CCB: [00:00:00] Welcome to the ONEder podcast. This is your host, CCB and for our conversation today, we're going to be chatting with someone who has a very deep expertise in, an interest and curiosity in health design. And we're inordinately honored to have with us today someone who is not going to toot her own horn, but we may have to tootle it a little bit for her. I'd like to say welcome to Debra Levin from Center for Health Design. Deborah, say hi.

Debra Levin: [00:00:41] Hi, CCB It's so great to be here. Thank you for inviting me to be a part of this great podcast.

CCB: [00:00:46] Well, we are, we want to hear so much about your investment in The Center for Health Design. But before we talk about that, tell us, what did you go to school for and why did you decide to do what you're doing today?

Debra Levin: [00:01:01] I started out in college at Arizona State wanting to be a lawyer, and I don't know why I wanted to be a lawyer other than I love the show Paper Chase when I was a kid. And I really thought that a law degree would, like, teach you how to think. And to take disparate pieces of information and make something new of it, right. Create an argument. And I just I was fascinated by that, not necessarily that I wanted to be a lawyer, but I was fascinated by the intellectual side of it. And I spent my first three semesters at Arizona State poli-sci pre-law, and the roommate that I was given was an architecture major. And I always would look at her homework and look at my homework, and hers looks so much cooler. And when I took all those tests in high school, they all said, become an architect. And I was like, Yeah, I'm not good at math. That's not going to work. But, you know, I just had all these signs when I was young that this is really what I should be doing. And I remember my third semester in college, my academic advisor said that she was not going to be my academic advisor the next year. That she was moving over to the College of Architecture, and it was like a lightning bolt CCB. I was like, what else is it going to take for me to realize that it was time for me to really do what I truly wanted to do? And so I moved over to the interior architecture program at Arizona State, and that's where I got my undergraduate degree from.

Debra Levin: [00:02:26] And what I realized somewhere along the way was that I got exactly what I wanted out of it. Which is a design degree, teaches you how to think, right? It teaches you how to take all these disparate pieces of information and put them together in a new way to create something that didn't exist before. And that was a blessing. Right. I, I never looked back. I love the industry. I loved the the program at Arizona State. I eventually went back while I was still working and got a master's degree in organizational leadership. But I'm a designer at heart, even though I never put pen to paper, and I don't design places. I am deeply a designer. You know, when I applied to get into the College of Architecture, I remember writing, you know, it's not what I want to be. Design is who I am. And I really still believe that, that there are people who are drawn to this industry because something inside of them is just hypersensitive to the environment. And I think I'm one of those people.

CCB: [00:03:29] So that's pretty fantastic when you think about the steppingstone of a couple of semesters studying political science and the process that and the kind of logic behind that and understanding that design thinking in the more organic perspective of looking, at holistically looking at a problem and as you say, creating something from it. I think that's just a fascinating transition. So, you graduate from Arizona State University with a degree in architecture and I'm sure your parents said you have to get a job.

Debra Levin: [00:04:04] You know, I was the youngest of four. And so, if you ask my siblings, they will tell you I was highly indulged. So, they didn't actually. When I was at Arizona State, I ran for a lot of offices at the university, president of my college, I wrote for the paper, eventually leading to the ASID National Student Council. And my last year there I was regional vice president, and I traveled all around the country talking to students and engaging them and just getting people excited about what we do and what we have the opportunity to do in this field. And I wanted to run for president. So, when I graduated, I actually went to grad school for a year so that I could continue on and eventually I became president of the National Student Council for ASID and that was extraordinary training for what I ended up doing in my career and for realizing that you could be in our industry in so many different ways. It didn't have to be as an actual interior designer or an architect. You could make an impact in in many different ways. And that is how I found my way here. I found my way to doing this kind of work versus what I really thought I was training for all those years, which was to be a designer. So, I didn't right off, get a job, but I met somebody who introduced me to this work and came out to California for eight weeks and ended up actually staying. It's now been almost 32 and a half years and I'm still in this job and it's been fantastic, right? So, I got lucky.

CCB: [00:05:38] You got a well, you know, there's never just luck. Let's put that over on the corner for a future conversation. But the idea of The Center for Health Design getting in on the ground floor, they brought you out to look at it or to be involved in it? And in what format did you find The Center for Health Design?

