Design That Saves Lives
Three Alumni on Healthcare Interior Design During the Pandemic and Beyond
COVID-19 has made it clear that interior design is, at its core, about well-being. We sat down with three alumni in healthcare design, Elsie St. Léger ’10 (BFA), Peter Agnew ’15 (BFA)/’16 (MPSH), and Pál András Rutkai ’15 (MPSH), to discuss their careers in this rapidly evolving sector.
Some of them were set on becoming healthcare designers as undergraduates; others found their way into the healthcare sector by chance. All were well-prepared for their challenging and fulfilling careers. At NYSID, students are exposed to healthcare design through dedicated studio projects and a holistic way of teaching interior design that puts the health, happiness, and safety of end-users at the forefront of the discipline. The College also offers an interdisciplinary Master of Professional Studies in Healthcare Interior Design. Here’s the view from three very different jobs in healthcare design during this time of crisis and innovation.
Elsie St. Léger ’10 (BFA)
Interior Designer and Assistant Project Manager, NYU Langone Health
Photo: Matthew Septimus
“What I’ve learned about healthcare design decisions made in the time of COVID-19 is to listen to the scientists, the people who are doing the research. We don’t have time to waste.”
Designing from within a Hospital System
Preparing NYU Langone Health for the onslaught of COVID-19 patients that stretched the hospital beyond its limits last spring was not in Elsie St. Léger’s job description. She threw herself into the task anyway.
The interior designer and assistant project manager is a member of the interiors department of NYU Langone Health’s Real Estate Development and Facilities division. The team of five manages about 13 million square feet of healthcare, research, education, and administration spaces, and St. Léger’s purview is the design of outpatient spaces that host a variety of services, including annual checkups, neurological treatments, and flu shots. “Many of us who work in the design departments of hospitals are trained interior designers or architects,” she says. “Here at NYULH, we work in collaboration with design firms. Our job is to be an informed client. Once the design firm completes their projects, we live with it and research how it works. We do post-occupancy evaluations every year.” The team creates long-term strategies for the design of healthcare spaces.
Of course, this is a description of St. Léger’s job in normal times, and 2020 has been anything but normal. When thousands of patients began streaming into NYULH’s emergency departments with symptoms of COVID-19 last spring, St. Léger and the interiors team, which consists of two other project managers and one intern (who happens to be recent NYSID BFA graduate Monica Seroiczkowski ’20 ), were tasked with adapting the hospital for the unprecedented health crisis and the impact of a disease medical researchers were only beginning to understand. All of St. Léger’s outpatient projects were put on hold, and the team began working from home and communicating via FaceTime and WebEx. NYULH had completed construction on the state-of-the-art Kimmel Pavilion in 2018, so the older building on the Manhattan campus, Tisch Hospital, had several empty floors slated for renovation that the team was responsible for transforming at lightning speed. They also had to erect and outfit tents for coronavirus testing and critical care. “The trades would come in on a Friday,” says St. Léger, “and have to get the project finished by Monday. It was non-stop.” St. Léger’s boss, Jennifer Eno, NYULH’s director of interiors, is the hospital system’s lead on all interiors, including inpatient, so St. Léger had to make herself useful within a team that was working 12-hour days under tremendous pressure.
While studying at NYSID, St. Léger worked as an intern for Jamie Drake, co-owner of Drake/Anderson, then joined the Saladino Group in 2007 as a junior designer, where she was responsible for the materials library and cultivating relationships with vendors. Both jobs were incredible learning experiences, and ever since, she has been especially skilled at sourcing. “Everyone on the NYULH team has a strength,” she says, “so we balance each other out. I had the market contacts, so during the crisis, that became my thing. I helped negotiate with vendors and got things we might normally get in three months, in ten days.”
Entrance, Helen L. and Martin S. Kimmel Pavilion, NYU Langone Hospital. NYU Langone Health, Real Estate Development and Facilities; Ennead Architects; And NBBJ. The Photo Works.
