Facility Design: A Catalyst for
Translational Health Science Integration
The idea of translational research (taking discoveries to patient benefit) has been discussed as an issue for the 30 years I have been working as an architect in the areas of healthcare and science and technology. Although there have been some notable successes of rapid translation—such as the highly active anti-retroviral therapy (HAART) for HIV infection which was rapidly developed and has drastically changed the mortality rates for infected individuals in the U.S.—for the most part advances that benefit patients have been few and far between given the size of the overall research enterprise. The time frame required for moving a discovery to application is also far longer than ideal.
Over the last decade, many international studies have identified "gaps" in the process of taking a discovery, new approach or invention to application in patients. These gaps cause delay and even stop progress in many instances. During the last five years, significant effort has been made to understand the lack of progress at organizations with a goal to take more research to patient benefit. In conjunction, much work has been undertaken to look at facilities previously identified as "translational" and understand how they can contribute better to the goal of improving patient outcome.
Based on these efforts and new funding opportunities, some of the world's leading healthcare organizations are transforming themselves to integrate research, education and healthcare to better leverage their expertise to benefit patients. Over the past twenty years, much of the focus has been on the "translational research" environment (laboratories and clinical research facilities) with the hope that the key to "translation" would be found there. We are finding that far more involvement with patients is necessary to gain a full understanding of disease. This is pushing the convergence of research, education and clinical care deeper into the healthcare environment than has previously been the norm. This integration is not just affecting the academic centers commonly associated with health research, but is also starting to regionally, in community and primary-care settings.
As we move toward accountable care where improvement in patient short- and long-term outcomes may dictate success and failure, leveraging research to accelerate improvement in patient outcomes will be critical, but not an easy task. Separating clinical, scientific and engineering teams and expecting knowledge to be exchanged among them, is unrealistic. Leading institutions are beginning to take steps to increase convergence to solve these complex problems. Taking translation into the healthcare environment is requiring many healthcare leaders to rethink their facilities, to look to the built environment as a catalyst for cultural, organizational and process change, conducive to interactive behaviors.
New tools and technologies are creating the ability to understand and solve problems in ways barely imaginable twenty years ago. The promise of both personalized and preventative medicine is being realized. We need to rethink our organizations and facilities to better leverage the combined knowledge of our people.
Jon Crane is an architect with over 30 years of experience in designing health, science and engineering facilities for leading academic, corporate and governmental institutions. He has worked in North America, Europe, Asia, Australia and Africa on integrating health, education and science facilities. Jon leads HDR's Translational Health Sciences Initiative, working with global thought leaders to better understand the impact of organization and facilities on success in translating discoveries to patient benefit.