Debra Levin: [00:06:01] The Center for Health Design didn't exist when I came out here in 1989. It was the National Symposium on Health Care Interior Design. We were just a conference that had just started, that was geared at bringing together architects, designers, health care executives, landscape architects, health care facility executives, all in one place to share knowledge. Right? To say, if there's something that's happening in Boston that's really cool, how do you make sure that somebody in California knows about it? And that was what the conference was about was, you know, bringing people together, creating a community and spreading knowledge. The Center started in 1993 as a nonprofit. We were a for-profit in the early days. We became a nonprofit in 1993 when we realized that we wanted to do research, right? We wanted to not just bring people together and create community, that was fantastic, but we wanted to help propel the industry forward. And to do research and to be able to get grants, you needed to become a nonprofit. And so, we went through that long and arduous task of becoming a nonprofit, and that's where the organization that exists today really came from.

CCB: [00:07:14] So that's very interesting to think about being truly part of the formation of it. And who were the other players that infused the energy to craft The Center for HealthCare, Health Design. Sorry.

Debra Levin: [00:07:32] We had an amazing board of directors. When you think about the early days of this industry, there were there were some people who just really stood out. Right. They they were doing really interesting work, like Robin Orr at Planetree or Derek Parker at Anshen and Allen, and The Center brought those people together and formed a board of directors who really helped propel this organization forward, right? It was a conference for a lot of years, and it was, it was starting to do some research in like ‘90, ‘91. And it was probably, you know, quite a bit later than that that we really formed this kind of three legged pedestal of research, education and advocacy, right? Really realizing that, that all three of them needed to happen for change to happen in the industry. That you needed to first understand something you didn't know and learn about it through research. And then you needed to educate, you needed to get it out there. You needed to make knowledge actionable, right? Get it out there into the industry. But then you needed to change the codes and standards that were like minimum expectations, in order to start raising the bar, right. And then go right back to research again. And so I think I took over as CEO in 2000. And I mean, to be honest, it was me in a spare bedroom in my house at that at that point. And, you know, we made an amazing partnership with Turner Construction, who really helped take us around the country. Myself and Ros Cama, who was the board chair at the time, would go around the country and talk about The Center's work and evidence-based design. And that helped us really grow the kind of a key, A key program for us, which was the Pebble Project.

Debra Levin: [00:09:27] And people would hear about Pebble and the research that was happening. And they were, it was a really different time back then. There wasn't as much available, there wasn't as much out there that you could go to. And people were just starting to talk about evidence-based design. You know, it's not like research hadn't been being used before, but The Center put structure around it, created community about it, and help to kind of leverage it and propel it forward in a significant way. And so people would hear that message and wanted to be a part of it. And that's how the Pebble Project really gained recognition. We had close to 80 projects all around the world who wanted to do research. They were building and designing and they wanted to understand how their project could both contribute to the body of knowledge, but benefit from everybody before them. And Pebble is what really helped propel us to that next step of being able to staff up and bring on people and build The Center as it is today, right? Honestly, The Center for Health Design is truly a community of awesome and amazing people. I mean, I love the staff. Anybody at The Center could choose to work anywhere they wanted and probably make more money somewhere else. But they choose to work at The Center because they want to make a difference. They want to have impact. And if those are your colleagues, you know that is a blessing you can't even design, right? You can only be grateful to have that every single day.

CCB: [00:10:52] Well, the enthusiasm, the enthusiasm with which you communicate your passion for this, for these efforts and for this institution, if you will. And I'm going to give it that kind of title, because it has grown in such prominence as a purveyor of information and a source of, and people will talk about it on a regular basis, even beyond the health care design world, which I think is pretty fascinating. So I want to say, for 30 years of involvement, there have been a number of kind of monumental achievements. And you talk about the Pebble Project in moving the information forward and sharing it in a more broad fashion. What other steps have you taken?

Debra Levin: [00:11:48] Well, you know, like I said, there was a point where early on we thought it was about creating research. Let's create, create, create. And we had an 'aha moment' that was that wasn't probably the best way and the best role that The Center could have, that creating research is really important and we continue to be involved in that. But making knowledge, making research actionable, that was where The Center could have significant impact. We're amazing at creating tools and resources that help people do what they do better, that help give them knowledge, that help them understand what they already know and how to build upon what others know. That is really where The Center staff shines and that's where we spend a lot of time in the last decade, is creating things like the interactive design diagrams, and the knowledge repository, and the various different tools that we have on our website, that most of which are free. Those are the things that we're great at. We spent many, many years creating a safety risk assessment tool. And when I say we, that is a big community of we, right, our researchers kind of created the framework and led the charge.