Listening & Collaborating
The pandemic made collaboration and communication of utmost importance. “We identified which rooms would be turned into COVID-19 patient rooms,” says St. Léger. “We turned doubles into singles and did away with the guest chairs. We had to retrofit rooms into negative-pressure rooms so contaminated air from the sick spaces didn’t flow into the corridors, and we had to work very closely with both clinical engineering and nursing,” she says. “We added HEPA filtration systems to rooms that hadn’t been used for a year…We even turned a bike-storage room into a COVID testing site.” The team had to take in information from many sources and apply it to design decisions at breakneck speed. Says St. Léger: “What I’ve learned about all healthcare design decisions made in the time of COVID-19 is to listen to the scientists, the people who are doing the research. We don’t have time to waste.”
St. Léger was involved in the design strategy for NYULH’s Kimmel Pavilion. She has helped design many more beautiful spaces than those she created during the height of the first wave of the pandemic, but this critical design response is the work she is the most proud of. She says, “NYULH lost many staff members—not just doctors, but also nurses, clerks, technicians, and physicians assistants and others. Many of these individuals volunteered to work in the COVID units. The experience gave us all PTSD, and I wasn’t even on-site giving the care. This has only increased my focus on using design to improve the lives of the people who work in hospitals.”
Designing for the Caregivers
St. Léger says the COVID-19 pandemic has intensified a movement in healthcare design toward approaching hospitals and clinics as workplaces with valuable employees. Break rooms and amenities for employees who need a refuge from emotionally taxing work are becoming more commonplace in hospitals. St. Léger says this makes good business sense because it helps the hospital retain talent and keep employees healthy and functioning. As she oversees the design of a healthcare space, she’s focused on the comfort and well-being of its employees. For example, she says, “Doctors have desks, but they don’t really have desk jobs. They have to get up all day to see patients, so we have to make sure our doctors are not going to hit their knees on the under-counter storage.” A small detail like this can drastically impact user experience.
St. Léger says the COVID-19 pandemic has also accelerated a movement toward the construction of preventative-care spaces, such as ambulatory care centers, in healthcare design. Testing, whether for SARS CoV-2, the virus that causes COVID-19, or breast cancer, not only saves lives—it’s also a growing profit center for hospitals.
Finding Her Way to Healthcare Design
St. Léger never dreamed of working in the healthcare sector of interior design, but she loves her career. She is a child of immigrants, and didn’t have models of interior designers in her life when she was growing up. She recalls: “I always had an interest in design, especially architectural history. I just wasn’t aware of careers in design.” After college, she worked as a writer and copy editor. She started taking classes at NYSID, one at a time, in 2004 because she was more than a design fan or just an avid reader of Architectural Digest and Interior Design. She wanted to attend a school with plenty of other career changers. She started with a color class and kept going, obtaining the AAS in 2008. She then took the plunge and went full-time for the BFA. At NYSID, she dreamed of working on the design of schools, because she cares deeply about creating educational equity for children of color, but she graduated in 2010, smack in the middle of a recession. Finding a job was difficult. St. Léger pushed herself to network, even though she describes herself as a quiet person. She had joined the IIDA (The Commercial Interior Design Association) and ASID (American Society of Interior Designers) as a student and continued to attend panels and networking events while working a sales job she disliked. “At every event, I made myself raise my hand and ask a question.” One of the people she connected with through this strategy was NYSID alumna Jennifer Graham, currently an Associate Principal at Perkins & Will, who in 2009 co-founded LMNOP, a professional-development organization for the A&D community. Graham became a mentor and friend to St. Léger and, in 2012, encouraged her to apply for an interiors coordinator job she’d heard about at New York-Presbyterian Hospital.
St. Léger says, “I thought I wanted to do education design, because I wanted to help Black boys and girls find the means to get ahead in the world. I found a job in healthcare design and thought, ‘Well, it’s adjacent to education design in that it’s not designing for the 1%. It’s designing for everyone.’ It turns out that I love the community aspect of healthcare design. I tell young designers: ‘Stay open, stay curious, because you never know where you’re going to land’.”
Mentoring Others
St. Léger says, “It’s important to give back to an industry that has given me so much.” She is both a board member and the president-elect of the New York Chapter of the IIDA. Her intern, Monica Seroiczkowski ’20 (BFA), says, “Elsie is just amazing. When she found out I was close to graduating, she automatically treated me as part of her design family.”
