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Winter 2012

equilibrium Universal Design Primer


University of Michigan I Taubman College of Architecture and Urban Planning

Winter 2012

equilibrium Universal Design Primer


equilibrium is an annual publication which includes student work from the Universal Design seminar at the Taubman College of Architecture and Urban Planning. In future volumes, it may include collaborative research endeavors on the issues of accessibility and inclusive design in architecture. Instructor + Editor in Chief U. Sean Vance Copy Editor Claire H. Kang Sponsor University of Michigan Taubman College of Architecture and Urban Planning All editorial correspondence should be sent to: ATTN: U. Sean Vance A. Alfred Taubman College of Architecture and Urban Planning University of Michigan 2000 Bonisteel Boulevard Ann Arbor, MI 48109-2069 USA equilibrium is subject to copyright. All rights are reserved. No part of equilibrium may be photocopied and/or distributed without written permission from the instructor. 2012 Ann Arbor, MI

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Contents 01 02 03 04 05 06 07 08 09 10 11

Foreword Universal Design_COURSE DESCRIPTION AND OBJECTIVES Space Making for People_PATRICK BRINNEHL Reach, Range, Proximity_JACQUI COLAIANNI Understanding Goals for Adaptive Design_RYAN GILES Beyond Compliance_KAREN HENDERSON Handheld Issues_YOONHO LEE Architects as Respondents_MATHEW SCHWARTZ Equally Experienced_DOUGLAS SHARPE Interviews at the Department of Pathology Appendix

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Over the last two years I have been formulating collaborative relationships and developing new trajectories related to the teaching of architecture which proactively determines health levels. During this time the transition of my seminar content has been from a foundation of research on accessibility, into a more holistic and responsive architecture of the physical body and mental state. The basis of the new research and teaching methodology is being developing along three avenues for measuring physical exertion: the body at play, at work, and at rest, with rest being defined as the act of respire and recovery. By examining the exertion of the body at play, work, and rest, and in particular the resulting metabolic rate, I hope to distill and define

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new methodologies for architecture related to design and health. The intent of equilibrium, as a yearly publication, is to bring together the advancements in medical processes, along with the entrepreneurial and engineering considerations that are influential in the development of this new doctrine of architecture. The participants, both professional and academic, have been collaboratively developing innovative solutions associated with the performance of the human body. Searching hospital environments for pitfalls through immersive study, with the intent of resolving certain circumstantial difficulties associated with access and ability. The integration of professional observations


Foreword to academia contributes an assessment of individual care by the participants who are defining health within a larger construct, and considering the collective embodiment of health in a built environment. The collaborative understanding of such a dynamic range, from the home as a microcosm to more pressing macro issues, facilitates a redefinition of traditional practices associated with medically oriented architecture. This issue of equilibrium covers the course studies of the Winter 2012 Arch 509 class on universal design, and includes how each student utilized these immersive exercises to redefine their understanding of accessibility. They did not explore the situational investigations with the intention of

making a more efficient building, but rather as a means of designing openness and connectivity from an understanding of how people associate with architecture in their daily lives at play, at work, and at rest. By dissecting architectural methodologies associated with accessibility, which are typically based upon the individual body, and using them to develop new methods for resolving larger issues of a collective human interaction, I believe a new understanding of accessibility can be developed forward into the future. Designing access that is not defined by the limitations or constraints of standards, but rather by a new vision of health and longevity in our daily lives as individuals, and collectively as part of a greater society. U. Sean Vance

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Universal Design Course Description

to adhere to our environment and devolving due to our age. These changes introduce new design The history of Universal Design dilemmas and constraints that as began as a collaborative effort designers we have the potential for change as early as the midof responding to. Historically, the seventies. Research into how formation of accessibility guidelines architects, graphic designers, and set the parameters designers industrial designers provided an responded to regarding the understanding of usability that extremes of limited human ability. engaged emerging accessibility More recently with the advent of issues even at that time. These studies in user based technology were the beginnings of an and greater understanding of understanding that brought about the removal of barriers through our ergonomic solutions, the design community’s passion for change accessibility codes through the leadership of many individuals who has begun to match its shared vision towards a better built shared a common vision across varying professional perspectives, environment. By studying the application of universal design acting as one. this course will be asking you to broaden your association in Given enough time, people architecture to the physicality of in today’s modern world will space, addressing the limits of experience some type of loss associated with their current level human ability and into a holistic of ability. Physically, our bodies are human centered design approach. in a constant state of flux, evolving