Debra Levin: [00:13:01] But we had dozens and dozens of industry experts from all throughout our industry who were part of figuring that out and creating it. Right? And again, that's one of the things I'm the most proud of, is this community that we continue to create, that is passionate about making a significant difference out there in health outcomes and in people's lives, and comes together to do that. Right? So that is where we have focused a lot of our energy in the last couple of years is building those tools and resources, building the database of citations that you can easily search, and creating key point summaries so that you can understand what the research is saying and see if you want to dive in deeper and actually go get the research summaries, right. We were trying to just make it so that an evidence-based design process is both required but easy to do, right? Creating all those tools and resources to tell you both how to do it, but then giving you everything you need to be successful at doing it.

CCB: [00:14:05] So I was also thinking about the Health Care Design Excellence Conference as maybe the blossom of your early symposium but has turned into a place to be for people involved in health care design.

Debra Levin: [00:14:22] It really is. I mean, we get thousands of people from all over the world who come to Healthcare Design every year. You know, the last couple of years have been tough for any in-person gathering, right? But one of the things that The Center did was we pivoted and realized that education was a big part of what we did. And so we started to become very virtual. And though we started it because of COVID, we came to realize that there's great value in it. We we now hit an international audience who might not be able to come to our workshops or the Healthcare Design Conference, but, you know, can log in in the middle of the night from other parts of the world and spend an entire day with us, right? So that combination of both in-person and virtual learning has been an incredible gift that has come from COVID. But as you said, the Healthcare Design Conference is it's our industry's key gathering place, right? It is where all the big thinkers come. It is where all the manufacturers show their their latest and greatest. Everybody gears towards that date in October to show their newest stuff. You know, we have all of our awards to celebrate ourselves as a community and to help build, continue to build that visibility. It all happens at at Healthcare Design every year.

CCB: [00:15:43] So everyone in the audience, mark your calendar. If you didn't know it, it's in October and there's all sorts of information available. And just as a point of reference on the the website for this podcast with Debra, there will be all sorts of references and links that you can access. So just keep that in the back of your mind. There's another question that is so topical and for so many reasons, and it's about sustainability and environmental responsibility. And I wanted you to spend a little bit of time, if you would, on the active involvement that you've got in the Environmental Standards Council.

Debra Levin: [00:16:23] Sure. The Environmental Standards Council was an early, early program that we started, I mean, close to 30 years ago, 27 years ago, to try to impact change in the guidelines early with the Joint Commission and the Facilities Guidelines Institute and all of the people who were creating the guidelines that were minimum standards. Right? And so it was our way to try to have some engagement in saying if we're doing all this research, if we're learning all this that we're learning, how can we help be a part of crafting those guidelines so that they're best able to take advantage of what we know? Right. And help to continue to raise the minimum standards of what's expected. You know, the whole Environment of Care came out of the Environmental Standards Council. You know, in the early days, all we were successful was getting it a heading. Write a chapter that said The Environment of Care, we know it's important. And now let's figure out how to build that out. And so we did over the many, many cycles after that, the ESC kept kind of pushing that forward and creating the guidelines that eventually got adopted in the Facilities Guidelines Institute. Right. So it's something we're really proud of because those minimum standards, you know, if that's all somebody is going to go for, which, you know, I think most people don't, but if that's all somebody is going to go for, continuing to raise those up so that they're based on common knowledge and research that we know impacts change, then raising those standards makes a huge difference, right? For those who might only use minimum, it improves the outcomes and the quality of the environments that are being designed.

CCB: [00:18:09] We had a great conversation with James Pease of UCSF Health Construction and his perspective on what's the point of his role. What's the point of anyone in facilities and health care design is to impact the health of the community? It's about it's about the patient. And so the commitment to sharing that information is beyond admirable. But it also is interesting to think how does Center for Health Design if it does at all, track those metrics? What are the changes or do we count on the health care systems to track that?