St. Léger (above) and Dana Sandberg organized the 2017 IIDA NY Residential Forum Panel “Designing The Glass Ceiling: Shattering The Status Quo.” Rio Hamilton, principal of Rio Hamilton Consulting, moderated the event. Speakers included Jennifer Graham, Jean Brownhill, Malene Barnett, Robin Wilson, and Gisue Hariri. Photos: Rio Hamilton.
Diverse Representation Matters
St. Léger is passionate about opening doors for other designers of color and creating more diversity in the design industry. “The other thing that has come to the forefront in this pandemic is the inequality in our society,” she says. “There are not enough varied voices in the industry, and I am very aware of being one of the few black designers in the healthcare sector. Our sector needs more Black voices, more women, more Asians, and more Latinx people at the table. When you have diverse voices, you create a stronger product, help nurture better patient experiences and outcomes, and you have a happier workforce… Representation matters.”
Peter Agnew ’15 (BFA)/’16 (MPSH)
Associate Interior Designer, Perkins Eastman
Photo: Matthew Septimus
“The challenge of healthcare design is to deliver on the functionality while still providing comfort and beauty for the patients, family, and staff. After all, staff work in these spaces for many hours a day.”
Working in a Healthcare Design Studio
When we caught up with NYSID alumnus Peter Agnew ’15 (BFA)/’16 (MPSH), his team at Perkins Eastman was just days away from the opening of the first of three “Post-COVID Centers of Excellence” for New York City Health + Hospitals, the public healthcare system of New York City. This particular center is located in the Bronx, in an underserved and minority community, where frontline workers and their families have suffered in extremely high numbers from COVID-19. Agnew is used to working on “big healthcare projects for big firms” that take many years to complete, but COVID-19 and this project in particular have drastically changed timelines for his team. Agnew’s studio must design for the new realities and codes that come with COVID-19, but also create spaces flexible enough to be changed when coronavirus protocols are no longer necessary. “This is the most fast-tracked project I have ever worked on,” says Agnew. “It’s been challenging. It was essentially design-build and the entire scope of work, from space planning, to user sign-off, medical equipment planning, and the selection of interior finishes and fittings all had to occur with a seriously compressed project delivery date.” In addition to designing six feet of distance between waiting room areas, workspaces and nurse stations, Agnew and his coworkers must select materials and finishes that can stand up to rigorous cleaning regimes while still delivering comfort and aesthetics. He says, “The challenge of healthcare design is to deliver on the functionality while still providing comfort and beauty for the patients, family, and staff. After all, staff work in these spaces for many hours a day.”
Agnew finds this pace stressful yet satisfying because the interiors he’s creating for New York City Health + Hospitals will directly impact hard-hit communities during a critical time, providing opportunities for vital services like OB-GYN, dental, imaging, and mental health counseling. His challenge is to make healthcare spaces beautiful, welcoming, functional, cost-efficient and safe, and he loves that his work enables him to use his talents to help people less fortunate than him. The projects he is most proud of are those projects in which he has had a hand in delivering beautiful, contemporary, comfortable spaces to hospital systems that have dealt with aged infrastructure and interiors for many years. He says, “Being able to bring joy to patients, as well as staff, is a great feeling.” He helped Mount Sinai West create a welcoming, open-plan neonatal intensive care unit, designed to solve the problem of isolation among the mothers of babies in intensive care. While at CannonDesign, he also worked on a redesign of the Women’s and Children’s Pavilion at St. Joseph’s Health in Paterson, New Jersey, a small hospital that serves a diverse, working-class community.
Neonatal Intensive Care Unit, Mount Sinai West, New York City. Designed By Cannondesign. © Bjorg Magnea / Cannondesign.
