We met Annie Coull during UX Week 2015 back in August. We witnessed her unique sensitivity to the special needs of children, families and staff in the healthcare setting.

We had the opportunity to talk with her on myriad topics including her talk, “A Journey Like No Other” at UXWeek 2015.

Here’s the the first part of our conversation.

What Would You Say Is Your Background?

My background is in Early Childhood Studies and Architecture, of course.

I have experience in the area of Child Development through work in settings for children with special needs and their families. I then moved on to additional education in Architecture and continued my career in that field for the last 30 years, focusing on healthcare design and especially on healthcare environments.

What’s Your Process When Designing for Different Types of Users?

In the old days we would meet with every user group separately in order to understand their needs;  how they work, how they wish to work in the future, and how that translated to basic requirements.

As time has gone by, we have realized is that it’s better to take people out of those separate silos and bring them together. This follows what’s happening in medicine today which is much more integrated, more collaborative, and more based on system than department.

We did this so that these folks can have conversations with each other and with us about how it will work on a bigger scale than just an individual department. So that is the approach that we have now as opposed to years past. It is very important to have people become involved with what you are presenting to them so that they can understand it.

And that is everything, they can interact with including two dimensional materials on the table to three dimensional mock-ups, and virtual reality which is now supporting more robust and easier to create tools for people to understand the design decisions they need to make.

Is It Difficult to Bring Stakeholders from Different Backgrounds Together?

I think that initially there may be some resistance. As an example, one of the hardest barriers to break down is between imaging and surgery. The boundaries between those two have really blurred and become less clear in that there is more imaging technology in the surgical environment and more basic procedures within the imaging department.

So, by logic, they want to come together more but they are traditionally very, very driven by their own needs and their own identities.

But there are many where it is easier once you demonstrate the value of bringing folks together. When they realize it themselves, they are more willing to be engaged that way. And you have to follow this up with meeting them individually to get their tweaks on what you come up with together because invariably each of them has a requirement that’s unique.

How Is Research Perceived in the Healthcare Industry?

In healthcare there is a wide range of how research is considered.

In an academic medical center, research is part of the mission. For them research is an integral part of what they do.

You have probably heard of Translational Research which is where people are learning about the impacts of research investigations on actual delivery of care. And that information wants to be transmitted fairly quickly so that you will have applied research in the clinical setting.

Even then, it is still challenging. I think there is medical research, scientific research, and then there is environmental research in our discipline.

Is It Hard to Convince Healthcare Providers to Focus on Environmental Research?

Environmental Research answers the question: How can the environment make a difference in outcomes for patients? This has become, in the last ten years, much more accepted by any healthcare provider that is interested in quality.

There is evidence that environmental factors such as natural light and access to nature actually shorten length of stay or decrease the amount of medication needed.  This has been demonstrated in research studies.

There are other aspects of design that can support safety, and create an environment that can help people do the right thing.  For example, staff are less likely to give the wrong medication, or do something on the wrong patient or on the wrong side of the patient.

More environmental research is required to demonstrate those design features that make a difference.

What Can Be Gained from Environmental Research?

As practicing architects in the environmental research area, we can contribute to the body of data by going to a client and saying, “we would like to engage you in an investigational study of something in your existing condition and something you would like to change and that we can improve in your new healthcare environment, or future condition, that we are going to help design.”

For example, we can measure the current rate of injuries and then measure it again in your new facility. Hopefully injury rates have decreased due to one or more design features. That data can be published and contribute to the body of data where many others have studied similar things.

We can also use whatever is published and promote it to the Center for Health Design, for example. We can then take that to clients and say, “Well, here is the evidence that doing XYZ actually results in better outcomes XY and Z. So we’d like to have you consider this in the design of your new facility.”

About Annie


Annie Coull is an architect with over 30 years of leading healthcare programming, conceptual planning, and project detailed design.  She has pursued a special interest in facilitating teamwork that successfully synthesizes diverse user input and a breadth of architectural options. Her main focus has been children’s facilities, women’s services, ambulatory care and other tech-driven areas of the healthcare industry.   Nowadays she’s a VP  at Stantec.

Our thanks to Annie Coull for sharing her experience in the Healthcare Industry and Environmental Research.

In part two of this interview, we will talk to Annie about evidence-based design, the value of designing an experience, and life as a design researcher.

For more, contact Diana Arvayo at [email protected]