Tune in to our podcast as we take a deep dive into design simulation. In this episode, we explore how we use advanced techniques to create realistic mockups, allowing clients to experience their future spaces in detail. Don't miss this fascinating discussion!
Skyler: Welcome to another episode of Laying the Foundation. Welcome everybody to another episode of Laying the Foundation podcast. I'm your host, Skyler, and I'm here actually live at the Iowa Health Care Commission conference here in Altoona, Iowa, And I'm here with Kylie, who's one of our interior designers from our Des Moines office, And I'm here with Angela, who we've actually talked with before on a previous episode. She's from our Spencer Iowa office. Welcome to the show. Both of you Hello.
Angela: Thank you for having us.
Skyler: Absolutely. If you hear any noise in the background, that's because we're live from this convention. There's a little bit of background music playing in the background, but no problem, i think we'll be doing okay with that distraction. I think we can push it out of our heads. But because today we're at the convention about healthcare, we're going to talk about healthcare and we're going to do a bit of a deep dive into design, simulation And a lot of that, specifically when it comes down to healthcare spaces. So, kylie, do you want to kick us off with some of the key topics that go into this concept that we're going to go into today?
Kylie: Yeah, so design simulation is a great way to sum that up, but I think the way we thought about this topic was through the cardboard mockups that a lot of our team members have used at CMBA to walk clients through spaces, and so, thinking about that tool, we broke it down into a few topics and how we use that in our design process. So I guess topic number one is what I was calling studying the client, referring to it as secondary information, because this is before the cardboard mockups, when we sit down with them in a meeting and they tell us like, hey, this is what we imagine our space will look like because we use it in this way, but it's words and not like visualizing them in this space. So that's what we do before we even get to the mockup part of it.
Angela: Yeah, absolutely, and I think it's important for listeners to understand that the cardboard mockups is a physically built room or a physically built environment constructed sometimes out of cardboard, sometimes out of like a blue foam insulation. It is the room constructed out of some sort of material that the client can interact with, and this can be as inclusive as doors and drawers that move. Sometimes in healthcare, we'll have them bring in their own equipment Maybe they'll bring in a bed or a stretcher and interact with the space. To help them fully understand if we were working in this mocked up environment, what would it look like? Oftentimes we will pin up different things on the wall simulating the equipment which we'll touch on a little bit more. But to Kylie's point, before we can ever get to that stage, before we can ever get to we're going to build this thing we need to take a step back and understand how they're going to function in this space.
Skyler: Because, at the end of the day, it's really about the client and the people that are specifically going to be using that space.
Angela: Yeah, absolutely.
Skyler: We tailor so much of what we do very specifically to what they need And sometimes that can be like, from what I've been told and from what I've had you guys mentioned to me before, it can be something as small as like could we raise this outlet up like a couple of inches just to make it more accessible or more convenient for the staff, because obviously, at the end of the day, we want them to be comfortable in their space, we want them to make the full functionality out of their space. I suppose.
Angela: You're correct, and Kylie had used a great phrase earlier when we were brainstorming of user expectation. We want the space that they end up with at the end of the day, at the end of our project, to meet the expectation of how they would, in an ideal situation, function. We don't want the outlet location to be causing undue stress at a time when their main focus needs to be patient care, quality care and measurable outcomes for their facility.
Skyler: Right, right.
Kylie: And I have a couple of thoughts on that. So first, it's like managing their expectations, a lot of them. when they look at a plan and we tell them, like this outlet's going to be at standard height, they didn't even realize there is a standard height. What does that look like? And then they're saying to us I need to have this piece of equipment on the counter and it needs to be plugged in at all times. So that's our cue to say, okay, you need an outlet above the counter. And those are just things that they would never look at the plan and be like ooh, did you make sure that there's an outlet above the counter there? So I know that's our responsibility, but it's something that we maybe won't catch until we watch them walk through their motions, because they just don't know how to say it to us.
Angela: Right. Yeah, that's a fantastic point. Yeah, i think the things I do myself take for granted understanding when you look at a drawing are not always clear to people that that is not their day to day work, right.