His Path to Healthcare Design
Agnew earned his BFA at NYSID. He loved the small class size and the fact that his professors were all practicing designers. He says, “I still hear my drafting instructor, Ann Barton, whispering in my ear as I work.” At NYSID, Agnew was exposed to multiple healthcare projects through his studio courses. “I took an instant liking to healthcare design,” he says. “There’s the altruistic side of it, creating the spaces that help sick people heal. There’s also the challenging aspect of healthcare design. It’s not just designing to make something pretty; it’s space planning to meet the needs of the staff, patients, and families. I’ve always loved the programming part of the work.”
Agnew was so taken with his undergraduate exposure to healthcare design that after he graduated in 2015, he went right into the Master of Professional Studies in Healthcare Interior Design (MPSH) at NYSID. He says, “This has been a really useful qualification in my career. Potential employers were impressed by the specificity of my training and portfolio coming out of this program.”
He landed his first job in the healthcare studio at CannonDesign directly out of the MPSH program. He says, “There’s a really good career path when you choose healthcare design, whether there’s a recession or not.”
Inside a Healthcare Studio at a Large Firm
Agnew works in Studio 6, the healthcare design studio at Perkins Eastman. The firm employs about 450 people, and Studio 6 has about 60 employees, including interior designers, architects, medical planners, and principals. Agnew usually works on several projects at once. “I do a lot of conceptual work in preparation for client presentations, that is, translating knowledge about the user group into drawings and elevations (conceptual three-dimensional drawings that convey a design idea),” he says. “Documentation is a big part of what we do: we need to be able to communicate to contractors about things as tiny as a millwork detail showing the design intent of a nurse station or reception desk. Selection of furniture and finishes is only a small part of what we do as interior designers.”
Agnew believes his sector of interior design is gradually becoming more focused on sustainability and healthier building materials, and he says this is a priority at Perkins Eastman. “Why not select bio-based sheet or tile flooring or a carpet tile with a negative-carbon backing for a healthcare environment?” he wonders. “It’s becoming easier to specify healthier materials, especially with tools like the Mindful Materials Database. It’s our responsibility as healthcare designers to make decisions about the long-term health of the patients and providers who will be using the interiors we create for the next 10 to 20 years.”
Pál András Rutkai ’15 (MPSH)
Founder and Principal of Healing Spaces, a healthcare design consultancy
“Flexibility and accounting for change has always been a cornerstone of healthcare design. COVID-19 is pushing us to new extremes in this, requiring us to imagine spaces that can adapt quickly and in a cost-efficient way.”
Transforming Hungary’s Healthcare Infrastructure
Pál András Rutkai ’15 (MPSH) lives and works in Budapest, Hungary. Within his nation’s universal healthcare system, overcrowded and out-of-date facilities are common. Rutkai’s mission is to help change that.
His parents and grandparents are doctors, but as a young man, Rutkai never expected to find himself in any aspect of the medical profession. Interior design and architecture were his passions, and he received his Master of Science in Architecture at the Budapest University of Technology and Economics in 2011. “When I started interning, I went to a large local firm and ended up in a studio that focused on hospitals,” he remembers. “At first, I was overwhelmed by the sheer scale and complexity of healthcare projects, but later I got drawn to the way of thinking required to tackle these challenges. I realized how much influence the spaces that we design can have on health outcomes. It turned my job into a calling.”
Rutkai worked at architecture firms in Hungary for several years, and also in the U.K.—for the prestigious Feilden Clegg Bradley Studios—before he came to understand that the most fulfilling part of his work was the healthcare projects. He says, “It’s a nurse who holds someone’s hand in a tough situation; it’s a family member by the patient’s side in a crucial moment. But it’s the healthcare designers who create spaces that allow for these interactions.”
A Bridge Between Cultures
Rutkai felt that he needed exposure to the innovations of healthcare systems in the West to stay ahead of the curve and optimize his impact on his projects in Central Europe. He applied for a Fulbright grant to study in the Master of Professional Studies in Healthcare Interior Design at NYSID, and he got it. “The local healthcare infrastructure is in great need of refurbishment and this need was recognized at the Hungarian Fulbright Commission,” says Rutkai.
