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Audible City: Intern Summer Program 2014

Healthy Cities is a topic that reaches city goers in many shapes and forms. Addressing the definition of a healthy city is a difficult task; an individual’s idea of a healthy city is shaped by their experiences. This past summer, MKThink proposed to its three graduate interns: What is a Healthy City? Kelsey Brennen, Sean Mengyue Niu and Katie Peksa, embraced this subject and began to follow MKThink’s six-step process: Discovery, Assessment, Strategy, Planning & Design, Prototyping & Testing, and Implementation.

Listen!

The discovery phase began with investigations into personal interests; homelessness, air quality, vertical farming, food deserts and neighborhood health, and heart disease. Individual discovery quickly transformed into group collaboration and knowledge sharing on this vast subject. There are many factors that make a city tick and each one of them is interdependent of the next. For example, noise levels, green space, hardscape, theft, assault and heart disease are all interrelated. Not one factor can be removed or improved to “fix” an urban issue. These issues are intertwined in the ever-changing organism we call the city. Through group collaboration and investigation it became evident that sound and its important yet discounted impact on our everyday lives was a topic of interest to all group members.

Mapping Sound Levels, Green Space, Race, and Income in San Francisco

Sound is an invisible, pervasive and underutilized resource in the design of the built environment. Its levels correlate to socioeconomic conditions, physiological impacts and individual experiences. Conscious or not, our individual auditory spheres guide us to known and unknown destinations. Sound is also part of the fundamental makeup of the city’s various neighborhood identities: whether that’s a musician at the 16th and Mission BART or the parrots on Telegraph Hill. While neighborhoods are often thought of as simple, geographic boundaries, sound provides an opportunity to share and connect to an underrepresented aspect of community identity.

Cities have grown significantly louder since the industrial revolution, largely due to motorized transportation. Despite this, it has been treated as a secondary problem from a city planning and policy perspective because noise has been viewed as “less offensive” compared to other issues like sanitation (smell).

Sound and Crime Mapped on Market Street

Over the last century sound technology has moved from a shared event to an individual one. The megaphone, radio and even the first Walkman encouraged communal experiences, while the CD & mp3 player as well as today’s cell phones foster individual enjoyment.

Individuals and Groups

Sound intervention into daily life is fascinating and deserves a conscious recognition. Therefore it became the focus of the Strategic, Planning & Design process. Sound guides both visitors and locals through the city and triggers similar feelings or a vastly different ones depending on previous personal experiences. Classical conditioning affects responses; a car horn will evoke a sense of attentiveness while a song can elicit strong emotions.

The Prototype development phase has been driven by a fascination of sounds ubiquitous infiltration. The installation evolution is centered on an auditory intervention that collectively engages the soundscape of the city. After users enter the installation, they can have a shared experience guided by a collage of individually recorded auditory experiences that subsequently draw a new map of the city

Hows Users Interact

Using a downloaded application, individuals that have an audio experience they want to share record the sounds of their environment. The recording is uploaded to a database and queued to play within the installation. Those present within the installation can be connected to that time and user through a shared auditory experience.

How to Use the Application
In its physical form, the installation will offer a buffered space in which users can listen to digitally recorded sounds.

Users Wait Outside the Installation

By providing a space where people can listen together to collected sounds in the city, Market Street can become a place to share dispersed experiences from around the San Francisco. Because these snippets are uploaded by people connected to the installation, the recordings can be interpreted as a fractured narrative or map of people who have previously passed through the space.

User Inside the Installation

Mozilla Mountain View Featured on Office Snapshots

Office Snapshots Online

MKThink’s recently completed workplace for the Mozilla Corporation is featured today on Office Snapshots, who, in their words, “displays and discusses the latest designs and trends in office design.” The 54,000 square foot space was designed after an extensive engagement process with over 200 ‘Mozillians’ to determine the most effective and efficient use of their space. Read more about the project on our website, here.

Rethinking Buildings to Heal Patients: The Shift Toward Energy Efficiency in Hospital Facilities

Figueredo_Headshot2014_WhiteBackground

 

by Isabel Figueredo, Researcher/ Analyst

 

How do we maintain satisfaction among a growing patient population while decreasing the immense amounts of energy consumption in hospital facilities? The answer is complicated.