Skyler: Right, kind of that concept of like sitting in math class and having no idea what the teacher's talking about, and then at the end the teacher says, and do you have any questions? And you just kind of sit there like I don't, because I don't even know what to ask.
Kylie: Right, you don't even know how to say what you're questioning.
Skyler: Exactly Yeah, so kind of along those lines, awesome, awesome.
Angela: And then helping them understand that if equipment needs to have a permanent home, if this is something you expect to be present at all times, that takes up space. Yeah, and that is space that you will no longer have for writing things or doing things. And to give each designated item a home, oh yeah.
Kylie: Especially in healthcare.
Angela: Especially in healthcare.
Skyler: Huge Because there's a lot of equipment and things that go into the entire process.
Angela: Oh yeah. And also to be able to plan flexibility for equipment that five years down the road they may not even realize they're going to need.
Kylie: Right.
Angela: So that's how you make this space function for years to come.
Kylie :Yeah, and another thing about the mockups that's nice is like we've found that in our most recent experience that one size does not fit all in so many ways in design in general, but then in healthcare, within the same hospital, within within the same facility, it doesn't. They don't fit one unit. I mean, every exam room is designed to fit the needs of the department and even within that they have multiple styles of exam rooms that they may need, and every little piece of casework that we put in an exam room is going to have a different set of drawers and cabinets and a different length of countertop, and so you can't just slap a one one fix to an exam room. So that's why it's helpful to mock up multiple kinds of their exam rooms so that each of the users can be like oh yes, this actually fits what we're going to use that room for.
Angela: And I think to that experience different departments borrowed things when they were able to walk through other departments rooms and say, oh, i didn't even know to ask for that, but now that I see that that would work great for us and it really helped evolve the design into something that when we had sat down with them initially they didn't even think to ask for because their brains just couldn't imagine that, looking in such a way, Right.
Skyler: So, out of curiosity, just something that popped in my head when we do these mockups with like the cardboard layouts and stuff like that is that, is there processes that we do before to kind of mock things up in order to make sure that we're not putting a whole bunch of money into buying all this cardboard and then spending a bunch of time setting it up in one layout and then them saying, well, could we get other layouts?
Angela: So there's sort of a sweet spot of when to do this In our process. we would refer to that somewhere in that design development phase, but maybe a little bit more developed. Okay, if we do it too early on, you risk not having had the full, inclusive conversations about all of their needs and really not having wrapped your head around what their experience should be or what their processes are or where you're going with this design. but if you do it too late, you're so far into the process that you may end up taking so many steps back to redesign and that's not helpful either.
With the example that Kylie and I did. they were were pretty set on their layouts. They had spent some time with these designs. They did end up making some changes based on that In other examples. oftentimes we'll sort of make use of the materials on the fly and kind of make in the day changes to the examples and then create them on the computer. So before we've ever gotten to this step, a model of this lives in the computer. There's drawings, there's documents, there's a Revit file. They may have seen a 3D version of it at some point And we can certainly talk about those other tools. But before we've gotten to this point, they're somewhat familiar with their design and it has already been presented to them in a visual format to some degree.
Kylie: Yeah, gotcha, and what's interesting about the timing and the sweet spot is in this example we keep referencing.
I think the trauma room that we mocked up was the most interesting in that regard, because up until that point we had met a lot with the director of the emergency department, who obviously knows so much about like the processes that go on there, and so we kind of designed that room with her as a representative of her staff, and she did an amazing job. And then, once we get in there with the rest of the nursing staff comes in as kind of like a second wave And we added so many things to their room that are just like little functional things that the director wasn't able to think of because she's not in the room with every case, right. So as they're standing in there, they're like okay, where is this? I mean, every time I come in here to do something, the first thing I do is push this button, and we didn't yet have a location for that button because that's what we needed to mock up for Yeah, so it definitely was serving its purpose in many ways.
Angela: Yeah, that's such great information, kylie, understanding that the user group will react to the space differently than a department head or someone who is maybe in there sometimes Or is maybe a part of the interaction periodically, but is not the day to day first responder.
Skyler: Right.
Angela: All day, every day, utilizing the space, and their reactions were very different and helpful for the end result. Yeah, Awesome.
