
Welcome to Contract magazine's annual issue focused on healthcare design. On the cover, you'll see the winner in the acute care category of our Healthcare Environment Awards—Butaro Hospital in Rwanda by MASS Design Group. That's right, one of the competition winners is a hospital in rural Rwanda. There, the healthcare delivery processes, issues confronted, and the places in which care has traditionally been provided are a sharp contrast compared to what we are accustomed to in the United States. I hope that the cover, and this remarkable project will make you sit up in your chair and take notice, just as it did for the awards jury.
Knowing that I am still new to a number of Contract readers, I will take this opportunity to add a more personal touch to this editorial and continue my introduction to you. Healthcare and healthcare design is a topic that has been important to me since I began my career. While in graduate school for master's degrees in architecture and urban planning in the 1990s, I was working for a healthcare planning consultant on projects ranging from health policy strategic plans for cities and counties to long-term plans for healthcare and senior living facilities. Working side-by-side with thought leaders, including a former public health commissioner of a major city, I learned a great deal about the multifaceted nature of healthcare delivery and healthcare's impact on our lives, from policy to buildings. What was important? The human impact of the decisions that influence public health, as well as the places in which care is delivered.
In my previous capacity as acquisitions editor at the publisher John Wiley & Sons for eight years, I had built a substantial list of key healthcare design books written by practitioners for practitioners, including Sustainable Healthcare Architecture by Robin Guenther and Gail Vittori, and Design Details for Health by Cynthia Leibrock and Debra Harris. As Rosalyn Cama points out in her feature story on advances in evidence-based design, I initiated a conversation with her five years ago about writing a book on her expertise. That book, Evidence-Based Healthcare Design really is the title on the topic, and was prescient in its release in 2009. As Cama points out in her article in this issue, since her book published, "Those practicing [evidence-based design] have produced enough data to develop the business cases necessary to show the benefits of particular design interventions' first costs revealing their health, organization, and economic return on investment."
All designers should care about healthcare design, even if this is not a building type one is engaged in. Advancements made in healthcare facilities have a broad impact on architecture and interior design practice for multiple building types. For example, evidence-based design emerged primarily in healthcare design, but evidence is now being readily applied to the design of many types of projects, including schools and even workplaces.
We all, individually, encounter healthcare architecture at points in our lives. For me, I personally became intimately aware of healthcare settings in the full continuum of elder care in recent years prior to when each of my parents had died. In those years, my siblings and I were immersed in being a part of that continuum with an elderly parent, from assisted living to subacute rehab to acute care to hospice care. I know many of you have had to do the same. I toured and interviewed more than a few assisted living facilities for and with my dad. What was clear was this: place matters. It matters to the patient, the caregivers, and the family members who are decision-makers for a patient's care.
Healthcare design impacts all of us, in all stages of life. The work presented in this issue—from a hospital in Rwanda, to a range of projects in New York, Seattle, and Houston, to the winners of the Healthcare Environment Awards—offers lessons for all readers about design for humanity.
Sincerely,
John Czarnecki, Editor in Chief







