- Good afternoon and welcome to the Architecture for Health Lecture series.
I am pleased to welcome Carlos Moreno for his first presentation.
Mr. Moreno is an associate principal and healthcare architect from Perkins Eastman, located in Austin, Texas.
Mr. Moreno graduated from Ball State University with a master of architecture, a bachelor's of architecture, and a bachelor's of science in environmental design.
His 30 plus year career has dedicated him to the continued exploration of trends and services in the healthcare industry for patient guests, long-term care residents, practitioners, and caregivers.
This includes the planning and design of healthcare facilities of all kinds, including all aspects of hospital services and modalities.
Mr. Moreno is an integral part of the Texas A&M Health Industry Advisory Council in support of the Center for Health Systems and Design, supporting the advancement of the incubation of ideas and talent in service to global delivery of healthcare.
He currently serves on the National Board of the Institute for Leadership in Capital Projects, the Board for Family Service Association, as well as the Board for the Texas Center for Infectious Disease.
His list of past accomplishments is long and varied and would require its very own hour here on KAMU TV.
Mr. Moreno's personal model is to surround yourself with great people, finding mentors for each season, read great books, and pursue great things.
In doing so, pour into others what you have learned and experienced as others have done for you.
I know that we are all happy to have Mr. Moreno here embodying this motto and sharing his wealth of knowledge with us.
Thank you for being here today.
- Thank you.
(audience applauding) Thank you very much, Cynthia.
That was very, very nice.
And thank you very, very much everybody for being here and everybody who's watching on the screen, thanks for joining us today.
Cynthia just ended with something that was very, very dear to my heart, relative to what does it mean to learn?
When you surround yourself with great people, read great things, and just expose yourself to great pursuits, it's not a matter of achieving greatness, it's a matter of being able to learn things, being able to actually gain from the knowledge that is being poured into you and you, and then, as Shweta said, you're pouring into others, and that's what we as architects are required to do, right?
You know, everything that we learn is based on observing, learning, of course, and then application.
Sometimes it goes well, sometimes it doesn't.
But today we're gonna talk a lot about these things, and I think that when we take a look at the title, A Global View of Healthcare Planning and Design, we're really talking about humanity.
And if we take a look at some of the other presentations, other lectures that have been done on the subject of healthcare, healthcare design, and planning, and what's going on globally, the common factor here that we're always focused on is humanity.
So with that said, Human by Design.
Human by Design is essentially the leading phrase that Perkins Eastman lives by, and that's not just relative to the client.
That's relative to actually how we treat one another in the offices as well.
We recognize that everyone has value.
We recognize that everyone has an opportunity to engage, be engaged.
Also, the opportunity to learn from those with whom they get connected.
We all come from different cultures, different walks of life.
We value that.
That's what makes us good at what we do.
Having said that, what comes out of that integration, if you will?
I'm gonna borrow a word that I'm actually gonna be using a little bit later.
Well, we become creative, creative in the solution, the problem solving process, we identify what needs to be built around us, for what?
For the people, okay?
That includes us, okay?
So we're part of that humanity as well.
We're all essentially within this same bucket.
So let's talk about the agenda, okay?
We have a lot of things to cover today, and my effort will be to make sure that I'm being as concise and as slow as possible, too, as we walk through this agenda.
After this slide, we're gonna talk about the learning objectives.
But first, let's focus on what topics we're gonna cover.
2022 Architecture for Health.
I wanna reflect a little bit upon what has been learned.
There's already been some presentations, as I've already alluded to.
What have we learned?
What have I learned?
What have I gleaned from listening to a number of people that have spoken, certainly larger giants than myself.
So I was so eager to just listen and watch and learn what it was that was being said by Ron Scags as a good example, and I'll speak a little bit to that.
Perkins Eastman, of course, I'm going to be speaking about my firm, Perkins Eastman has been a wonderful experience for me, and I'm definitely looking forward to the next many years in concert with everything that we're doing.
But we're gonna talk about its history, its global reach, the practice areas, and its experience, particularly that in healthcare, but really going even deeper, getting really into the grain of what that means, because healthcare, as Ray, and I've even discussed many, many times, in fact, when he first approached me in working with Hayek, working with him, working with the center, it was all about not just raw healthcare, it was about the fact that what we do in architecture and design for health has an impact on everything that we do.
And I'll be speaking to that.
