Recently a friend and her son visited a modern healthcare facility and, on the way to their relative’s room, came across the well-appointed lobby with sculptural features, art on the walls and warm colors. “Wonder what that’s costing?” said the son. “That’s one area they might save on healthcare costs.”

My initial response, when I heard this, was that a growing body of evidence is showing that an upgraded hospital environment can positively affect health status and improve treatment outcomes. If anything, those fancy architectural features might well be reducing healthcare costs.

Then I had some second thoughts. Was healthcare design(to which I had devoted that last eight years of my journalistic career and helped usher in the evidence-based movement) really having that sort of impact? What is architectural “evidence,” anyway, and how does it differ from what designers have always done? What are architects and their sponsors doing to make it work for them? Or is it working for them?

It turns out that this is a big and largely untold story outside of health care, with implications for architecture in general. On the one hand, evidence-based design is advancing more rapidly than perhaps many realize, both within architecture and the general public. Over the past decade or so, a growing number of projects have signed on and formal research papers are indeed being published. On the other hand, though, the trend shows every sign of a work in progress, evoking persistent questions and lingering skepticism from many designers and sponsors. I must confess that I, too, had my doubts in the early days about the scientific validity of evidence-based design, wondering whether it measured up at all to the standards of evidence-based medicine.

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Photo: Morley Von Sternberg.

It’s ironic to think that some of the most pleasant and appealing structures in the U.S. have had some of the most painful births. Take Yale’s Kroon Hall. This $33.5 million LEED Platinum flagship building of the University’s School of Forestry and Environmental Studies (FES), opened last spring, has the comforting exterior of a classic Connecticut barn set amongst Yale Gothic. Bordered by inviting courtyards and a water garden, its sun-filled 58,200 sq. ft. interior features red oak paneling from sustainably managed forests, healthy low-VOC workspaces and cheerful gathering areas for students and faculty. A 100 KW photovoltaic rooftop supplies 25% of the building’s electricity, its water is heated by photovoltaic panels embedded in the southern façade, its air is heated and cooled by deep-well heat pumps, low-velocity basement fans and cooling water spray, and circulated by natural convection. Rainwater is captured for grey water toilet flushing and irrigation. Windows can be opened and closed at will (optimally by heeding sensor-activated red and green light signals during the day).

Kroon Hall is indeed one of sustainable design’s pioneers, having had its genesis from the 1990s through the first decade of the 21st century. At its heart is a concept called biophilia, advanced for the past 20 years by Stephen Kellert, Yale professor emeritus of social ecology, and famed entomologist Edward O. Wilson. Biophilia acknowledges the human need of a fulfilling connection with nature. Its structural expression in Kroon Hall was driven to fruition by James Gustave Speth, the then dean of FES and a world-recognized leader in environmental studies.

Photo: Morley Von Sternberg.

Yet Kroon Hall came about only after the near resignation of dean Speth and repeated frustrations experienced by professor Kellert and others. Read more…

Though I edited the magazine Healthcare Design for eight years, and wrote and commented upon dozens of projects, I’ve seldom visited them personally to see what they really look like and how well they work. An exciting exception occurred this past October, when on a trip to Las Vegas I visited the Frank Gehry-designed Lou Ruvo Center for Brain Health.

To say that the Center, which opened this spring, is controversial is putting it mildly. Though it’s gained its share of praise from professional architecture critics, who have called it Gehry’s most impressive work since the Disney Concert Hall in Los Angeles, other observers have said that it resembles a cake melting in the sun or a building falling down. Still others have seen a fitting metaphor for brain disease and disorders, particularly Alzheimer’s disease, with the image of a collapsing cerebellum.

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