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Course Objectives As a result of the course, students will be able to demonstrate the knowledge and application of design ideologies that benefit from a universal design approach. How different modern societies benefit from universal design, and the designer’s role. Students will examine and discuss various barrier typologies in the built environment and the physical and behavioral influence on human function and socialization. Inclass exercises will allow students to observe and question design implications when meeting the needs of people with differing physical abilities and the natural range of human performance that can include variances in sight, hearing, movement, and cognitive processes.

1. Teach the principles and strategies for creating spaces related to the limitations of design for accessibility, and the differences between accessible and universal design in architecture. 2. Teach the national and international social and design considerations of universal design. 3. Teach students to observe the environmental conditions considering the physical abilities of people and apply universal design approaches and practices in their studio work. 4. Facilitate exchange of knowledge among students by working collaboratively observing designed projects and architectural programs.

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PATRICK BRINNEHL UG4 I B.S. Arch Candidate I Evans Scholar

As a young designer, Patrick is still exploring many concentrations within the greater discipline of Architecture. Growing up in a small town, there were few people around him who went to college, and less who studied design. His education in Architecture will allow him to go back to a community with a different view of how people, buildings, and systems interact with one another. While this is his first encounter with Universal Design, it will be an area of continued study. More specifically how Universal Design can be incorporated in digital parametric systems, both in formal exploration and building information systems.

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Space Making for People

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INTRODUCTION

“The design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.”

-Center for Universal Design Up to this point, Architecture has been about designing space that is both visually and experientially engaging and profound. The experience has been a created perception, worked out through various means of representation to begin to understand the potential of space. It is common practice in school to disregard certain real world aspects of project development, such as building codes, to develop the space making skills. The hopes of this document is to break down what a “true building experience” is, and create a new set of tools available in the design process. To begin, a few terms that will be important to the discussion on the following pages must be definedI.:

- ADA: Americans with Disabilities Act - Adaptability: Ability of certain buildings, spaces, and elements (e.g., kitchen counters, sinks, grab bars) to be added to or altered so as to accommodate the needs of persons with or without disabilities or with different types of degrees of disability. - Accessible: Of a site, building, facility, or portion thereof, in compliance with ADA guidelines. - Clear: Unobstructed. - Common Use: Describes interior and exterior rooms, spaces, or elements that are made available for the use of a restricted group of people (for example, the occupants of a homeless shelter, the occupants of an office building, or the guests of such occupants). - Public Use: Describes interior or exterior rooms or spaces that are made available to the general public. Public use may be provided at a building or facility that is privately owned. - Occupiable: Room or enclosed space designed for human occupancy in which individuals congregate for amusement, education, or similar purposes, or in which occupants are engaged in labor, and which is equipped with means of egress, light, and ventilation. Universal Design is a way of thinking about design. It is a tool used to provide a better built environment for everyone to use. Universal Design is not a set of codes, regulations, and guidelines that restrict design potential.

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Areas of Universal Design Universal Design Art + Design

Industrial Design

Landscape Architecture

Graphic Design

Proportions

Architecture

Movement

Proportion, in large part, set up the experience of a space. Universal Design is not a set of strict standard proportions that make a space accessible. Instead, create new solutions that will serve all people, physically and aesthetically. There are vast possibilities when designing to the specific codes set forth by the ADA and other Building Codes. Using accessible proportions for ramps and stairs creates rich, functional spaces.

Space

Occupant

Ensuring enough space for mobility by all persons will require unique solutions for each individual project. The process leading to a Universally accessible building will push the design to new heights. Architecture is for people, creating shelter to protect and please. This is the heart of the discipline, and thus should be the heart of design. Keeping the future occupants needs in mind early in the design phase will produce a superior project.

I. McMorrough, Julia. “ADA and Accessibility.� Materials, Structures, and Standards: All the Details Architects Need to Know but Can Never Find. Gloucester, MA: Rockport, 2006. Print.