Energy consumption is one of the most prevalent problems facing U.S. healthcare delivery. U.S. healthcare facilities spend 8.8 billion dollars on energy annually. Individually, they use almost three times the amount of energy a typical office building requires (Bendewald and Tupper 2013). As a result, there has been a dramatic shift towards energy efficiency initiatives that can decrease operational expenses while allowing the facility to retain maximum operational efficiency and patient satisfaction.

Retrieved from: http://www.nationalgridus.com/non_html/shared_energyeff_hospitals.pdf

Retrieved from: http://www.nationalgridus.com/non_html/shared_energyeff_hospitals.pdf

Managing energy costs in hospital facilities is never straightforward. Almost all hospital facilities are open 24 hours and require cooling and heating systems that vary significantly by climate (Bendewald and Tupper 2013).

“In a typical hospital, lighting, heating, and hot water represent between 61 and 79 percent of total energy use depending on climate”.(National Grid 2014)

Although there are basic fixes and practices that can be conducted in order to decrease overall energy use, the tools for understanding space occupancy, activity, and energy requirements have yet to be effectively constructed or deployed. In other words, there could be an air-handling unit that is serving an unoccupied area at night, but how do we know it is unoccupied (National Grid 2014)?

By being more energy efficient, hospitals could assist in preventing greenhouse gas emissions, improve the air quality in their local communities, and serve as a lead example in their dedication to public health (energystar.gov). An even larger selling factor is that by being more energy efficient, hospitals would save a significant amount of money. As an example, the New York Presbyterian Hospital (NYPH) has developed diligent energy saving initiatives since 2003, and as a result saves $1.77 million in annual savings. Providence Health and Services, a Seattle-based healthcare system has made similar advances and has increased their energy savings from $700,000 in 2003 to $3.4 million in 2006 (energystar.gov). Even so, the majority of hospital facilities have made very little progress towards addressing these challenges and opportunities.

In order to holistically rethink systems that generate inefficiency, it is also important to consider other issues the healthcare system needs to address. For example, new policies and regulations have made health care more accessible to a much larger population (Anderson 2014). Because of this increase in access, healthcare organizations’ energy demand costs are dramatically spiking to meet patient needs. With volume increases, hospitals simultaneously struggle to maintain overall patient satisfaction, the basis for their Medicaid reimbursement revenues.

Hospitals view patient satisfaction as a key priority for various reasons. It has a heavy influence on revenue, cost, and government reimbursements. Hence there has been an abundant push towards studying what factors within the hospital environment can affect a patient’s overall experience. The majority of this research has focused on social environmental factors, such as the staff’s attitude and its effect on patients’ experience.

Even though there has been less focus on environmental and architectural design, there is still a significant amount of existing empirical research to suggest that properly designed hospital facilities can improve patient safety, satisfaction, and overall experience (Reiling et al. 2008; Joseph et al. 2011). Evidenced-based research has also found that properly designed hospital facilities can decrease the facilities’ energy consumption and energy costs (Bendewald and Tupper 2013). Regardless of the multiple studies conducted on each subject, there has been little to no research that suggests looking at the relationship between them.

Understanding the relationship between energy consumption and patient satisfaction and their influences on hospital productivity and cost can lead to essential information the healthcare system could use to decrease energy consumption while maintaining or increasing overall work functionality.

Fig 2. Energy consumption and its relationship to patient satisfaction. Graphic by Annie Liu

Fig 2. Energy consumption and its relationship to patient satisfaction. Graphic by Annie Liu

It is evident that further research is required to explore how physical structures and environments interact and shape cultural outcomes within hospital facilities. Understanding how the environment, culture, and facility structure may influence the overall experience of the patient is essential to helping hospitals meet their primary objective of customer satisfaction.

Architecture, Culture, and Assets all intersect to create a holistic understanding of how patient health is contingent on multiple factors.

Architecture, Culture, and Assets all intersect to create a holistic understanding of how patient health is contingent on multiple factors.

MKThink believes that opportunity for operational and planning improvements can be found through studying the relationships between physical and social structures. We have developed a framework that studies the overlaps of three dimensions: Assets, Environment, and Culture. This logic has been used to help give organizations the ability to increase human performance, use fewer resources through optimized resource use, and develop more effective investments in technology and energy efficiency. The initiative has already been supported through the Office of Naval Research (ONR) and the Asia-Pacific Technology (APTEP), and is in the process of expanding and becoming more accessible, non-technical, and efficient.

