After recently participating on a jury for a healthcare design competition, it’s clear to me that the industry has raised the bar of minimum expectations in facility design. The level of design work being done in healthcare is thoughtful and well executed, and the general sense from jurors was that the work was all very good. But what was equally interesting to me was that very little rose above that baseline level of quality. There were no “wow” moments of innovation.

As reassuring as it was to see the minimum standard of expectations so high, I couldn’t help but wonder what’s inhibiting us from additional innovation in our industry. We seem to have been idling in this same place for quite a while now, stalled at “very good.”

I’ve been using this question as a jumping off point for some one-on-one conversations that I’ve been having with key leaders from many of the architectural and design firms that make up our industry. A few interesting ideas have surfaced from this group of leaders that I’d love to share.

The first is around the recession and design fees. The last recession hit our industry very hard. In many ways, we lost an entire generation of design professionals who left the industry to find work elsewhere. It will take a long time to recover from that talent drain. Even more impactful has been the effect the economic downturn had on driving down fees. Though the industry is building again, fees remain low even as the costs of operating a firm have gone up. This has led to a leanness in the design process that has reduced the amount of time and resources available for research, design exploration, and the creative process, which directly lead to innovation. As one architect shared, “When you are out of time, you take less risk.” Another colleague made the astute observation that “We’re doing fine for the healthcare of today, but what about the healthcare of the future?”

The second interesting idea that surfaced in these conversations is the misinterpretation of the evidence-based design (EBD) process. It’s possible that a process that was put in place to encourage innovative thinking (Step 5 of the EBD process is “create a hypothesis”) might in fact be limiting innovation by causing people to not take risks that aren’t already supported by evidence. As one architect shared, “Innovation has no evidence, so does the rigor take away the ability of someone to try out something new and innovative?” It’s interesting to think that the rigor that leads to more informed decision-making may be having a boomerang effect and causing people to no longer feel comfortable making decisions in the absence of research. And yet, the only way to contribute to the body of EBD research is to step out of the box and try new things.

Moving forward, what can we do to ensure and encourage innovation? The answers will come from many fronts but, from The Center’s standpoint, we need to work to more quickly gather and spread new ideas on a large scale. We are broadening the conversations we’re having to include disparate industries that have successfully solved similar problems and bring a broader influence of disciplines into the conversation. We’ll work to better personalize the information you receive from us so we’re not contributing to the noise and distractions in your world. And we’ll listen more, so please come talk to us. Call, write, email, or visit—we do our best when we’re informed by you.

Debra Levin is president and CEO of The Center for Health Design. She can be reached at