Creating a Tipping Point

"The Tipping Point is that magic moment when an idea, trend or social behavior crosses a threshold, tips and spreads like wildfire."— Malcomb Gladwell, author of The Tipping PointIn 1988, when The Center for Health Design's founders started talking about creating healthcare environments that support healing and well-being, only a small number of the hundreds of thousands of design professionals and healthcare executives in the U.S. understood and embraced the concept. Understandably, architects and designers resonated with it because it reinforced the value—and purpose—of their work. Facility managers also saw the connection.Their bosses and clients, healthcare senior executives, weren't as convinced. They needed to see the data that supported the claims that the design of the environment could help increase patient satisfaction, improve medical outcomes and reduce costs. To many, a new building was a capital expenditure that was a necessity rather than an investment in their future."Enlightened clients will—and are—demanding healthcare facilities that are patient-focused, staff-friendly and reflect the institution's mission and values. They are also asking for facilities that promote safety and help reduce costs. Some are even asking for facilities that don't harm the environment."

But much of that has changed. Today, through the efforts of The Center for Health Design and other organizations such as Planetree, Picker Institute and the Institute for Family Centered Care, many healthcare executives are aware that the design of the environment does affect the quality of healthcare.

How did this happen? Part of it is timing, part of it is luck, and a lot of it is hard work of trying to get the word out about what the center does. For years, the facility and design magazines were the only publications covering the center's work. We couldn't get the healthcare business magazines interested. The consumer press was another story. We didn't have the resources to mount a major consumer public relations campaign, so we sent them the information we could—and hoped for the best.

But we kept trying—and began to have some success with the healthcare business press as soon as we started showing them data from our Pebble Project in 2001. The Journal of the American Medical Association wrote a story about the Pebble Project. Stories followed in the Healthcare Forum Journal and the Governance Institute's newsletter. These are publications read by healthcare CEOs, CFOs, COOs, medical directors, directors of nursing, etc. Finally, last fall, we hit the big time—a front page article in the Marketplace section of the Wall St. Journal, which has a national circulation of more than 650,000. Since then, our phone has been ringing weekly with calls from reporters or writers at various healthcare publications, as well as a few of the architecture and construction magazines who found out that healthcare design was interesting again.

One of the strengths of the center has always been its partnerships with industry organizations. We have enjoyed good relationships with the AIA, ASID, IIDA and others in the design industry for many years. Recently, we have begun discussions to partner with healthcare organizations such as the Institute for Healthcare Improvement (IHI) and the Healthcare Financial Management Association. Foundations that support healthcare research and projects, such as the Robert Wood Johnson Foundation and the Cummings Foundation, have also been interested in our work.

We're being asked to present at these organizations' national conferences, and several of our board members have given successful talks at meetings of the Governance Institute and IHI in the last six months. Our "Competing by Design" program, sponsored by Turner Construction, has been given to design and healthcare professionals in 18 cities across the U.S. since 2001.

While we may have passed the tipping point in the design industry long ago, we are just now approaching it in the healthcare industry. They have noticed our work and are interested. This is good news for designers. Enlightened clients will—and are—demanding healthcare facilities that are patient-focused, staff-friendly and reflect the institution's mission and values. They are also asking for facilities that promote safety and help reduce costs. Some are even asking for facilities that don't harm the environment.

The center has come a long way, but we are continuing to push the envelope. To that end, we have ended our relationship with the Symposium on Healthcare Design and are launching a new conference called HEALTHCARE DESIGN.03 in December. Our partner for this endeavor is Medquest Communications. Together, we plan to produce a conference for healthcare design professionals that provides the most forward-looking information, ideas and resources that are shaping and transforming the healthcare design industry.

We are also discussing a new program with Turner, as well as a mini-conference for senior healthcare executives at IHI's IMPACT meeting in October.

And our Pebble Project continues to grow. We are now up to 12 participants and counting—including our first long-term care facility, Sitrin Health Care in New Bedford, NY. In a few years, we hope to have a collection of researched and documented projects that show how evidence-based design improves the quality of healthcare.

In his book, The Tipping Point, Gladwell writes that, ". . . word of mouth is—even in this age of mass communications and multi-million dollar advertising campaigns—still the most important form of human communication." Won't you spread the word about what we do to your colleagues and clients?

Sara O. Marberry is director of communications for The Center for Health Design and president of Sara Marberry Communications in Evanston, IL. She can be reached at (847) 475-0427 or via e-mail: [email protected].