Implementing this unique framework could benefit hospital facilities in determining what decisions would be the most effective in order to decrease their energy consumption while retaining or even improving overall patient satisfaction.

With all this in mind, back to the original question: how do we maintain satisfaction among a growing patient population while decreasing the immense amounts of energy consumption in hospital facilities? It is still complicated. However, the first step is to reform the way we think about current issues within the healthcare system. Only then can we can use the rapidly developing technologies and preexisting cultural factors around us to determine what the most efficient, cost-effective decisions for the future would be.

 

 

Cited references:
Anderson, Amy. 2014. “The Impact of the Affordable Care Act on the Health Care workforce.” The Heritage Foundation, March 18. Retrieved September 8,2014. (http://www.heritage.org/research/reports/2014/03/the-impact-of-the-affordable-care-act-on-the-health-care-workforce).

Bendewald, Michael and Kendra Tupper. 2013. “A positive diagnosis: How hospitals are reducing energy consumption.” Green Biz, November 21. Retrieved August 9,2014 (http://www.greenbiz.com/blog/2013/11/21/health-care-energy-consumption-retrofits).

Energy Star. Healthcare and Overview of Energy Use and Energy Efficiency Opportunities. Retrieved August 8,2014 (http://www.energystar.gov/ia/business/challenge/learn_more/Healthcare.pdf).

Joseph, Anjali, Eileen Malone, Debajyotie Pati and Xiaobo Quan. 2011. “Healthcare Environmental Terms and Outcomes Measures: An Evidence-Based Design Glossary.” Tandus Flooring, November 2011. Retrieved September 8,2014 (https://www.healthdesign.org/chd/research/healthcare-environmental-terms-and-outcome-measures-evidence-based-design-glossary).

Reiling, John, Ronda G. Hughes and Mike R. Murphy. 2008. “The Impact of Facility Design on Patient Safety.” Patient Safety and Quality: An Evidence-Based Handbook for Nurses, edited by R.G. Hughes. Rockville, MD/United States: Agency for Healthcare Research and Quality.

National Grid. Managing Energy Costs in Hospitals. E Source Customer Direct. Retrieved August 9,2014 (http://www.nationalgridus.com/non_html/shared_energyeff_hospitals.pdf).

Other references:

http://www.hermanmiller.com/research/research-summaries/adaptive-facilities-correlate-to-patient-satisfaction.html

MKThink Lectures at SPUR: Innovation, Prototyping, and You

Allan's talk addressed collected information about people on the street using sensors and how we are able to measure pedestrian traffic, clusters, and paths of travel, by assessing this sensor data.

Allan’s talk addressed collected information about people on the street using sensors and how we are able to measure pedestrian traffic, clusters, and paths of travel, by assessing this sensor data.

MKThink Senior Strategist Allan Donnelly was at it again last night, lecturing at the San Francisco Planning and Urban Research Association’s “Innovation, Prototyping, and You” event last night at their headquarters downtown. In response to the question, “What makes an urban space special?” Allan lectured alongside the likes of Jason Kelley Johnson of Future Cities Lab, and Neil Hrushowy of the San Francisco Planning Department.

Allan used the example of the Living Innovation Zone and talked about how we collected information about people on the street using sensors and how we are able to measure pedestrian traffic, clusters, and paths of travel, by assessing this sensor data. He also talked a little bit about how using this data can help designers to develop highly detailed models of complex systems so that we can make better decisions at the planning and architectural level.

Senior Strategist Allan Donnelly Speaks on “Internet of Things” Panel @ Method Design

From L to R: Moderator Patrick Hussey, Eric Rodenbeck, Paul Cloutier, Jim Walsh, and MKThink's Allan Donnelly.

From L to R: Moderator Patrick Hussey, Eric Rodenbeck, Paul Cloutier, Jim Walsh, and MKThink’s Allan Donnelly.

MKThink Senior Strategist Allan Donnelly spoke last night on a panel at Method Design, a San Francisco and New York-based design consulting firm. Speaking alongside Jim Walsh, CTO of GlobalLogic, Eric Rodenbeck, Founder and CEO of Stamen Design, and Paul Cloutier, Principal at Method, Allan discussed the advanced connectivity of data, products, systems, and services, and the ramifications these connections have on design and business.