Skyler: So we've talked about kind of bringing in the equipment and the equipment needs within the space and how we do the mockups for those. We talked about the people that are using the space, the staff members, like you said, that are coming in every day and they need that button or they need their plugins to be at a certain point. What about with technology? So technology is constantly changing. Technology is new. Every day It seems like there's something that's being factored in or being added to the process. How do we do these mockups with the idea that the equipment and the resources that they have in this room that they'll be bringing in once we finish the design might be completely different 10 years down the line.
Angela: I think our intention is always to build some flexibility into the design, the ability for them to change and grow. We could start this project with them and it lasts three to four years.
That's a long time in technology land, that's a long time for equipment sizes to change And so there's a balance between designing for what they have and what they're projecting for the future. Some of that, at a very rudimentary level, could be just making sure that you have extra space on either side of a piece of equipment, making sure that we've looked at the electrical requirements with our consultant data. So many of the equipment pieces that are in their rooms now need to connect to Wi-Fi, or if it needs to be connected to a hard port. have we made that accommodation or knowing in the future this may be coming? We certainly don't have a crystal ball, but we can use our resources. we can use our consultants as resources and the different continuing education opportunities that Kylie and I attend to kind of pull that information together and understand what could be coming down the road for the users.
Kylie: Yeah, and I like that you mentioned the consultants, because I think we've been able to lean on them in those scenarios and say, hey, we're not really able to think of a reason we should be adding this extra XYZ in, and they are able to tell us from their experience. okay, well, in a few years, you can expect this part of it to grow.
We're going to prepare for that in this way, like they have their own set of experiences that they're bringing in that help us plan for the stuff that we're not able to think of.
Skyler: Absolutely.
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Skyler: To learn more about our available positions, visit the careers page at cmbaarchitectscom and apply to join the CMBA team. Like I mentioned before, the process of bringing in a whole bunch of cardboard and putting it all together and creating this mock-up, it's a lot of time and money And obviously, with staff time, that's also money. So it's a lot of money and money. And how, like how do we, I mean, is it worth, would you say in your experience, to the client to do this process?
Kylie: I mean, i have an example in mind that makes me think that it's worth it. Sure, and the example is that you know the provider needs a workstation, and we've talked about this a lot with them, about, like, patient experiences directly related on how the provider interacts with them when they go into the room, and so we've done a lot of research on it. We've laid out exam rooms in ways that are beneficial to that process, and then their workstation and their landing point is really essential to that, and so there's a couple options. I mean, we can build in that desk area for them or we can utilize furniture Like.
Those are the types of conversations, or conversations and decisions we have to make, and the reason I'm using this as the cost example is because those costs do vary quite a bit, and they also lock them in on flexibility. So if we build in their desk and then, a few years down the line, they actually decide they need to move that somewhere else, not only are they tearing out the built-in part, but they're actually purchasing the furniture. So making that decision can happen in real time in the mock-up. So the amount of money spent on the materials and the time to go in and evaluate. That, i think, is very much made up by the fact that in a few years it's going to serve them better than if they had just been like. I guess we'll see if this works best for us.
Skyler: Replacement cost is definitely something to avoid when possible.
Angela: And there's a certain client that this is the right approach for.
There is a certain size of project or dollar amount of a project where we would start to recommend that we do this large of an undertaking. In the example that Kylie and I participated in, outside consultant built them in a space that the hospital rented. So there was that time, there was the consultants time to build them, so there was a fair amount of time invested in that as well. But it is a larger project, and so to change something out of cardboard is a lot easier than to change it out of a built drywall or a built room or moving a column, and so the pros and cons of doing that are easy to see. For another owner, a digital simulated walkthrough using some of our computer tools, using our virtual reality headset. There are other ways to do something similar. It's not exactly the same experience, but at a smaller scale we can start to have them interact with the space differently than a constructed room.
Skyler: Right.
Kylie: I think we should compare those, The 3D digital walkthrough and the physical one, because I think there's an immediate instinctual answer of like well, why wouldn't you just do it all digital? That seems like it's a lot less expensive in time.
Angela: I have an owner that did both And so we have a model. We have a headset. Early on in the process They did the walkthrough. They wore the headset and walked through their space. We've also done walkthroughs with this same owner on the computer multiple times during a lot of our design development meetings. It would be something that frequently the team would do with them.
