderson
Thanks very much.
Vaissnavi Shukl
Special thanks to Ayushi Thakur for the research and design support, and Kahaan Shah for the background score. For guests and topic suggestions, you can get in touch with us through instagram or our website through our website archoffcentre.com, both of which are ‘archoffcentre’. And thank you for listening.