That'll lead us into the topic of convergence.
With convergence, we'll be talking about its power.
Again, the subject for integration, design-informed experience, okay?
That's what we do everything by, that experience, creating experience, living through that experience.
Then I also wanna focus on the social determinants of health.
Very, very important subject, because that's gonna then lead us into what's happening globally, the world impact, and the outreach opportunities thereof.
So what is this doing?
This is creating a foundation.
A foundation, if you will, that will then lead us into two case studies.
One that's gonna focus on Aastrika Midwifery Centre in India, and then the next one, Kuwait University in Kuwait.
So learning objectives.
You might have said, well, Carlos, you've already went through the agenda.
That looks like a lot to learn.
Well use these following comments that I'm gonna share with you as kind of like that baseline, if you will, the blanket or the blanket that's gonna cover this agenda.
All of them are gonna be about what is it that you're gonna recognize at the end of this lecture.
So you're gonna recognize the borderless interrelationship between the art and practice of architecture and health medicine.
Okay, there's a lot to be said about this, and I'm looking forward to diving into that.
Recognize how design for health has a consistent influence on humanity.
That sounds probably lofty to you, but really it's not as lofty as you may think.
Everybody in this room, everybody listening to me, everybody within the sound on my voice and the image that you see in your screen, we have that impact.
Everyone has that ability to influence, recognize what it means to be an ambassador locally and abroad.
We are ambassadors of Texas A&M as I am an ambassador of Ball State University.
I'm an ambassador of Perkins Eastman, but we're also ambassadors of a nation that is now going abroad to engage, to teach, to learn, to help.
Recognize the application of design principles with culture, community needs, and environment.
And that ties directly into the comment I just made a moment ago about being an ambassador.
And then finally, again, the things you'll be learning about relative to these two case studies.
So the agenda, all right, so what can we talk about, about issues, ideas, thoughts that we can reflect on?
I'm gonna focus right now in two organizations, two organizations that have already spoken.
One is HKS, the other one's EYP/PAGE, okay?
I learned a lot just by listening, listening to the four giants that actually presented in these two chairs, and speaking about what those firms do and what they are doing globally, but what they're also doing internally, okay?
So let's talk a little bit about what Ron and Joe spoke of.
And I'm gonna read these verbatim, and I know you can read, but I wanna read them out loud in case someone's only listening.
"When it comes to global health, there is no them, there's only us."
Let that sink in a little bit.
There is no them, it's only us.
And that comes from a comment that Joe Sprague had shared emanating from a quote taken out of the Global Health Council.
Next, there are other forms of medicine and other cultures outside of Western medicine, okay?
We're not it.
We're not the only thing that is operable, okay?
Me and one of the students earlier, before today's lecture, were speaking about that very issue when we're looking at medicine that is holistic from the ground, okay?
How are we actually utilizing it?
How are we actually leveraging that?
Next, the objective is to provide the best possible design.
I love this.
The best possible design in the shortest period of time at the lowest possible cost.
I thought that that phrase was just magic, because that is what we're in charge of doing as we work with our clients, as we work with the population, the health of everyone that would be affected by those that would be walking into the facilities that we design, or the master plan that's actually gonna be exhibiting what is to come.
Next, architect first, specialist second.
But the process never ends.
Know your stuff, okay?
Bill Edy and I talk about this every time we're visiting, whether it's on the phone, whether it's in text, or whether it's in College Station.
We're constantly talking about know your stuff.
Just yesterday as a good example, I was just meeting with a group of colleagues on the very issues of construction administration if you will.
Know your drawings, know your specs, okay?
I'm not trying to deviate from the subject matter of healthcare, but it's about knowing what you're doing, okay?
It's a constant practice of refinement, okay?
And both Ron and Joe spoke of this.
So learn and share with passion, okay?
If there's anything that you would listen to me on today and just take away, it's that passion, okay?
That passion for humanity, that passion for what you're doing, no matter what it is, whether it's architecture or anything else, Do it with passion.
Don't worry about the money part.
At least that's what I tell my kids.
Relationships and relating.
You are a guest, a servant.
Save the needs of the hospital and the community.
So you're serving the needs, you're serving the community.
That is what's next in line.
Let's go into EYP/PAGE and understand, I'm not just trying to focus on them, but I'm trying to just lay further this foundation, this foundation upon what more we're gonna learn about and talk about.