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“To provide for the public welfare, governments at all levels establish and enforce building codes and regulations”

CLEARANCE

-David S. Collins, FAIAI.

Knowing what to measure is the basis for any analysis. When breaking down a building, getting the correct measurements allows for the study of the spatial and performance qualities. Assessing the correct measure of people allows for design which empowers occupants. It is more than getting the correct measure however, it is understanding that there is no “standard.” People come in every shape, size, and ability. Designing for all of those clearances is what makes it Universal. The difference between being handicapped, and having an action be handicapped lies within the designer. The easiest way to handicap the environment is to design for one measure of people. There are a number of codes designers must follow. They come in many forms, but for the sake of this argument, two will be examined: prescriptive and performance.

- Model Codes - Model codes are a group of codes and standards accepted by more than one of the Building Code regulatory agency such as SBCCI, BOCA, and ICBO. Previously separated regionally these standards or codes established to provide uniformity in regulations are now centrally contained in the IBC. - Prescriptive Codes - Prescriptive codes are any group of codes which use standards to define methodology or construction type. Examples of a prescriptive Building Code include NFPA standards dictated by OSFM and UL standards for equipment and construction type. These codes are commonly referred to via the specification documentation and are commonly intended to prevent loss of life or death. Prescriptive codes essentially makes up a checklist which inspectors can apply to all buildings. - Performance Codes - Performance based codes are any group of codes which use standards to the level of performance expected to satisfactorily bring agreement on the level of use. Examples of a performance Building Code include Accessibility standards defined federally yet verified locally. These codes are commonly intended to defend civil, moral, or ethical use and considerations.II. 14


Stability Reached

Step ladder reach range (as shown in the photo’s on following pages) is a limit in the spectrum of performance. Comfortable reach comes from a combination of elements including the width and depth of the step, height of the bar, and the height of the step. The clusters of tape mark different subjects ability to reach in common directions, the main question asked, is one step enough to accomplish the main goal? The test suggests that only one subject was able to reach the ceiling, below is a set of considerations when designing a new step.

Dual Steps - Improve the range accessible without compromising stability. Sturdy construction is a must if only to convince the user it is strong.

Wall Clearance - Being closer to the wall improves user stability, however it may also limit range. Using the bar as an extension can help solve both problems.

Wide Base - Promotes stability and improves range. I. The Architecture Student’s Handbook of Professional Practice. Hoboken, NJ: Wiley, 2009. II. North Carolina State Building Code, Accessibility Code

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Mapping full extent of Stable Reach

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Reach range varies greatly for each subject

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“In like fashion the members of temples ought to have dimensions of their several parts answering suitably to the general sum of their whole magnitude.�

WORK ZONE

-VitruviusI.

History of Human Factors in Design: Human factors engineering looks at products and vehicles and their relationship to the measure of the body. This begins during WWII, as soldiers were required to fit into sophisticated equipment. This equipment was not designed for the long periods of time required by the soldier. In order to produce a more efficient soldier, better design was necessary. Ergonomics refers to designing for the workforce around equipment use. It is inefficient to ask employees to cope with difficult to use working conditions. To improve their output and efficiency ergonomics was created. The work zone demands three principles to be considered in the design: Transfer, Transact, and Transition.II.

- Transfer: Generally used when describing moving from an assistive device, such as a wheel chair, to a fixed position in a room, a seat or bench. Not only is it important to have the proper fixtures to allow for transfer, but also strive for multiple ways to transfer from device to chair. This requires multiple approaches for both front and side transfer. Clearances around the chair must be considered; too much clearance and there is nothing to use as support, and too close presents the potential of getting wedged between the chair and wall. - Transact: The ability to operate and engage any device, not only as an able bodied adult, but also those handicapped, and persons still growing and developing. Devices may not always be accessible to all people, but may instead have the ability to easily transform to accommodate the current user. Flexibility in the object will produce a longer usable life span, and allow for all to use.

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-Transition: At least one stepless entrance is essential, preferably at the front door. When able to provide more than one consider the additional entrances through a garage or from a patio or raised deck. This is not only for those in wheelchairs, but also for bringing any large object into the building. Rolling luggage, and large furniture become exponentially more difficult to maneuver when a step up or down is required.

