by Louis D. Astorino, FAIA

Every hospital architect strives to create a physical environment conducive to healing. But an elusive challenge in achieving that goal is understanding the innermost thoughts and feelings of the people who will occupy the hospital.

This challenge prompted my architecture firm Astorino to adopt the Zaltman Metaphor Elicitation Technique (ZMET), a research protocol that elicits information from respondents based on visual images, metaphors, and emotions. ZMET — most often used in market research studies — gave us a new perspective on the needs of patients, families, and staff as we designed the new Children's Hospital of Pittsburgh.

The design started with a clear objective, to create a state-of-the-art pediatric healthcare facility that would anticipate and respond to the deepest needs of its users. The existing facility is one of the top ten children's hospitals in the United States, so the new design was required to meet and exceed the standards of quality of the medical, professional, and support staff.

To fully understand user needs, the team integrated its existing design process with ZMET research protocols. ZMET was developed by Gerald Zaltman, a Harvard Business School professor. It is based on the premise that 95 percent of thought occurs in the unconscious mind and is not captured by traditional research methods. Astorino's goal for using ZMET was to gain insights that would give structure to potential design ideas.   >>>

Discuss this article in the Architecture Forum...

A montage of images selected by a young patient reveals some sadness as well as the importance of color, toys, and access to nature. Image: Astorino A redesigned patient room features "home-like" fabrics and colors, separation for a family area, and hidden medical gases. Image: Astorino   Click on thumbnail images to view full-size pictures.