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What is the Design Phase?

The Design phase includes schematic design (SD), design development (DD), and the creation of construction documents (CDs). The phases range from high-level concepts in schematic design through refinement of details during design development, and providing all information required for bidding and building in construction documents.

 

Depending on how the project is implemented, these phases can overlap. For example, if your project is design-build, certain aspects of the building (such as building infrastructure) may be finalized before others (such as interior details).

 

During the design phase, the design intent should illustrate the relationships between project components (adjacencies, forms, size, and overall appearance). Floor plans, sections, ceiling plans, power/communication plans, finish plans, elevations, construction details and written specifications are refined for the project. Coordination with mechanical, electrical, plumbing, fire protection, and other building systems are completed during this phase.

 

Some question you should ask during this phase are:

  • What project components require outside expertise such as lighting design, landscape design, wayfinding, or acoustical design? 
  • How can the site topography be maximized to capture the best views, building access, and landscape features?

 

Many design decisions of varying level of detail need to be made at this stage. Activities occurring during design that are also led by the healthcare organization include: selecting a construction manager/general contractor for estimating, if not already engaged during predesign, determining specialty consultants needed for project, initiating the permit process, and developing a purchase plan for items not included in the design and construction scope of work (often furniture and equipment).

 

Design Activities

Activities developed during this phase that are led by the design team include: refining the space function/flow analysis, confirming the conceptual diagramming developed during pre-design, and architectural design process (schematic design, design development, furniture fixtures, equipment, technology planning, and construction documents).

 

Evidence-Based Design

The evidence to support design concepts gathered during the pre-design phase can be supplemented with additional detailed evidence to answer specific issues or questions that come up during design. Review and interpret any additional evidence for its quality and applicability to your project.

 

As design details are developed, you can create preliminary hypotheses linking the design innovations with potential outcomes—for example, the use of a defined entrance and clear signage will improve access and navigation for patients. Define outcome metrics for the set interests prioritized by your organization and collect baseline data in the existing facility (if relevant).

 

The EBD steps that occur in this phase include: Step Four: create and innovate EBD concepts; Step Five: develop a hypothesis; and Step Six: collect baseline performance measures. See the Evidence-Based Design Tab for detail about the EBD activities during this phase.

Evidence-Based Design Activities

The team identifies specific topic(s) for research and translates selected research topics into hypothesis(ses) about the relationships between design solution(s) and targeted outcome(s). Not every hypothesis needs to become a formal research project, and the organization should establish how many measures are already collected as part of a standard operating or reporting process.

 

From a clinic perspective, having a team member familiar with evidence-based design or research will help you understand where outside resources and expertise may be required. There may be existing tools and methods available to use, but there may also be new material to be developed. If the clinic is associated with a hospital, there may be an identified process to work through the hospital’s IRB protocols. However, where an affiliation does not exist, there are independent IRBs that approve individual projects. Unlike clinical trials that have a direct clinical impact on patients, research surrounding the built environment is usually considered less invasive, and most often is considered as part of an expedited review process. Most peer-reviewed journals require IRB approvals to publish results.