The Green Vanguard: H is for Health Care
Designed by Gianfranco Zaccai
Just over 40 years ago, Robert Propst checked into the University of Michigan hospital in Ann Arbor for back surgery. During his six-week convalescence, the president of Herman Miller Research Corp. and inventor of the company’s Action Office noticed that the hospital’s inefficient supply, storage, and distribution sys-tems placed unnecessary strain on doctors, nurses, and support staff. Returning to work, he launched a research project and soon produced a solution: Co/Struc, a modular, rail-mounted storage-and-delivery system for hospital clinical areas. Herman Miller introduced it in 1971.
Last June, almost 40 years after Propst first wrestled with the health-care conundrum, Herman Miller has climbed back into the hospital ring with Compass, which won a Best of NeoCon Gold award for health-care furnishings. Compass is a rail-mounted, environmentally friendly, interchangeable furniture system that offers hospitals unprecedented flexibility in adapting to the rapidly changing nature of patient care.
Hospital patient rooms have always been a difficult problem for designers. Ordinary safety codes are ratcheted to extremes. Sanitary and health regulations eliminate a slew of materials regularly used in offices and homes. Spaces need to feel homey—but not too homey—while accommodating caregivers, diagnostics, and, more recently, friends and family members, who spend entire days and nights at the bedsides of their loved ones. Rapid changes in technology and care patterns, and the stringent financial constraints of managed care, further clutter an already unruly scene.
“We need to look at patient rooms as an eco-system,” says Gianfranco Zaccai, the designer of Compass. “As a confluence of interests: caregivers, support staff, the patient, visitors, designers, administrators, even fund-raisers.” Zaccai, president and chief design officer of Continuum, a design consultancy, worked with Herman Miller Healthcare for three years, brainstorming with clinicians, patients, and administrators in an attempt to sound out their present and future needs. He found that even in the best collaborative environments, planning efforts in health care still fell short: “All these people—doctors, nurses, architects, hospital planners—work very closely to design the ideal patient space. The trouble is, as soon as it’s built, something in the care system changes. A pediatric ward is converted into a geriatric ward. A new piece of technology is introduced. A new hand-washing solution is purchased and needs to be integrated. Suddenly the ideal space isn’t ideal anymore.”
The fruit of a five-year research process, Compass consists of a selection of panels, furniture, and storage elements that are easily assembled, disassembled, and reconfigured. “We sought the opinions of over 500 health-care and design professionals,” says Mollie Everett, Herman Miller’s senior health-care program manager. “They all said the same things: Make it safe, make it cleanable, make it durable. And above all, make it flexible.”
Composed of wood-panel cabinets and shelves and Corian work surfaces, Compass contains as much as 58 percent recycled content and is up to 37 percent recyclable. Furniture and cabinets are mounted on rails above the floor to aid room cleaning. Each panel ends in a shingle that prevents liquids from seeping inside the cabinet or dresser. Surfaces and edges are sealed in Durawrap, a 99.9 percent PVC-free plastic that protects the materials, helps contain spills, and prevents the spread of infection. “Trying to use the most environmentally friendly materials does pose a bit of a challenge,” says Thaddeus Owen, design lead for Compass. “But Durawrap has the same aesthetics and functionality as PVC. And hospitals are willing to pay a slight premium for a superior material.”
Incorporating recycled materials and removing PVCs are consistent with Herman Miller’s environmental ethics. Yet the biggest impact that Compass should have on the environment—and on hospital balance sheets—is that it is far less likely to end up in a landfill than patient-room casegoods. “We heard customer after customer talk about working hard to design spaces, and how when technology or care practice or room function changes, they basically had to rip up the furniture, throw it out, and start over,” says Joel VanWyk, director of product management at Herman Miller Healthcare. “That’s not great for the environment, or for the hospital economy.”
In many ways, Compass is a direct descendant of Co/Struc (and that system’s modules can even be mounted on the new rails). Zaccai, like Propst, spent significant time in the hospital during the course of the project, both as a patient and as a parent, during his son Gianluca’s emergency appendectomy. “Talking to people only gets you part of the truth,” says the Italian-born Zaccai, who founded Continuum in 1983. “My surgery, and especially my experience with Gianluca, showed me how stressful hospitalization is for patients and loved ones, and how hard- working and diligent health-care professionals are. And it reinforced my conviction that if we can streamline work flow and improve efficiency, doctors and nurses will have more time to spend with patients, which is what patients ultimately want.”
In early 2008, after Herman Miller gave the green light to what would be its largest health-care project since Co/Struc, the design team produced a series of computer renderings of the new system, its components, and its capabilities. “But people couldn’t grasp the concept of radical flexibility from renderings,” recalls Doug Bazuin, a health-care researcher with Herman Miller. “They needed to see the system in action.”
That fall, Bazuin and his colleagues took a suitcase-size scale model to the Health Care Design show in Washington, D.C. “We did thirty focus groups at that show,” Bazuin says. “When they saw the model, they began to nod. I could see their minds light up as they finally understood that we can change a room from general medicine to surgery to orthopedics in a matter of minutes.”
Robin Guenther, a principal at Perkins + Will, thinks the Compass system could help designers achieve a more unified aesthetic in patient rooms. “Patient-room furnishings have never been holistic, drawn from a single source,” says Guenther, a longtime hospital-design specialist and a leader in sustainable health care. “They’ve always been an amalgam—a bed from one company, side tables from another, clinical equipment from a third. These things have never been brought into a common language. With Compass, this could very well change.”
Compass’s impressive showing at Neocon has generated strong interest from Herman Miller dealers across the country. “More than three times the number of dealers I estimated would be interested have ordered the product,” says Drew Nielsen, director of new-product commercialization at Herman Miller. “And Compass isn’t as easy or inexpensive to display as a chair or desk. You have to build walls. You have to mount it.”
While the Herman Miller team is decidedly proud of its five years of labor, its members also know there are no guarantees the system will retain its flexibility in the face of a profession that continues to evolve at a dizzying rate. “We understood when we began this project that we wouldn’t be able to predict what might drive change in these spaces in ten or twenty years,” VanWyk admits. “But that realization helped us in our work. It reminded us that every object in the system will probably need to leave the room and play a different role in another. It made us ask ourselves how we might create this thing differently, because we know it’s going to have to change.”