Tushar Gupta and Charles Griffin, both excellent speakers, highly favored with regard to the profession that they are leading in their own right.
They spoke of building trust as this biggest challenge globally that they recognize, isn't that what we all chase, whether it's locally, domestically, or abroad.
It's about that factor, that human connection of building trust, especially with a client in healthcare who's also trying to establish trust with their patient and their families, okay?
It's all encompassing.
Attributes for business success.
What would that be?
Maintaining your brand and promises and knowing when to say no.
We're all learning this all the time, every day.
I would say that this is probably one of the biggest components of practice that every one of our firms needs to constantly look to and abide by.
You know, keep your promises, respect your brand, and know when to say no, it's okay to say no.
It's even okay to not know, to say that you don't even know the answer.
But hey, I'm a resource and I will find that answer for you.
As an architect, that goes miles, okay?
The journey begins with each of us in our challenged environment.
Objective, to make a positive impact and make a difference at a local level by bringing value.
It doesn't matter what the size is.
In fact, I'll go again back to Mr. Edy.
He and I were talking about healthcare projects and our decorated histories.
There is no such thing as a bad healthcare project.
Doesn't matter what size it is, they're all providing a service.
They all have an impact.
It doesn't matter what the size is.
In fact, I'll even say this, and I say this often, to many clients and to many staff and colleagues, sometimes the smallest projects are the most complex.
So just keep that in mind.
Opportunity, the next generation of design professionals to be more mobile on a regular basis.
So those of you who are in this room with me, you may be thinking that you're gonna be joining a firm that is located not too far from here.
Maybe Houston, maybe San Antonio, Austin, Dallas.
Those firms are quite often looking for work, not just in this state of Texas, but other states as well, like Perkins Eastman, but also globally.
Why is that?
Well, part of it is that our world has shrunk, okay?
We live in a very, very small community we call planet Earth.
And that probably sounds highfalutin to you too.
But the point is that it really is small.
And if you take a look at a few things that I'm about to show you with regard to our global reach as Perkins Eastman, you're gonna discover, hey, yeah, it's not too far fetched that I could be working for some XYZ ABC firm in Dallas, Texas, but yet my office is located in Egypt.
That's where all my work is, as an example.
All right.
But let's go to another further baseline.
Even before today's lecture, some of us talked about the application of medicine.
Recognize that art is part of this process, art in architecture, art in medicine, and the practice thereof.
Hippocrates, if we take a look at what the Hippocratic Oath speaks to in the fifth century about upholding the art of medicine and then act in the best interest of the patient, as well as preserving privacy, let's look.
Let's look at what else he had to say.
"Whenever or wherever the art of medicine is loved, there is also a love of humanity."
There again is that word, humanity.
And respect for humanity.
Vitruvius.
I know that I can't ask for a raise of hands, but hopefully many of you have stumbled across the 10 Books of Architecture by Vitruvius.
Hopefully, some of you all are also very well aware of commodity, comfort, and delight relative to Vitruvius.
Well take a look at what he says here.
"The architects should also have a knowledge in the study of medicine on account of the questions of climate, air, the healthiness and unhealthiness of sites, and the use of different waters.
For without these considerations, the healthiness of a dwelling cannot be assured."
Isn't that what we're doing today?
Isn't that what we're constantly learning about academically?
For you all here at A&M, but also all of us who are practicing.
Louis Pasteur.
I know, I know, everyone knows who Louis Pasteur is, the whole pasteurization process.
What did he say here?
"Science knows no country."
The Mayo Brothers believe this as well.
That science knows no country.
In fact, the Mayo Clinic is well established on the principles of going abroad, actually taking the art of medicine abroad for them to learn, not just to apply what they've learned, but to learn more.
Louis Pasteur, "Science knows no country, because knowledge belongs to humanity."
There again, humanity.
And "Is the torch which illuminates the world."
This is a fantastic quote, and if I can get it on a T-shirt, I certainly will.
But I wanna mention also that Louis Pasteur not only saved people by developing or helping to develop vaccines for anthrax and cholera, but he also saved beer and wine by virtue of his talents and abilities.
So give that some thought.
All right, next, let's talk about Perkins Eastman.
Perkins Eastman established in 1981 in New York City by Brad Perkins and Mary Jane Eastman.
I respect these two individuals highly.