NYSID offered Rutkai entry into the world of U.S. healthcare design in many ways. “Our teachers were working for leading firms or prestigious healthcare institutions and they could share with us the most up-to-date knowledge. Through the school’s vast network, we could visit state-of.the-art facilities and go to trade shows throughout New York City. The student team was a unique experience as well,” he says. “Our diverse backgrounds, not only in architecture or interior design, but also in healthcare administration or social work, meant that the team had to find a way to work together, just like in a real project-development environment.” Rutkai won NYSID’s Chairman’s Award upon his graduation from the MPSH program, and used the award to finance a research trip to 17 hospitals in 11 states.
Bringing Innovation Home
Typically, budgets are strict and spaces tight in the design of Hungarian hospitals. Many Hungarian healthcare professionals who go abroad, stay abroad, but Rutkai’s purpose was to bring design innovation back to the healthcare infrastructure of his country, and to help hard-working doctors like his parents save lives. He worked for Zoboki Design and Architecture, and ÁEEK, the Hungarian National Healthcare Services Center, before striking out in 2018 to start his own healthcare design consultancy.
What a Healthcare Design Consultancy Does
As an independent healthcare design consultant, Rutkai is hired either by architectural design firms or hospitals. He says, “I usually find myself between the hospital leadership, the hospital’s steering committee, and the hospital’s doctors, and on the other side there is the designer and the medical planner. I’m a bridge. I shape the conversation. I bring in innovation. I educate about the newest achievements in healthcare design and I help the design firm get the buy-in from hospital leaders.” Oftentimes, Western European architecture firms working on huge hospital projects hire him to provide knowledge of the way the Hungarian medical system works, and to create solutions that bridge cultures. Local firms that want to follow U.S. standards go to Rutkai for his international perspective.
Evidence-based design is at the heart of everything Rutkai proposes, and this is a focus that was instilled in him at NYSID. He draws on research to make his clients understand how innovations can increase efficiencies, improve outcomes for patients, and make caregivers more productive. He says, “I was working on the operating theaters of a hospital. As it was built originally, each room had its own preparation area and washing station. This wasted space, and it was difficult and time consuming for the nurses, because they had to do preparations in separate rooms. We used research to convince the client to go with a centralized area for preparation and sanitation that connected to all of the operating theaters.” His design allowed the hospital to build larger operating rooms and to use fewer nurses. He says, “A building designed in an efficient way has the ability to save more lives with fewer resources.”
In the less than two years since Rutkai started his own company, Healing Spaces has won major awards and attention. His small, start-up firm won second place in an international competition to design the South Buda Center, a 2.2 million square feet facility with 1,200 beds that will be the backbone of a new hospital infrastructure in his nation’s capital. Healing Spaces did not ultimately win the bid, but news of the success put the company on the map. Rutkai is now collaborating with the Hungarian firm Zoboki Design and Architecture, and the Austrian firm, Architects Collective, on a major project because their entry won first place in the South Pest Hospital international design competition. Healing Spaces is helping these two firms design what will become the largest hospital in Budapest.
Renderings from Rutkai’s competition entry for the South Buda Central Hospital in Hungary.
A Field that’s Changing Overnight
“Flexibility and accounting for change has always been a cornerstone of healthcare design,” says Rutkai, “COVID-19 is pushing us to new extremes in this, requiring us to imagine spaces that can adapt quickly and in a cost-efficient way.”
He adds, “Clients are asking for architectural and interior design solutions that help to decrease patient and caregiver exposure.” COVID-19 has been traumatic for hospital workers. Healthcare designers are considering how the built environment can support the mental health of care providers. Rutkai explains, “Providing breakout spaces and places of respite for healthcare workers got value engineered out of most projects in the past. Extraordinary work and emotional load during the pandemic accelerated burnout problems among staff and there is a greater focus now on preventing this.”
Every Decision Matters
Rutkai feels tremendous pressure to help clients make the right design decisions, because he knows the hospitals he creates will be places that will serve communities for decades. Understanding the ways his work impacts health outcomes drives him. He says, “Design has a profound impact on the mindset of patients and caregivers, which results in better outcomes. But sometimes design is even more directly involved in saving lives. There are cases in which literally every second counts. Designing functional links, like connecting a heliport to the right part of an emergency room, can save time through design, which means design can also save lives.”