Andrew Petrosoniak and Al’ai Alvarez on The Process of Health Design

Al'ai Alvarez, MD aka LA is a national leader and educator on Wellness and Diversity, Equity, and Inclusion. He is a clinical assistant professor of Emergency Medicine and the Director of Well-Being at Stanford Emergency Medicine. He co-leads the Human Potential Team and serves as the Fellowship Director of the Stanford EM Physician Wellness, and Co-Chair of the Stanford WellMD's Physician Wellness Forum. His work focuses on humanizing physician roles as individuals and teams through the harnessing of our individual human potential in the context of high-performance teams. This includes optimizing the interdependence between Process Improvement (Quality and Clinical Operations), Recruitment (Diversity), and Well-being (Inclusion). Currently, he is one of the 2021-2022 Faculty Fellows at the Stanford Byers Center for Biodesign. 

Andrew Petrosoniak MD is a trauma team leader and emergency physician at St. Michael's Hospital in Toronto, Canada. He's an assistant professor at the University of Toronto and he leads the translational simulation program at St. Michael's Hospital. His research focuses on the use of in situ simulation and design thinking to support human-centered care. He's also co-principal at Advanced Performance Healthcare Design, a firm that consults with hospitals, start ups and high stake industries using simulation to improve decision making and inform the design of systems, spaces and teams. White paper on simulation informed design.

In 2004, Patrick MacLeamy drew a set of curves based on a pretty self-evident observation: an architectural project becomes more difficult to change the more developed it becomes. For this earth-shattering revelation MacLeamy named the curve after himself (although the title should probably go to Boyd Paulson who drew the curve much earlier [see Noel’s comment to this post]). You have probably seen the graph before. It gets trotted out in every slide deck promoting BIM / IPD / or early-stage environmental analysis.  The key point is that architects expel their effort at a time when design changes are relatively costly. MacLeamy and his disciples advocate shifting design effort forward in the project, front loading it, in order to reduce the cost of design changes.