They have done so much for the art and medicine of architecture, those things that all come abounding through the thoughts that they come up with to the application of their knowledge on PAGE and into the built environment.
It's amazing that after 40 years where we've been, where we're going with this vision in mind, a vision founded on the idea that design can have a direct and positive impact on people's lives and the planet.
So here again, you've got to have a global perspective, okay?
Recognizing already that I mentioned that that global perspective could be on a planet that is very small, like planet Earth, but everything's well within reach.
Design is within reach.
The service of design in the promotion of good healthcare is within reach.
So let's talk about this global reach.
Austin, as was mentioned earlier, is the office that I represent, Austin, Texas.
But we have 24 offices firm wide, okay?
Two of them are in Texas, one in Dallas, and one in Austin.
Again, we were founded in 1981, over 850 design awards and growing.
And then also with regard to the quantity of staff, the number of staff, the number of people that we call our team, well over 1,100.
I mentioned earlier, this map, this small globe that we're on that we call planet Earth.
You can see where Texas is.
You can see where these two small dots are on the screen relative to where Austin and Dallas are located, south of the United States.
You'll go to Ecuador, where we have one of our other offices.
And on my far right hand side, your far right hand side, you'll see our offices in Shanghai as well as Singapore, and then Mumbai, and then Dubai.
And, and I wanna speak briefly about friends that I've made globally.
When we take a look at this global reach and the ability to take our practice areas across borders, you make friends, you make colleagues, colleagues within the same firm that you are representing, such as Tarik in Dubai, or let's say four architects that I came to know very, very well out of Egypt, Alexandria to be exact, and Cairo, we actually brought them stateside to work alongside with me on some modular work.
I can't tell you exactly what that work is because I'm under an NDA, but I will tell you that the work was not the focus necessarily.
Yes, we had a job to do, but it was the relationships that were built.
And so I will continue to return back to what was built out of my friends in Egypt.
The practice areas.
I've spoken several times about senior living.
I remember meeting a few of you on that subject, but healthcare and senior living, they go hand in hand, right?
Well, they do, but so does everything else.
If you take a look at the things that I mentioned earlier, discussions that Dr. Pentecost and I have had about the full wide range of what architecture's impact is from everything and on everything.
So all these brochures speak to that.
But let's go a little deeper.
When we take a look at our healthcare experience from inpatient to outpatient, behavioral healthcare, science and technology, you're gaining knowledge project by project by project, refining that knowledge, okay?
As healthcare architects, that is really what we have to do.
You heard Joe, for instance, speak a lot about the FGI and I loved how he actually had a copy of the FGI in his hands when he gave his part of the presentation and how it had post-it notes all over it.
I have a book more than one that actually are just like that.
They're like Bibles, if you will.
You've got to know those verses of scripture, if you will.
And it's a constant volume of reference that you're making.
I'll tell you with regard to comprehensive cancer care, as you see here, infusion, bone marrow transplant, specialty care programs.
I remember when I broke my teeth on the healthcare codes in relation to airborne issues, was doing a BMT in San Antonio as a matter of fact.
And this was actually within a children's hospital.
And if any of you here have already done, and I hope will do any kind of construction in the field in an existing condition where there's construction while also the care of patients going on at the same time, that's actually a fun challenge.
It's one of the reasons why I love architecture within healthcare, because of some of the most challenging components of what we do as architects and designers and engineers.
You know, from HVAC systems to electrical components, to the lay of the land within the room itself.
This BMT actually was very critical because we had HEPA filtration at the actual air handling unit.
So the supply as well as the point of emission within the room.
And we had to exhaust everything 'cause this was a protective environment.
What was really interesting about though this is that we're working with the facilities management team on understanding how do you control aspergillus?
Because aspergillus in an immunocompromised body, someone who's gone through a transplant is deadly.
And so this was 26, 27 years ago.
And that experience stuck with me, stays with me to this day.
And which is why I'm so vigilant about codes, healthcare codes, regulations, getting to know the authorities having jurisdiction, but even more than that, understanding and knowing the families that are actually gonna be engaging the project that you're actually working on and developing and planning, but also getting to know the staff, getting to know the doctors, getting to know those people that are principal to the problem solving process, the contractor, facilities management team, CEO, the C-suite of the hospital, engaging, understanding, reading the journals, reading what is actually happening today in relation to this issue in BMTs.
Okay.