Mobility Tested The Art + Architecture has its problems, but accessibility for those in wheelchairs became painfully obvious during a trip around the building in a self propelled chair. The most notable and problematic issue is the location of the elevator. It is difficult to find and very far from many of the entries into the building. The painfully obvious orange strips used to contain the studios and provide adequate egress can easily be filled and inhibit the movement of any individual in the case of an emergency. Allowing outlets for facility requirements could keep the space clear. Various day to day tasks are not well suited for the building either. Below are the mailboxes, and the top boxes are extremely difficult to reach, and would be impossible for some users. Making the armrest strong and stable enough to support the weight of the user may allow them to push up to reach all boxes. It was impossible to access the mailboxes on the interior due to the doors swing and clearance.

I. Vitruvius, De Architectura: THE PLANNING OF TEMPLES, Book 3, Chapter I II. Lichez, R. B. “Resources on Architectural Accessibility and Housing Adaptation.�Independent Living Institute.

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Orange lines provide a suitable pathway, but it is easily filled with obstructions

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A large majority of mailboxes are in reach

It is much more difficult to send mail

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OPPOSABLE THUMBS

“Hand held devices benefit from a user’s ability to contract muscles in the hand and forearm which assist in closing the fingers.” In the case of an emergency, a quick way out of a structure could be the difference between life or death. There are many codes and regulations which are concerned with loss of life and the ability of occupants to exit safely, while at the same time allowing emergency workers to enter. An entire section of the International Building Code (2012 Section 1007) is solely concerned with egress and accessibility. The attention to details concerned with egress are imperative during the design process. The following is an attempt to deduce just a few of these decisions that went into the Art + Architecture Building. For the consideration of time, only the stairwells, and more specifically the handrails will be discussed. There are precise measurements governing the distance and height a handrail is from the wall and floor. The inside edge of a circular cross section handrail must be 1.5” from the wall, with a diameter of at least .25”, and no greater than 1.5” (see facing page). It also must be a minimum 34” from the finished floor, but no higher than 38”. [8.3.2] This ensures that nearly all able to use the stairs can not only reach the bar, but fit their hand in a manner that helps support the body. The dimension limitations to the cross section is to utilize the “power grip,” or having the hand completely closed around the bar.

Minimum Requirements 22


Unobstructed Help

A major problem in the design of the Art + Architecture Building lies in both of the southern stairwells between the second and third floors. There is a protruding air supply vent that creates a situation where the handrails are no longer clear from the wall. Not only is there an obstruction making it difficult to fit the hand between the wall and handrail, but this vent supplies hot air to the building, potentially burning the hand of someone who needs the assistance of the bar. This is just one of many serious problems that prevent comfortable use for everyone around the world. It is here that a new proposition for a stair assistance tool be made. Instead of relying on the users hand and forearm strength for stability, create a moving grab bar that moves the length of the stair. The bar would then be resistive while going down, to prevent falling, and powered while moving up in order to assist the user. This can be a simple mechanism using a resistance band within the handrail itself, or as a retrofit. The device is not meant to act as a lift, rather control the pace at which the stairs are traveled. It would also solve the problem of having an obstruction between the bar and wall, as the users hand is always on the moving handle.

Resisted Decline

Assisted Accent

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Current Problem State

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Correct State elsewhere in building

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VISUAL ACUITY

User experience is comprised of multiple information sources. Vision, touch, hearing, are all instruments to resolve the environment in which we live. The heart of Architecture lies within the eyes. The perception of a space, its look and feel, is created by the signals and input of the body. It is not limited to sight, however the eyes arguably provide the vast majority of all information about a space. There are a few theories of how the brain collects and interprets visual signals, dominant the bottom up and top down theories of perception. The one commonality is that the brain is in control, at least most of the time. Below is a short list of ways visual acuity can be impaired.