They still felt the value was there to do a built cardboard mockup. Sure, in this example CMBA constructed the mockup, so that was our team that built them. But there were still things the outlet locations, the adjacencies from other parts of the room. The user groups came in and moved a stretcher around the room. This is an emergency room example So they were able to utilize the space with some of their own pieces of equipment in the mocked up built room. Then they did end up changing some of the dimensions of the length and the width of the room as a result of that, because they were able to physically be in the space with pieces of equipment they knew they had And there was value in both.
They're just different experiences.
Kylie: Yeah, and the value of the digital walkthrough, too, is that it can be spontaneous.
This physical mockup has to be scheduled out quite a ways. I mean they need space to do it, and so, while I think there's exactly what you just said a ton of value in that If there is supplemental ways that we can use digital walkthroughs, it's so helpful in the moment When we're in those first meetings that I mentioned, where we're getting this secondary information. We can really quickly relay to them the way that we're interpreting what they're telling us. So you're telling me you need this configuration, but you, looking on a plan, have no experience with what that will look like when it's popped up in 3D. So we'll do that for you And we'll throw it up on the screen And you can see that quickly, with the disclaimer that things aren't correct right away because it's instantaneous. So it's like you can have the best of both worlds. You can use that tool early on to communicate And then, once you've gotten further into the process, they can go in and physically be in the space once we've built it out.
Angela: Absolutely. I love the example of a hybrid or a spontaneous version of that. You did a great job with the owner that we're working with And you were using a 3D image or an Enscape model of their space And then in real time, we measured pieces of furniture. We showed them. This is two feet away from the screen. This is about how far you would stand. In a very organic way, We used both our physical space that we were in to say, OK, if this computer monitor is in the room that we're looking at on the computer, this is how far away you'd be. Very rudimentary, counting ceiling tiles using a tape measure, But there was a way to use both. That helped that specific owner understand OK, this is how I would interact And that was a huge, huge difference for her.
Kylie: Yeah, Oh yeah. I mean that helped solidify a lot of questions she had And I just think that that worked way better than any way I could have tried to articulate. Sometimes design elements go way beyond what you can provide. Yeah, exactly, You need to show them what it looks like.
Skyler: Well, that definitely speaks to the level of expertise and professionality that you guys obviously have to be able to go into that space and be able to show them, in a number of different ways, what that space is going to look and feel like which is really cool And be able to put them into that spot And, like you said, measure it out and show them. this is about where you'd be standing, or this would be where you're sitting, or if you were doing a presentation. this is about what the layout would look like.
So, that's pretty cool.
Angela: Yeah.
Speaker 4: Well, I appreciate it. I appreciate the compliment.
Angela: Also, I think it goes to the owner's experience.
Kylie: Oh sure.
Angela: We want them to, at the end of the day, when they arrive in the building that we've worked on, not be negatively surprised or not feel as though, oh, i wish this had been done differently. And if there are small things that we can do in the design process I mean, that was maybe an hour meeting to go through and do that spontaneously with them If there's small things in the design process that we can work through that makes their end result that much better, it's so worth it.
Kylie: We took an hour to manage one expectation, and I think that in the long run we're going to be so grateful that the hour exists, because if they had gotten there and it was said and done, even if the finished product was pleasantly surprising to them, it was still a question they had in their head that we were able to take care of at this stage. I think it just saves a lot of anxiety.
Angela: And to have the owner take responsibility for their space and ownership of that And that was a decision we all made together. I mean that could have been a paragraph email saying, well, this is just how it's going to be Right, But to spend the time making that decision together in the long run is the better choice.
Kylie: I agree.
Skyler: So, as somebody that hasn't gotten At this point although I'd love to be there for the process of building these, these cardboard layouts, what, what does that full process look like? So you've decided on a layout. You guys ordered in. I, if I remember correctly, like it's just palettes of like this very thick cardboard. The palettes are there. Who shows up? Who's? I mean, what does this look like?
Angela: So this particular space for for our Iowa folks if you're picturing like a machine shed, i mean as large of the spaces you can have available to you with, you know, heating and cooling We were there in January So at least temperature control of some kind.
