There are an incredible number of variables that can influence the direction a healthcare building project might take, from budget to schedule to delivery method to ownership goals and everything in between.

Managing all of those pieces is critical to a successful facility, and telling the story behind how it all came together is just as critical for Healthcare Design’s Architectural and Interior Design Showcase.

Each year, a panel of professional architects, interior designers, academics, and owners come together to sift through dozens of project submissions for the competition—and each year there are inevitably components of those submissions that juror’s say they wish had been done a bit differently.

Here, our jury will offer insight into practical approaches firms can take to submit a presentation that’s thorough, effective, and—hopefully—a winner.

Start at the beginning
No matter how skillfully prepared a presentation may be, the Showcase jurors are first looking at what’s being presented: the facility. For juror Yvonne T. Elias, architect, Dewberry (Tulsa, Okla.), that means hitting all of the major notes and at least most of the minor ones.

“We saw some projects that were sound in planning and architecture but really fell down on interiors that were stark and institutional. Others were great in terms of site planning or green building design but didn’t show the architecture at all. It’s hard to judge these projects in comparison to the really strong entries that are successful in many different areas,” she says.

Juror Ryan Hullinger, principal/architect, NBBJ (Columbus), also notes the need for projects to solve the inherently complex problems that healthcare design presents. “I’m always drawn to designs that simplify this complexity into highly rational, understandable solutions,” he says.

And those solutions presented, says juror Daniel J. Miesle, administrative director of space planning and transition strategy, Stanford Hospital & Clinics (Menlo Park, Calif.), should flow seamlessly back to the stated objectives for the project. “There must be a connection between the circumstance and the result,” Miesle says.

Presenting well
Even projects that achieve the above may still leave jurors a bit underwhelmed, if the presentations submitted don’t hit the mark in properly explaining a project’s success. “Evidence of the thought process and how the design was developed and tested really set some projects apart,” Elias says. “We looked for rational decision-making that explained how the project progressed from concept through construction and beyond.”

And jurors say they’re interested in more than just looks. Instead, submissions should capture both aesthetic improvements and data that supports how efficiencies were achieved, Lean design implemented, or operations improved.

“In the age of the Affordable Care Act and other aspects of healthcare reform, we cannot continue to rely on aesthetic advancement alone. I believe that great design can lead directly to empirically improved patient outcomes; but in order to do so, beautiful aesthetics need to be our starting point rather than our finish line,” Hullinger says.

Cohen also suggests that presentations tell the story of how specifically data was used to deploy a certain design approach, like Lean or evidence-based design, and what that process looked like—from evolving team dynamics to overcoming adversity. “Get to the outputs or outcomes of your work; don’t teach us the ins and outs of design principles that have been well documented. We know you know it, and we know it already, too,” he says.

Jurors also recommend that firms submitting projects be mindful of voice—in other words, stay away from marketing speak. “The voices of the owner and designer are more relevant than that of the marketer. The owner’s voice is particularly instructive because they are the people using the building every day,” Hullinger says. Miesle concurs, saying, “hands down—the owner” is the voice he’d like to hear telling a building’s story.

And while text that thoroughly explains approaches to challenges and solutions is important, so are the visuals submitted. From practical details like ensuring the text on slides is large enough to read to paying attention to whether major departments are labeled on building plans, Elias says there are a number of small details to consider.

“Don’t take a plan directly from construction documents and make a slide of it; clean it up, take out extraneous items, add appropriate color and text, or render the plans to show the character of the space. Don’t include unflattering photos just to fill space, and don’t fill the slides with eyewash elements (close-ups of green leaves, photos of hands) that look like there wasn’t enough substance in the project to fill the pages,” she says.

Something extra
One of the jury’s tasks is to review submissions in order to approve them for publication in Healthcare Design's September issue Showcase supplement; however, another objective is also to identify projects that stand apart from the rest. Those few are awarded a Citation of Merit. So what does the trick?

For Todd Cohen, director, environment of care, and hospital safety officer, MedStar Montgomery Medical Center (Olney, Md.), it starts with a “solid presentation, comprehensive in approach, with some data on how they came to design a space more leanly or with an eye for efficiency. I liked that different types of spaces were considered and stood apart.”

Hullinger says he was looking specifically for design coherence in a “seamlessly integrated interior, exterior, and landscape design, all developed in the service of improved clinical operations.”

Elias notes that for the projects awarded citations this year, there was consensus among jurors that they did, in fact, excel beyond the rest. “This was probably because they accomplished so much in diverse categories: sound planning, good architectural design, humanistic in their appeal, successful in its detailing and interiors, respective and sensitive to its site, and having a kind of ‘lagniappe,’ as the Cajuns would say: a little something extra that creates a strong sense of place,” she says.

Hullinger, too, looked for projects that hit notes across the board, measuring architectural design, interior design, landscape design, and clinical innovation. “Many of the projects were excellent in one or more of these areas, but very few were strong in all four. The projects that excelled holistically were the ones I nominated,” he says.

At the same time, while several projects made it far enough to be considered for the award, not all made the cut. Elias says at times it was because a project didn’t include information on a detail the jurors felt was important or had great site designs but incongruities between the site and architecture, which became obvious in what was and wasn’t pictured.

“If you don’t show a photograph of a key element, we wondered if it was poorly done or simply ignored. Other projects showed a space with great attention to detail in some areas but with harsh execution in others that made us wonder if the team actually developed the design together,” she says.

Miesle agrees it was often the submissions themselves that affected wheth
er he voted that a project was award-worthy. “There were several projects that were truly of a level that I was disappointed when reviewing the submission. I think too often the marketing staff throws ‘looks nice’ [photos] in submissions that have little to do with the core of the project,” he says.

The tipping point
With all of the right pieces in place, it also never hurts to have a little something extra. That something, jurors say, is balance—facility projects that respond to patients and staff, aesthetics and efficiency, satisfaction and outcomes.

“What makes healthcare design so difficult is that it has to accommodate so many users and their different needs: the patients, families, and healthcare providers,” Elias says.  “A project that manages to do this and be coherent in design from the macro scale to the micro details is what really impresses me,” she says.

Jennifer Kovacs Silvis is managing editor of Healthcare Design. She can be reached at

To read about the projects awarded a Citation of Merit, see the following:

For those that were recognized with an Honorable Mention, see Honor Roll: Thoughtful Design Approaches Stand Out In Annual Showcase