- Macular Degeneration: The deterioration of the macula the central area of the retina, is prevalent among older patients. This Illustration shows the area of decreased central vision, called a central scotoma. With macular degeneration, print appears distorted and segments of words may be missing. - Cataract: An opacity of the lens results in diminished acuity, but does not affect the field of vision. - Glaucoma: Chronic elevated eye pressure in susceptible individuals may cause optic nerve atrophy and loss of peripheral vision. Early detection and lose medical monitoring can help reduce complications. In advanced glaucoma, print may appear faded and words may be difficult to read. - Hemianopia: A defect of the optic pathways in the brain can result in vision loss in half of the visual field. Universal Design is concerned not only with these problem, the visual problems which come with aging, and other medical abnormalities, but also producing a more efficient work space, and area for youth to grow and develop. To get a sense of these ailments, seemingly simple tasks were performed while wearing sensory deprivation equipment. Large gloves, and goggles with soap distorting vision. As numbers were read off, subjects were asked to perform calculations and read back the numbers. It was nearly impossible for test subject Q to read back the numbers (as shown on facing page).

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Difficulty Operate Difficulty ToTo Opperate

New Limits

This hammer has a series of screwdrivers nested in the handle, each tool is progressively smaller. It was extremely difficult to manipulate the last 3 tools with the sensory deprivation gloves on. While the test subject was able to disassemble and reassemble the entire tool, they were unable to use the small tools as designed.

“Normal� Vision

Impaired Vision

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MOTT’S CHILDREN’S HOSPITAL

“Our new state-of-the-art facility enables us to fulfill our continued commitment to providing newborns, children and pregnant women with the best health care possible.”

-Mott’s Website The new children’s hospital has been hailed as a marvel of patient care, technology, and Architecture for months leading up to its opening. Upon entering however, it is obvious that there are still some significant problems the staff faces on a day to day basis. Many of the issues could have been avoided if input from the doctors and staff were incorporated into the design. At 1.1 million square feet there is plenty of room to provide private rooms for patients. While this may leave the patients more comfortable, it proves to difficult for the staff to assist one another in the case of an emergency. By placing an additional door, just a few extra feet of floor to cover, a patients well being may be in jeopardy. The hospital focuses heavily on patient privacy, but this may lead to a lower quality of care because of the physical limitations.

The main corridor doors have switch activated openers to easily move beds around the hospital. However the location of the switches are too far from the door (see diagram below), often reacquiring the staff member to leave the patient, go back to the switch, then continue on their way.

AUTOMATIC DOOR SWITCH

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Navigating Mott While visiting Mott, our guide was paged into emergency surgery on another floor. As he was giving us a tour though, he could not easily find a stair or elevator that would get him to his patient. Even after spending three months in the new building, it was difficult for him to find a route quickly. There were no signs, placards, or color coded bands on the floor or walls to find the way to the vertical circulation. There is a sever lack of signage throughout the corridors, making way finding nearly impossible. Temporary signs have been placed by the staff to navigate more efficiently (as seen in photo). These signs not only benefit those who work every day, but also patients who might only use the hallway a few times. It is impossible to differentiate one hallway from another, and there are few (if any) windows in most that could be used for orientation.

There are some features which, although simple, very effective in assisting patient care. Colored markers outside each room indicate the status of the patient, or room itself. This allows for doctors and nurses to be sure they are in the correct room, and that they are the correct specialist for the patient. It also helps to the staff track the status of each room without the need to interrupt the patient.

“Facts and Figures about the New C.S. Mott Children’s Hospital.” One of the Best Children’s Hospitals in the U.S. Web. 10 Mar. 2012. <http://www.mottchildren.org/about-us/new-hospital-facts>.

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OCCUPY PERSONAL

Access TCAUP: Engaging the student body in critical thinking by creating awareness of situations often overlooked.

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Our goal is to create awareness around the building, and around campus about the everyday interactions that seem simple for most, but can be extremely difficult for others. Efforts were focused on way finding throughout the Art + Architecture building, focusing on those who donâ&#x20AC;&#x2122;t occupy the building as much as students. It is incredibly difficult to find the offices, lecture hall, and media center even though a few signs have been posted. Additional labels have been placed in an attempt to move people around the building. In addition, labels were added to spaces which are used every day, but must be learned about through word of mouth, such as the CMYK space. By simply placing labels on various surfaces, including the stairwells on the first floor, a first time user is now able to better navigate the building. It is not a perfect map, but it is a way to start making educated guesses at where the desired location is. Going to the offices can be difficult, but now it is obvious to go to the second floor. There is inadequate clearance for a main corridor on the third floor

Knowing the room numbers for a particular hall way can save weaving in and out of the building. There is a numerical system in place, but it is not easily known


Enter TCAUP

During the installation of new signage and way finding, an encounter with a faculty member led to the question, how can way finding start outside the building. The Art + Architecture Building is interesting in the fact that many users enter from the “back” of the building and are faced with a choice; left or right. Starting in the right direction can save time and headache for new users, however it may eliminate some of the great exploration throughout the building and the ability to see the great work produced by the occupants.

