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Evidence-Based Design Helps Designers Reach the Best Future Reality Post COVID-19
Rosalyn Cama, FASID, EDAC, has been a practicing interior designer for over 30 years.
The author of Evidence-Based Healthcare Design founded CAMA, Inc. a health design lab and studio, as well as the CAMA Collection, a product line that addresses the gaps inhibiting the development of dignified, supportive care environments.
A fellow of ASID and an ASID National Awards winner, Rosalyn served as the Society’s 24th president and as the chair of its Healthcare Specialty Network.
As COVID-19 moves the principles of healthcare design into every other design sector, ASID connected with Rosalyn to gather her insights and to discuss the path forward in design.
ASID: What are the biggest challenges facing healthcare design now, in light of the pandemic?
Rosalyn Cama: The question, as an evidence-based interior design problem solver, is why? Why this pathogen’s spread could not be contained.
Because this virus has gotten ahead of us and our built environments are so complex, our problem solving has to be methodically staged at different rates of response over different periods of time.
We need to leave behind the fantasy of a post-industrial life as we knew it, known now to me as our “Past Reality of Life Indoors.”
We moved into a Crisis Management Reality that was a reactive workaround to get some of our past-life behaviors back on track through an internet connection or job modifications.
The Best/Next Reality is now unfolding as an adaption of all of our existing infrastructure as we begin to open up commerce and step beyond our front doors.
Yet to come is our Future Reality, which lies in our ability to empower true innovators to use evidence-based intelligence to solve for a more sustainable life indoors.
ASID: How do you envision healthcare design changing? What elements do you think will stay the same or become even more prominent?
RC: Here are my evolving thoughts that are still steeped in an old toolbox.
(Photo: "Culture of Wellbeing": Developed for the Planetree Visionary Design Network to explain the delicate balance of multiple theaters in healthcare delivery; Credit: CAMA, Inc.)
Technology will process safe spacing and inform occupants when they will be allowed into the building, how they will be cued through the front door, screened for symptoms, and staged for admission, appointment, or visit.
Hospital lobbies will be the coronavirus diagnostic equivalent of TSA weapon detection— there is highly detective temperature technology available and its placement in public buildings needs to be explored fully in our Future Reality.
Elevators will be called upon by security, and passengers will signal a cab that will only open with a code.
Waiting as we know it is over—there is an opportunity to move to a more efficient care system with cueing stations that keep patients together, moving from one sterilized place to the next.
Healthcare facilities will have to address team huddles and congregate staff spaces, family visitation may be limited or will likely be just one at a time, and telemedicine will continue to grow.
Materiality is also key as old habits die hard in healthcare.
CAMA did an investigation into the intelligence around the cleaning schedules of the “Nightingale-esque” cubicle curtain—a form of nursing unit inspired by the way Florence Nightingale cared for soldiers in the field during the Civil War when cloth-based privacy screening was introduced—and found little was documented.
It led to the development of CAMAflage by Skyline Design, a series of glass screens that promote dignity in care environments by providing the necessary levels of visual privacy, amongst other considerations to reduce the spread of contact infection.
There is much to reinvent. But first, we will work to get the questions adequately developed.
ASID: Will evidence-based design take on a new meaning? How could it become even more important for occupant safety?
RC: Timing is everything. Evidence-based design (EBD) contributes to how we serve the why, which allows a project to be successful, particularly around the primary outcomes sought by healthcare providers.
Six aims were set by the Institute of Medicine in 1999 when there was a push to reduce medical error in practice, including:
- Equitable care delivery
These six aims are as important today in a pandemic as they were in 1999. It was these six aims that ignited evidence-based design practice. We have never turned back. This pandemic may recruit some additional followers.
I do believe EBD gets us to the best Future Reality and believe its acceptance is growing.
ASID: Considering how COVID-19 disproportionately affects Black, Latinx, and Native American communities, how can healthcare design impact equity?
RC: One of the six aims by the Institute of Medicine is equitable care delivery.
(Photo: Rosalyn Cama; Credit: CAMA, Inc.)
Access is not just economic or about having health insurance, it is also knowing where to go to get information or good counsel to stay well, or how and where to be diagnosed before it is too late.
CAMA went through an exercise a few years ago with the Connecticut Department of Social Services to provide better health access while living independently for New Haven’s AIDS community.
What we developed was called a “POW” or “A Place of Well-being,” the Carnegie equivalent of the free public library.
The timeliness is to see how we can develop community resources to offer access to testing, vaccination, and education that leads to health and wellbeing programs.