So you can literally take what we know from what we know as an architect and really apply it, pinpoint to become a specialist.
I know people that this is all they do, they do nothing else but focus on cancer treatment, oncology.
That's it.
And that is their forte.
Master planning.
I can speak to Hillary Birch.
Hillary Birch, who is a managing principal of our office in Austin.
She's FAIA, highly decorated, highly skilled architect.
In a master planning standpoint, her architecture skills are also applied to placemaking.
And what does that mean?
Placemaking within a healthcare arena, we're talking about activating space to become a place, there is a zone between the inside and the outside.
What do you do with that zone?
How can you actually incorporate activities that are happening inside to the outside and vice versa?
These all work together and I'm so glad to know Hillary.
All right, so let's get to the big power word of convergence, because there is a lot of power behind this word.
And in doing so, this slide kind of reflects here again those brochures that you just got finished looking at, those brochures that represented the myriad of type of projects that we do at Perkins Eastman, as you see on the board behind the words, the power of convergence, you see hospitality, you see healthcare, of course, government, civic, cultural.
You see our urban planning and design, transportation, sports and entertainment, senior living, all of these make a map, if you will, left to right, right to left, top down, down top.
Not one of these is more significant than the other.
It's kind of like taking a look at the parts of your body.
Not one piece would function well without the other, okay?
Now we've been able to adapt and overcome in certain cases to be sure.
But recognize that from what we do as practitioners in design for health, all these elements come into play.
So let's talk a little bit more about that.
At the top of the screen, you see integration, okay?
So this is the key foundation as to where we bring the things that we've learned by converging all these different disciplines, all these different types of projects into healthcare, okay?
So when we look at healthcare, we're engaging or informing, if you will, hospitality.
And some of you have seen that.
If you've visited a hospital that is designed with a high hospitality flare to it, I hate to use the word flare, but forgive me.
But with hospitality in mind, science, technology, obviously that's gonna be the bedrock for the things that we do in healthcare.
We also have healthcare being informed by large scale mixed use, okay?
Workplace in higher education.
All these things ebb and flow with one another.
But we also get into the granular, the detail components of what all this means.
Now we're talking about design informed by experience and vice versa.
Experience informed by or impacted by design, right?
So here you see in the middle convergence where we've got under convergence, the academic, the research, the clinical, the healthcare.
The future in personalized precision medicine, close creative interaction between faculty, researchers and clinicians.
Okay, well, how did we bring these things together?
Well, let's take a look at the transformational side, all right?
That part of the experience, 'cause everything that we're doing, including everything that's happening in this room with the lights off, there is a different experience happening by virtue of what your senses are collecting and addressing through your mind, through that synapse of how you're reacting, okay?
You're reacting to the sound of my voice with probably greater pitch and greater sensitivity because the lights are off.
So look at the transformational slide.
Part of the slide, inspire.
Everything we do as designers is seeking to inspire.
We're inspired with the passion that we bring to the table.
We enhance the institution's brand, we enhance our own brand as well by what we're doing in design.
We enable success, we're adaptive.
And I like to use the words adaptive to sometimes even overcome because there are some cases when you're dealing with projects, when they're either existing conditions or brand new conditions, there are always issues to be overcome.
Things that you cannot see, things within the wall, so to speak, that you're unaware of.
And of course absolutely being sustainable.
It's part of one of the bedrocks, if you will, of our philosophy in design that everything is based on a sustainable process.
Even charging toward that condition of being net zero.
Hospitality.
Of course you're gonna see that in a lot of our work, including the work that I'm gonna show you in a moment from wellness, quality of experience, positive impact of the foundation of human by design ethos.
So with all of that being said, all of it very important, we're gonna take what we just got finished talking about in terms of convergence.
Convergence of all the design areas of expertise that Perkins Eastman in this case brings to the table by way of the slide that you saw, the slide that you're looking at right now, what is that focused on?
The social determinants of health.
I'd like you to listen to a quote.
It's gonna be a little bit of a lengthy quote, but an important quote that goes back to almost, gosh, we're getting close to a decade and a half of when this quote was actually published.
This is published out of a book called "Hospital."
Let me show this to you and hopefully shows well on the screen "Hospital" by Julie Solomon.
This is an addition that goes back to 2008.
In this quote, please listen to the following.
"In 1998, the Association of American Medical Colleges recommended that medical schools teach the following."