Art + Architecture Building

Alfred A. Taubman College of Architecture and Urban Planning School of Art + Design

WEST Woodshop Maskel Studio’s

EAST Ground Floor

Elevator Slusser Gallery

Second Floor Media Center Courtyard Access

Facility Office Building Technologis Lab Auditorium

Third Floor Architecture Studios

Architecture Studios

A simple sign at the bottom of each stair in the parking lot, along with proper signage upon entering can make the experience much easier on all users of the building

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The branch of medicine concerned with the cause, origin, and nature of disease, including the changes occurring as a result of disease.

PATHOLOGY

-Websterâ&#x20AC;&#x2122;s Dictionary

A primary goal for our research throughout the semester is to understand the University of Michigan Hospitalâ&#x20AC;&#x2122;s pathology department. Documentation will provide a base for further research and development of proposed design solutions for future construction. To begin, we were fortunate enough to interview Dr. Myers, below is a summary of the information gained through conversation. Pathology can be separated into two categories: clinical, which deals primarily with blood and urine testing, and anatomical, which takes tissue samples, cytology, and autopsy. We are concerned with the anatomic pathology department. Samples of tissue, acquired through biopsy, are carefully dyed and placed into wax blocks. From here thin slices can be made, revealing the cellular makeup of the sample. This sample is placed on a slide, and sent various locations and personnel for diagnosis. Samples can be sent anywhere in the world for consultation. As a teaching university, The University of Michigan archives all of the tissue samples they create. Most facilities dominantly use analog samples, that is physical slides for diagnosis, but the future appears to be in digitized samples. Currently Michigan does have some capabilities for digitizing samples, but they are used mostly for reference when viewing the actual sample. Multi-head microscopes are the main tool used for diagnosing and teaching. An experienced doctor can take a student through the process of diagnosing while looking at the same sample. This method is how pathology is taught.

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Digital vs. Analog The potential benefits of digital samples are practical and very exciting. There will no longer be a need to mail samples from location to location, and there will be no lost time associated with it. Right now a sample going from one department to another on the same campus can take hours, when it is just across the street. Digital samples will allow doctors to access all the information necessary from practically anywhere in the world, as long as there is an internet connection. There are still a great deal of technological hurdles to overcome before a completely digital work environment can be achieved. The main concern is quality. No image produced today can duplicate the quality of a physical sample viewed through an optical device. Even though it is a seemingly flat slide, there are minute variations in depth that are crucial to proper analysis. No digital sample comes close to this quality and realism. The means by which a sample is viewed is also a critical part of the process. With a microscope, a doctor can focus only on the sample, and remove all distractions, in a way creating an alternate environment that only serves one purpose. Viewing digital samples is done on a computer screen. The same screen that e-mail, videos, news, and a multitude of other distractions is displayed. This may become less of an issue as new generations of doctors come to practice, but the quality of focus on a sample may not be duplicated in digital means. There are also concerns with the amount of data, and storage space that data will require. In order to get image quality high enough for correct analysis, files are impressively large. They are far too big to send via e-mail, so dedicated servers must be set up to access the information. The interface for the server is clumsy at the moment, but will likely improve quickly as more focus is put on digital samples. The file sizes will likely get larger as well when three dimensional scanning becomes a practical option. More data requires more server space, and more bandwidth to get to the people who need them. For now analog will dominate, but in the near future, digital samples will start to take the forefront. For a successful transition, thoughtful consideration to both the analog and digital methods must be considered in the space planning of Pathology departments.

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Multi-head microscope

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The current state of digital technology in the Pathology department does not go much further than a computer strapped to the wall.

