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'Thoughtful Design' From the Patient's Perspective
Q&A with George Tingwald, MD, AIA, the surgeon-architect who planned the new $2 billion Stanford Hospital.
OSD Staff
Publish Date: February 3, 2021   |  Tags:   Facility Construction and Design

What prompted you to go architecture school after medical school?
I double-majored in biology and art history, with a fine arts minor, so I've always had an interest in architecture. I just assumed it would remain an interest, not a career. But the Cleveland Clinic, where I did my residency, played a critical role in my path. The Cleveland Clinic encourages all its physicians to gain experience in non-clinical areas and, while there, I was essentially mentored by campus architect Malcolm Cutting. He believes in involving doctors and nurses in construction planning and asked if I would help him with the planning of a large facility. That was the start.

How do you view healthcare design differently than your clinical peers?
I know what an architect does; I've been in the trenches. This understanding is key. Because I understand square footage, I know why we can't just make it smaller and cheaper. I grasp the relevance of mechanical and structural infrastructure needed for function. I see cost in a way you can't without formal training. Next to nuclear power, healthcare is the most regulated industry in the country. There are so many variables that factor into a project's cost, from funding to current and future regulations. Those fancy finishes account for only 5% of a project's total cost, while HVAC expenses account for 45%.

How do you create a facility that's functional and aesthetically pleasing?
The key is "thoughtful design." When a patient arrives, they should instantly feel that the facility was designed with their needs in mind. That's why the "Five-Minute Space," the welcome area where patients spend those first five minutes, is so important. In surgery, there's so much patients don't see or understand. They need to grasp onto something that lets them know they're in a safe environment. Thoughtful designs can do that. For the final 20 years of my mother's life, she served as my muse for every one of my projects. I tried to see every angle from the patient's perspective. The patient I had in mind when I made those decisions was always my mom.

How will COVID-19 alter healthcare design moving forward?
The pandemic is forcing us to reevaluate what's needed to stay operational during emergencies. We need to future-proof facilities for any emergency — whether it's a pandemic or a natural disaster — in ways both clinically and economically appropriate. The pandemic highlighted the need to overhaul structural and air-exchange systems in facilities, but it's not feasible to redo all buildings and add negative pressure to every space. The challenge post-pandemic will be striking a clinical and economic balance as we prepare for whatever comes next. OSM