Debra Levin: [00:18:55] Yeah, that would be an amazing project that we would love to be involved in. And it would take a significant grant from a significant foundation who wants to invest in that. It's part of what we tried to nibble away at with the Pebble Project, but it's not so easy. And, you know, there's two folds. One, it's not always something people are comfortable with sharing data, right? So that's sometimes difficult to get the data. Two, people start with all the best intentions to do the research once they've open the health care facility. But, you know, the reality is, is these are buildings that run seven days a week, 24 hours a day, and are inundated with giving care, right. That is that is why they're there. And even though the goal might be to do research, the reality doesn't always end up there, right. And that's the one thing I could change. That's where it would be. It would be to have this core of people who could go into the facilities and kind of do the research afterwards to see what did change. Did the hypotheses pan out the way they were expected? Because we were able to gather, you know, it is happening. But if we could light a fire under how much is being gathered, how quickly that's being gathered, making comparisons between various different facilities, that would be amazing. Right. That that would be like adding fuel to this movement that has been growing over the years. But it grows at the rate that it can.

CCB: [00:20:31] Gosh. Yes. I just think of the magnitude of the the information that you touch or that anyone in Health design touches. It does take a specific focus to be able to get to some of those metrics that would be valuable for not only the system itself, but for the entire industry. So truly, passion is the word that I just keep hearing in my mind listening to you. But how do you, how do you keep up the energy aside from your amazing colleagues and that repository of enthusiasm? How do you keep up your building a vision?

Debra Levin: [00:21:31] I mean, part of what fuels me is I've always, always wanted to be somebody who made a difference in the world. I mean, that was something that was important to me, right? Was to pick a career and to live my life both personally and professionally in a way that is of service and makes a difference in the world, right. I want that. I've been on this earth for however many years I get to be here to count. Right. So that's that's a fuel that never goes away, right? That's just part of my DNA. And I think that's a piece of it. As you said, the people coming to work every day and getting to work with a group of people that you admire and are grateful for, is is a piece of it as well. But I think the biggest issue is, there's still so much to do, right? I mean, it's over three decades that I've been doing this and there's still so much left to do. That you know, COVID was a wake up call watching what was happening in hospitals, seeing the conditions that these people were working in, and realizing that for as much change as we've made, there's still so much more that has to happen in order for everyone to really benefit from.

Debra Levin: [00:22:46] receiving care or working in environments that support the highest level of outcomes. Right. So you know, I don't get bored you know that I've had the same job for over 32 years isn't really true because it changes every year, right? Our industry changes, The Center changes and grows the direction we go in changes and grows. And so I feel like every year I have a different job, just I get to benefit from anything I've learned the year before and, and I already know the people, you know. And we continue to grow as an organization, right? We a couple of years ago created an advisory board so that we could bring really smart people from different industries, not necessarily health care design, together to see what can we learn from them, right? What have they done in other industries that we should know about and learn from and mimic in order to continue to create change? So, you know, it's always different here. And that's how you stay engaged, right? That for me, the worst job would be doing the same thing over and over and over again. You would lose me very quickly because I would get bored very quickly.

CCB: [00:23:57] But you wouldn't have it turned up on your high school test. To what would be next? No repetitive tasks?

Debra Levin: [00:24:07] No. Yeah. I'm not a repetitive person. I would not do that. But, you know, living in an industry that is thriving and changing and growing and I mean, in the end, what it comes down to is what you said earlier. All this we do is to impact people millions and millions and millions of people that we will never get to meet that are oftentimes in some of the most challenging and difficult times in their lives. And we help to create the environments that maybe make that a little bit better, maybe, you know, support them in their times when, you know, so much is bleak for them. And also, for people celebrating, you know, having babies, you know, the positive things that happen in health care, you know. The environment is the part that's always there. You can't get away from it. And it's helping or it's harming, one or the other. It's happening all the time, whether you know it or not, you're just not aware of it. You know, I always, I fly a lot and I love when you sit down, somebody's making small talk and they're like, so what do you do for a living? And I share with them, you know, who we are and what we do. And it's not an easy thing to share, right? It's not like you could say, I'm an accountant. I always love watching that light bulb go off, because everybody's had an experience in health care, right? Everybody. And when they realize that the environment did have an impact on them one way or the other, you literally see this, like, moment of understanding go off. And it's, it never gets old for me, right? When you help people to understand that even in their homes, right, the environments we create make a difference.

CCB: [00:25:38] Well, we couldn't agree with you more. The One Workplace commitment is to make places better for people so people can be better people. And you think about how, how much place impacts any experience. Except and/or I wanted to ask that question about digital health and what are you looking at or what are you seeing or what are you thinking when you hear that term?

