2019 Rising Star: Erin Peavey, AIA, NCARB, EDAC, LEED AP BD+C, architect and design researcher, associate, HKS (Dallas)

Erin Peavey serves as the health stories lead for HKS. In this role, she helps integrate research and practice to advance the creation and communication of knowledge across the firm. Before joining HKS, she was a senior researcher and medical planner at HOK in New York, a research consultant with The Center for Health Design, and adjunct faculty at New York School of Interior Design and The Pratt Institute. She is a trustee for the Academy of Architecture for Health Foundation, and her research has been published in international scientific journals and industry publications.

Healthcare Design: What drew you to a career in healthcare design?
Peavey: Growing up in a family of caregivers, I took for granted that life’s purpose was to help make the world better for those in need. My mother was a special education teacher and a counselor, and my father was a primary care physician. But it wasn’t until sitting in an environmental psychology class that I found my own path to caring. I remember being captivated by how the environment can help comfort the sick, provide space for connection, and shape our actions. In learning of this powerful tool called “environmental design,” I made it my mission to use research to create environments that care.

What’s one recent project that you’re most proud of?
For almost a decade now, I’ve been studying the topic of clinician teamwork and communication. Teamwork is of critical importance due to its links to patient safety, adverse events, and patient health functioning, as well as staff retention, satisfaction, and burnout. This past year, Dr. Hui Cai and I published what I consider my most valuable contribution to the field: a paper called “A Systems Framework for Understanding the Environment’s Relation to Clinical Teamwork.” The paper helps define, from an interdisciplinary perspective, the relationship between clinician teamwork and design. It’s a great example of how we can think beyond just the physical building to integrate the system of healthcare and provide tangible takeaways we can apply to design and operations. My core takeaways include: (1) professional proximity and visibility are essential to clinical care teams; (2) facility changes provide strategic opportunities for system transformation; (3) despite increased digital communication, synchronous face-to-face interaction plays a major role in effective teamwork; (4) a variety of spaces (size, formality, public or private) are needed to support both collaborative teamwork and focused task-work; and (5) interventions in the physical environment are more effective when done in conjunction with system-level change.

What do you think is the number one issue facing the healthcare design industry in 2019?
The top issue facing the healthcare design industry is the lack of data we collect around our designs, their intent, and outcomes. We’re stuck where the field of healthcare was decades ago. We know our decisions have repercussions, but it’s rare that we can show the definitive impact of those decisions. Currently, firms do not seem to fully grasp the incredible value of their own data or that of their clients.

What’s one idea you have for overcoming that problem?
One of the most prominent ideas for collecting valuable data using technological advances comes from the aviation industry: the use of digital twins. A digital twin is essentially an identical digital copy of a physical machine or system, such as an airplane. When the real-life airplane has an error, the digital copy can be used to understand the root of the failure and apply artificial intelligence to find ways to eliminate errors in the future. In many ways, we are already creating rudimentary digital twins with our BIM models, but how many facilities do you know map their errors, hospital-acquired conditions, or patient outcomes over the skeleton of the physical building? Architecture shouldn’t be something that most people ignore until it’s not working. Whether from training, research evidence, or just our own lived experience, I think most of us can say without a doubt that the environment matters, but its effect is often an intangible. We can change that.