Please pay attention to this.
"Knowledge of the important non-biological determinants of poor health and of the economic, psychological, social, cultural factors that contribute to the development and/or continuation of maladies."
It continues, get this, "There is a language."
This is where we start talking about global, global influence and global impact.
"There is a language of healing that needs to encompass gestures, fears, desires, superstitions, beliefs."
What are we talking about here?
We're talking about trying to take those who are practicing medicine, and I dare say those of us who are practicing architecture to be sensitive.
Again, it's all about humanity.
That's where we began this talk.
It's about being sensitive to ourselves, being sensitive to our neighbors, being sensitive to everyone globally.
'Cause from a design perspective, that's where it works.
Lastly, cultural competence has become a goal within the industry.
Learning that the language part is easy, okay?
A lot of us probably know more than one language and that's fantastic.
Learning the language is one part of it, but as this quote states, it's the comprehension part that's the hardest because it's all culturally based.
Words are words.
Now I believe that words have power, There's no question about that.
But when you're dealing with cultures not of your own or a culture not of your own, that you're not familiar with, understand that it's more than just knowing the language.
It's knowing the people, it's knowing the demographics, it's knowing the research behind why things are happening the way that they are.
Okay.
It doesn't mean that your culture is better than the other.
Let's be clear about that, okay?
If you think otherwise, that's actually gonna hinder the success factors that you're trying to present.
So SDOH, again, I wish I could ask for a raise of hands, but those of you who are watching the screen right now, I don't know, give me a thumbs up.
Social determinants of health.
We're talking about health and healthcare, neighborhood support, social community, engagement, economic stability, education.
It was mentioned a little bit ago that I'm a board member of Family Service Association.
It's the oldest nonprofit in the city of San Antonio, an architect in Family Service Association.
Social engagement is not something to put aside, okay?
Public engagement, public health, those things that you actually have a definite opportunity to create impact and service.
Bring thought power from what your education is informing you of to those tables.
Being informed agent of yourselves as architects, as designers, as clinicians, know what's happening within the communities within which you serve or maybe you don't serve, but you're learning of that community to take that somewhere else.
It's that application here again, observing, learning, and applying.
Okay.
So I, as a board member, and I've been a board member of other organizations and there's great value to be taken away from those things and to be utilized in a manner that you typically wouldn't be, definitely not from doing anything else that would be more for what you would be receiving, you're giving.
So now let's talk about what does that mean from a world impact standpoint?
Let's take a look at what Antonio Gutierrez, the Secretary General of the United Nations has to say about the things I just talked about.
But even more.
Here, we're gonna be talking about the 2019 pledge that the United Nations has taken to actually address sustainable development goals across the world, okay?
Look what he said.
"We must rise higher to rescue the sustainable development goals and stay true to our promise of a world of peace, dignity, and prosperity on a healthy planet."
Okay, so some of you might be thinking, well Carlos, where's all the design?
Where's all the pizazz?
Well, this is part of it.
This is the stuff behind it.
This is the stuff that's behind the successful projects that Perkins Eastman has done.
And here again, this is laying the groundwork, if you will, for those projects that we're gonna talk about.
You heard me say a little bit ago that, and again, the power of convergence by the way.
Everything coming together, now you see the SDOH, you see the 17 goals and also transposed across the field or range of services that we provide, expertise that we provide at Perkins Eastman.
You heard me say earlier, before getting to these case studies that there is no such thing as a bad small project 'cause there's not.
There's actually form and function being provided, being addressed.
There's actually need being addressed.
We're gonna talk about these two projects.
One is 5,300 square feet and the other one is one and a half million square feet.
So here you're thinking, gosh, we're gonna see something extraordinarily amazing between the two by size and so on.
I want you to understand that everything that I've spoken of up until this very moment is all addressing what?
It's all addressing the human, okay.
They're the end result and the result and factor as to what is being designed.
So let's talk about the Aastrika Midwifery Center, a good friend of mine, Tanya Phillips, she's the principal in charge of this project.
She's actually residing out of the Mumbai office in India.
And this project, as a matter of fact, is receiving an award on Monday next week at the HCD conference, which I hope you all will be attending, this is actually one of three awards that we're receiving.
But Tanya and her team did a phenomenal job in engagement, understanding the culture, recognizing the issues at hand and what are those issues at hand.
Let's talk a little bit about that.