But as long as big of a space is the owner can get their hands on. This was a rentable convention hall space on fairgrounds. So before that the consultant had come in for two to three days, but before that Kylie had spent, you know, time sending them the drawings, sending them the layouts of the spaces that we wanted, making sure that the different elevations or the different cabinetry layouts were understandable and that they could build them off of that So sort of made like a mini construction set in order for them to construct these. Ok, and then we brought paper images or printouts of some of the outlets and the equipment. The consultant had included some of those in the build And we brought some additional ones that could then be taped or tacked up. We brought markers, we brought post-it notes, we brought things that we could physically draw on the walls and make changes on the fly. And then, you know, on on mock-up day, they they bring their crew in.
So, to Kylie's point, they had set up first some groups to come through and then a secondary group to come through. Obviously, you don't want it to be too cluttered with people. We don't want them to get the impression that, well, this is a really small room when in reality, there's 12 people standing in a room that probably doesn't need 12 people. And then they they interact with the space. Yeah, we're available to answer questions, walk through anything that maybe isn't meeting their expectation, maybe they don't know what something's supposed to be, and just make ourselves available to physically walk through. Physically talk through. In our example, there was a door that opened and closed in a couple of spaces. So understanding, watching them interact with the pieces so that they can fully experience what they're looking at.
Kylie: And one of the best parts about it. Well, first, actually, if you're having trouble picturing it, i mean literally the room. If you're in a room right now, like they built the cardboard that height to the like to what would be the ceiling, So, you'd walk into a room, you could close the pretend door behind you and you'd be in a room. you just wouldn't have a ceiling. So that was like, yeah, I mean, they're full scale. It's pretty cool, It's like a movie set almost.
Angela: It really. Yeah, that's a great analogy, wow.
Kylie: Yeah, and then I think my favorite part about it was in the moment. I mean, my head is in these drawings, like I know so much about the space just from time spent. And so in the moment, as these people are walking through their space and they're like, how far out is our exam chair going to go right here, like, are we going to have enough space on this side of it, I can take some blue tape and I can show them. This is just how far that is. Here's what it's going to look like when the foot extended parts are out. I mean, this is what it looks like for you to walk around and use this gas on the wall here or use this outlet on this side. So us being there in the moment with our knowledge of the space is super valuable to them, as they have questions too, and I think that was a really fun part of it was being that answer person for them.
Skyler: That's awesome. That's incredible. I'm really hoping that at some point, the next time that this is done for a project, someone needs to give me a call so I can be there.
Kylie: Absolutely Make a cool video about it going up like a time lapse, absolutely The pictures.
Angela: Really don't do it just.
Speaker 4: No.
Angela: I did take a few photos during hours and I know other owners have photos of theirs, but really to see the different user groups interacting and asking questions and really getting excited about their space is really pretty remarkable Wow.
Skyler: Yeah, absolutely. That's incredible. Well, I mean, i know that my mind has been blown 100% by this process. Like I said, i hope so badly that the next time this goes up, somebody calls me and says hey, come on down, We want you to see and get some pictures and stuff and I'll be able to obviously share it on social media. So obviously, if you're listening, you should definitely be following us on social media so you can not miss out on that.
Angela: Absolutely.
Skyler: But otherwise I mean thank you guys so much for being on the show and for sharing this expertise and this whole process that you guys, you know, use, i guess, multiple processes honestly to really help the clients out with Visualizing their space with more than just like the drawings that they see.
Kylie: Yeah, thanks for letting us talk about it. Thank you for letting us share, yeah.
Skyler: And thank you, of course, for listening to the podcast. You can, of course, follow the podcast anywhere that podcasts can be found, whether that be iTunes, apple podcasts, google podcasts and Spotify and just everywhere else that podcasts are being streamed at. Of course, you can follow us on social media, like I mentioned before, check us out on Facebook, twitter, instagram and LinkedIn and, of course, be sure to check out our website. You can see all the projects, or a lot of the projects, that we've worked on in the past as a firm. You can see projects that both Angela and Kylie were involved with, which is really awesome, and you know what we're working on currently. So, again, thank you all for listening. This has been another episode of Laying the Foundation. We'll see you guys next time.