In this series, Healthcare Design magazine asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject.

Here, Mike Zambo, principal for healthcare design at Bostwick Design Partnership, collaborated with colleagues Robert Bostwick, Matt Bode, Judy McGlinchy, and Mala Yin to offer some perspective on bariatric design standards, patient rooms, and the importance of validation for evidence-based design.


1. Patient room environments

With the amount of scrutiny on cost of service coupled with evidence based design practice, there’s a lot more attention on these spaces. Most recently, the study of acoustics and its application to the patient’s sleep environments have floated to the top. In addition, we continue to incorporate new technology into the patient room while continuing to give patients as much control and choice as possible over lighting, temperature, and entertainment. Incorporating all of these factors while still remaining cost competitive will be the challenge moving forward.


2. Setting bariatric design standards

From issues of patient comfort to nursing fatigue as a result of lifting, bariatric design has woven itself into all aspects of our daily work. The design guidelines are under development and are currently a trial-and-error process. Often in direct conflict with the ADA, current design recommendations are minimal, products are cold and institutional, and solutions are less dignified for the patient. We are constantly looking for economical bariatric solutions to better serve the patients and staff who use them.


3. Team building

We’re convinced that the traditional design/bid/build method of creating healthcare facilities is broken. With higher emphasis on construction mangers and integrated project delivery methods, we’ve focused our efforts on team-based solutions to project delivery. No longer is it just the architect’s role to design and the contractor to build. Both parties need to collaborate from beginning to end to achieve the best results for the project.


4. Validating evidence-based design

While there’s been a move towards evidence-based design, only recently have some of the results been published that allow us to confidently incorporate them into our designs. The quantity of these results is minimal compared to the amount of new design projects underway. Does UVC paint and lights or copper-coated elements reduce infection rates?  Are single-handed rooms the best for all patients? Do patients heal better in single-bed environments? We will know only by challenging every project to produce results, even if it’s just a simple survey.


5. Healthcare reform and the future

We’re all wondering what the effect of healthcare reform will be on the design industry. We believe institutions will be required to provide the same amount of service with less capital expended. This may create a transition back to simplicity: smaller, less flexible rooms. This is difficult with high-tech spaces such as IMRI’s and hybrid OR’s being requested. Also, with more emphasis on wellness, what will the hospital of the future be like? Will only the most acute patients be admitted to high-tech medical institutions while less acute patients recover from home via remote monitoring and internet physicians?

From left to right, Mike Zambo, Judy McGlinchy, Mala Yin, Matt Bode, and Robert Bostwick.

Want to share your Top Five? Contact senior editor Anne DiNardo at for submission instructions.