A Consciously Applied, Design-Driven Dialogue Can Improve Healing Architecture.

OBJECTIVES This article states that a consciously applied, design-driven dialogue can improve healing architecture. There are different forms of knowledge, beyond evidence, which are partly hidden from our consciousness. We call this type of knowledge tacit. By using a design-driven dialogue, where staff and management participate in the design process, this tacit knowledge may transform into a more conscious and explicit one, a kind of knowledge that will inform the architect's work in a richer way and thereby increase the possibilities for improving healthcare architecture. BACKGROUND Among proponents of evidence-based design (EBD), there has been an aspiration toward rigor to avoid arbitrary decision making. The concept of evidence has been put forward as a way to achieve this. Some of the advocates of EBD have looked upon subjective and aesthetic decisions with great skepticism. However, today, there is a growing number of architects who have lately become critical of that attitude in design. They search for alternative ways to understand the use of different kinds of knowledge in order to promote better architecture. This article aims to overcome some contradictions between different ways of looking at the design process. METHODS This discussion article is based on personal introspection and literature studies. The personal experiences referred to stem from three major design projects for general and forensic psychiatric care facilities. RESULTS This article presents a tentative design theory on how a design-driven dialogue process can be formed in order to achieve better outcomes in healthcare architecture. CONCLUSIONS How the design-process is driven has a vital influence for the physical environment and its impact on treatment outcomes.