India, 1.3 billion in population.
The healthcare system is a multi-payer system.
So you've got a combination of public and private healthcare coming together.
Interestingly though, there has been a significant rise and really a continuing rise of cesarean births.
And this project is focused on midwifery.
Here you can see a little small caption that reads a more natural setting for childbirth.
In doing this project, a lot of things were recognized.
Let's take a look at what the journals speak of.
If we look at the Journal of American Medical Association speaks to the World Health Organization and their recommendation that rates of cesarean delivery should range between 10 to 15% while in India and South India, that's been eclipsed.
And why is that happening?
Well, you have families that have other members of the family getting cesareans, in some cases, the operation in and of itself can be lucrative to the clinician who's actually performing that.
But there is a definite problem is that when you have a cesarean, you're actually creating harsh conditions for the mom and the baby, pre-birth and post-birth.
And so the genesis of this project was focused on, okay, well, if we have autonomy, the women having more autonomy in South India, what can we do to help them by way of this doctor who's actually wanting to initiate a program to where they do away with cesareans as much as possible?
And we do everything more naturally, if you will.
So this project was really focused on addressing the unwanted or the need of cesarean procedures, getting away from that and really reducing that percentage.
So what you see here is the main lobby of this 5,300 square foot renovation within an existing hospital.
Okay, and if you take a look at the interior finishes, the objective here is to enliven, get away from the institutional.
And we always talk about that, bring in even the objective of less sterile by approach in terms of the way it looks to more engaging, more inviting.
Let's focus on this wall for instance.
And I would say that this wall for this actual practice says it all, transforming birthing.
And if you can see some of the small print on your screen, Choice Agency Collaboration has a quote on the wall that says, "I participate in making decisions for myself and my baby."
And to the far side, you see the word empowerment.
So this was an opportunity for the staff and for this medical practice to really take it upon themselves to offer something new, offer something different to actually say you've got options, okay?
You don't have to have that cesarean, right?
You actually can give that birth naturally.
Further you can see down that hallway color.
Well you want your, that the pregnant mother to ambulate and exercise.
So they're walking down this path here again, vibrant colors, invitation, getting away from, once again the institutional, although we are still engaging by way of the nurse station and so on.
But even getting into the room, what did we talk about a little bit ago?
Hospitality, but we also talk about residential.
If you take a look at the bed that looks like a contemporary bed that you might find in your own home or a home, not the hospital, certainly.
The colors, the fabrics, the material usage, just the entire vibe, including the curtains, you feel at home.
Okay, so from a local culture standpoint, you're engaging those who have the ability to make those choices.
You have the ability to be autonomous in selecting this option, okay?
You can see the birthing tub in the far right hand corner, but everything else, it looks like an apartment, if you will.
Or what you might find in a more contemporary home.
Beautiful stuff.
Now we're gonna go completely opposite.
That was the 5,300 square foot building.
Now we're going to Kuwait University.
And it's more formally known as the Sabah Al-Salem University City.
And this is located in Kuwait.
This actual campus is a 600, offers a 690 bed hospital, but also a 1.5 million square feet.
Okay?
So we just got finished talking about 5,300 square feet healthcare application.
We talked about the midwifery, here, we're talking about inpatient and outpatient services in Kuwait.
This is one of the largest educational campuses in the world.
And this building that you're looking at is designed by Perkins Eastman.
This is part of a consortium though, that's a consortium of other firms like (indistinct) who happens to be doing the research center, the academic side of this campus.
And this campus, by the way, is located just west of the main campus in Kuwait City and the campus center itself, just to kind of give you a sense of scale here, again, I wish I could ask for a rise of hands, but the Texas A&M campus, for instance, is 5,200 acres.
It's huge.
This one is 1.5 acres.
And, and so when you take a look at the size of the A&M campus and chop it up into four pieces, that fourth piece, that would be the size of this campus, very, very big.
Huge.
And to wrap your brain around that, obviously having a team that's local to this site in Kuwait is advantageous.
The teaming up just as I did with my team out of Egypt.
Understanding the local cultures, understanding what's going on with the manner of how work is done, how work is actually divided and so on.
You have Perkins Eastman, as I mentioned, (indistinct), the Ted Jacob Engineering Group, and Dar Al Jazera Consultants.
What's very unique about this project though, is that it's kind of like a gem, a diamond.