Debra Levin: [00:26:12] Well, that is part of why we created our advisory board was to bring people like from Microsoft on to be a part of our thinking, so that we could understand how to best have an impact in what the next generation of health care might look like. You know, our core values of research, education, advocacy, they're not changing. But I think of things like, you know, DEI and digital health is like a fabric that lays on top of that and understanding the impact that these things have on traditional health care settings, and what the future of health care is going to look like. How it's going to be delivered and how we're going to improve health outcomes for people day to day, not just when they come in contact with health care environments. It's a part of the thinking. Do we have answers? No, we don't know what the role of The Center will play in that is yet. We don't know what that's going to look like yet. But we know that it's a conversation that needs to be had and that it is going to have an impact on on the future of our industry and on health care delivery.

CCB: [00:27:23] And the whole health care experience. I'm curious what some of what we're seeing here in the West Coast is the migration, if you will, to the retail health care setting. A lot of the big, huge hospitals, they are there for the for the, oh, gosh, what's the word I want? The most extreme interventions that are required, but that intersectionality within community of how health care is becoming more embedded in community.

Debra Levin: [00:27:59] Yeah. Yeah. So, I'm a visual person. I create pictures in my mind to help me understand things. And I used to think of our industry and the work we do is like hub and spoke. You had the hospital and then you had all the spokes coming out to all the different kinds of secondary types of environments. But you know, in the last couple of years that picture my head has changed to a spiderweb because I think that those interconnections are so much more complicated than the hub and spoke. And I see that we're continuing, as you said, to have large hospitals and not as large hospitals being built that are for the highest level of need. But we are creating communities where we realize that health care has to happen, where people are. Whether that's in the transit centers and their office buildings and the grocery stores and CVS. We're seeing health care pop up in so many places and in so many different formats. And in time we'll see which ones survive and which new ones come up. But to me, it really is this amazing spiderweb of health that's kind of overlaying our communities to bring knowledge and access to health care to where people are and in the way that they need it, and in a way that they'll understand it.

CCB: [00:29:18] Mm hmm. Gosh, Deborah, this conversation could go on forever. And I can only imagine there are so many people that would love to just sit down and have a conversation with you, because the perspective that you bring and the scope, the scale of what you're thinking about is just delightful. Absolutely delightful. However, we only have a brief, abbreviated period of time. So is there anything that we haven't talked about that you might want to share or reinforce from a message standpoint to the folks that are listening?

Debra Levin: [00:29:51] Well, one, I want to say, if you listen this long, thank you. Because I am passionate about what we do. I do love it. And, you know, I don't always know that that is translated. So I am grateful that that that people are still here listening. If you are a foundation and you would like to give us millions of dollars to do the kind of research that we talked about, definitely give me a call. But what I would say is, is use The Center as a resource. Call us if you need things, go to our website. The amount of information that's available on our website is just incredible. We have toolboxes around different topics. We have a variety of tools that are free. You know, engage with us in any way you can, become a member. We are not a membership organization, but you are welcome to join our affiliate program and be a member and support the work that we do. But engage, be a part of our community and reach out if we can ever be of help. And you see that there's a way that you might want to, whether it's do research together or engage in a conversation. I welcome the opportunity. I could talk about The Center and our work forever and ever because I honestly, I truly do love it. So, reach out and be a part of our world because our industry makes a difference. It really does. And we should all be really proud of the work that we do. And any way we can support those of you listening, those of you involved in this work, that's what we're here for. And that's the mission side of the organization that that speaks to all of us. So I just I welcome the opportunity for future conversations, and I thank you CCB for your time today and for asking me to be a part of this. It's been it's been a great experience.

CCB: [00:31:31] Well, we completely appreciate it. As I mentioned earlier on the ONEder podcast page for Deborah's podcast, there will be a number of different links so that you can get easy access to The Center for Health Design. You can learn more about Debra and her colleagues and all of their their amazing work and research, education and advocacy, and the podcast is heard on all the streaming services. And one final thing that I'm going to point out, Debra, and I think you should share this One Workplace, our enterprise organization offers a ONEder grant cycle each year, and wonder grants are up to $20,000 for research to architects and designers in our West Coast marketplaces where we live and work and thrive. And so that's Northern California, that's Washington State. And if folks are interested, they should check out the ONEder Grant page because there is actual funding there. Now, it's not the millions of dollars that you need, Debra, but it does support time and effort towards research in design efforts to have an impact on people and workplaces and environments where we heal and learn. So, thank you very much, Debra Levine, Center for Health Design and the ONEder Podcast signs off.

Debra Levin: [00:32:57] Be well, thank you.