And I know that we're reaching a stopping point, so I'll come to a close quickly here.
So here we are looking at the block diagramming as well as the means by which we actually take the plan, devise the plan, the vertical towers themselves and the bed towers, the mechanical building systems, the podium.
And here's what it will look like.
And what's critical about this is that you don't see, let's go to the site plans.
You see a sea of parking, okay?
But not as much as there could be.
There's a vast amount of parking underground.
Okay, why are we doing that?
So that we can actually maintain as part of this gateway, this entry to this campus, focus on what the patient wants to see, needs to see.
This is my destination, this is where I'm going.
I'm not going to a parking garage, okay?
I'm actually going to a healthcare services center.
So this healthcare campus that is telling me to come here, you're actually looking at the north side of that hospital.
The triangulation of the patient towers is actually done so that we're actually minimizing the number of views from one patient room into another, but also at maximizing views to everything else around this campus.
So here again, it's understanding where you are from a climate standpoint, a environmental standpoint, but understanding your teammates as well.
And I'll leave you with this, that everything that we do as architects in healthcare is about an episodic opportunity, okay?
Every project that you do, large or small, garners those opportunities for you to engage at the various levels that I just went through.
So I'll end right there.
I really do appreciate your time listening to me, hopefully you got a couple of chunks of knowledge.
I think the biggest thing I'll just reiterate is that passion.
Okay, that passion for what you do.
Okay, recognizing full well that it's got an impact and the opportunity for influence on someone or something.
Thank you.
(audience applauding) I'll leave it to the segment for Q&A and I believe that I haven't seen any questions come across my screen.
So I don't know if anybody's going to be receiving questions.
Anybody from the group, by all means there's an opportunity to come up here to the microphone and ask me any questions you possibly can.
Anything that comes to mind and don't make it a hard process.
Alright?
There's, yes, you probably want to not get up here and embarrass yourself, believe me, you're not gonna do that.
There is no such thing as a poor or dumb question.
Be inquiring minds.
So ask me anything except Bill Edy.
You're good.
- Well thank you very much.
It was great.
I really enjoyed it.
Learned a lot.
I have a lot to learn.
So initially I was gonna ask a question about Western culture and its overwhelming non-Western culture and the way of design.
And so yeah, thinking about that a little bit and I'm curious, have you run across any non-Western culture elements that have influenced either how architecture is made or the architecture itself?
- You know, it's interesting 'cause we were actually having somewhat of this discussion even earlier.
I can't say that I have directly, but I know that members of my team have, I mean, again, we're looking at a firm that is well over 1,100 people across this globe.
And so I know that those things have definitely happened because there is an intrinsic sense of what's happening in that location that you might discover that is non-Western and how you're going, how are you going to approach that?
What's fascinating about this, from my perspective and from what I've read and what I've seen and researched, this globe has become so small from a healthcare application standpoint, even though we may say the Western medicine is of its own, and that there is no other genesis of medicine out there that is so different from us, we are sharing so much now because of the platform we call the internet.
Everything is so accessible, readily accessible, okay?
But unless we're actually working with an Indigenous population to where we're actually now looking at holistic health to where we're now looking at the mechanization of medicine, now we're talking about closer to what you're describing.
And I can tell you that with the people that I've spoken of or spoken to in Mexico, for instance, in the High Hills, they don't have access to what we're talking about here to the mechanizations, the equipment and the technology.
So how can we actually help them from an environmental standpoint, from being able to build from raw ground, how to further influence how they're wanting to promote their healthcare.
You know, I wish I can show you a project right offhand, Bill, but it's a great question and I just see that our practice of medicine is just becoming so much tighter.
Okay, now you're still gonna have issue of, wants and needs where we're not being able to address certain things.
But I do see that we're closing in on that gap.
There's still disparity, no question.
But I still think that we're gonna have the opportunity to close in on that gap.
- There is still learning.
We don't have all the answers.
- Absolutely.
- Thank you, Carlos.
- Thank you.
- Appreciate very much.
- Well thank you so much for being here today, Mr. Moreno.
- [Carlos] Thank you.
- Your passion for your craft is forgive the joke, but infectious.
And I think we all had something to learn today from you and we really appreciate you being here.
And with that, that's the end of our show.
Thank you.
And please come back again.
- Thank you.
Thank you very, very much.
Thank you.
(audience applauding) (light music)