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PATHOLOGY REVISITED

Sign out rooms are where the first look at the sample is taken. From here a more refined analysis and diagnosis can be made. The sign out rooms are extremely important in the Pathology process. All of the samples are examined by the attendings, and preliminary reports are produced. Each sample is labeled, by hand, with the patient and sample information, and has a barcode for future digitization. The samples are then placed on trays by patient, and organized by organ and day. The following is an analysis of a sign out room: Digitizing the work flow, while keeping physical samples will be the first step to an all digital office, and provide more efficient handling of data. Utilizing the bar codes already in place will help quickly and easily identify if a sample has moved to the wrong doctor, or filing station, as well as streamline the process of pulling up supplemental patient information.

Here are two examples of holding units for the samples in a sign out room. Separated by stacking trays, it is easy to move a stack to reach a specific tray, and forget to replace it. 36


Repeated Rotation After observing a doctor run through a few samples, it is clear that the sequence of events is very repetitive, with a few exceptions for checking resources. It is a two person operation, with both having eyes in the microscope. The computer has been outfitted with a wireless keyboard to relieve some of the motion from the microscope to the keyboard, and multiple monitors are set up. With all of this word processing capabilities, the preliminary report is still written by hand. There is also a microphone in the room for recording the conversation, but is not utilized very much at this time.

Reference Cabinet

Main monitor + microphone

Sign out room

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Monitor - Microscope configuration

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Full Set Up

Main Desk Set Up 38


WORKS CITED

The Architecture Student’s Handbook of Professional Practice. Hoboken, NJ: Wiley, 2009. Lichez, R. B. “Resources on Architectural Accessibility and Housing Adaptation.”Independent Living Institute. McMorrough, Julia. “ADA and Accessibility.” Materials, Structures, and Standards: All the Details Architects Need to Know but Can Never Find. Gloucester, MA: Rockport, 2006. Print. North Carolina State Building Code, Accessibility Code Vitruvius, De Architectura: THE PLANNING OF TEMPLES, Book 3, Chapter I

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JACQUI COLAIANNI M.Arch Candidate 2012

Jacqui graduated in 2006 from Central Michigan University with a Bachelorâ&#x20AC;&#x2122;s degree in Interior Design. After graduation she worked for WorkSquared, a Herman Miller dealer in Traverse City, MI, as a designer and project coordinator. During her time with WorkSquared, she became PEAK certified; PEAK is Herman Millerâ&#x20AC;&#x2122;s health care and design training. This training made her aware of current design practices in the field of health care, and the challenges it presents, and sparked her passion for health care design. Function plus aesthetic are responsible for creating the overall experience, and she is passionate about creating positive healing and working experiences. She believes that a healthy work environment reflects in the morale, productivity, and efficiency of the caregiver, which ultimately results in better care to the patient; and that is a design goal worth pursuing.

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Reach Range Proximity When dealing with universal design, one consideration is the fact that one size does not fit all. Universal design is not about accommodating for disabilities, but rather, accommodating for differing abilities. Under the category of ability are range of motion, and size; these dictate how much space a person occupies and requires for movement.

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REACH, RANGE & PROXIMITY

60º 55º 45º 45º

60º 70º

35º 30º

70º 60º

60º 50º

45º 30º

45º 50º

Subject 4 Subject 5 Subject 6

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45º 30º

40º 40º


Subject 4 Subject 5 Subject 6

13” 11” 17.5” 16” 7” 6”

16” 16”

68” 62”

55.5” 52”

20” 19”

This exercise measures the size and range of motions in three subjects. Size is measured using the link system, and range of motions is measured with a goniometer. Architecture 509 | Design Analytics for Ability in Architecture Architecture 509 | Design Analytics for Ability in Architecture

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REACH, RANGE + PROXIMITY How can we apply these investigations to a design situation? Every body has different limitations. The goal of design is to mitigate challenges that come with these limitations. There are flaws even in the best designs, as can be seen in this Herman Miller Caper chair, but this creates opportunities in changing how we think about seating and working at a desk.

Arm Rests

Pro: Allows a place to rest arms releasing shoulder strain Con: Not flexible, so people may be too wide to comfortably sit in or use chair Opportunity: Provide removable arms to allow user to decide when/if to use arms

Pneumatic

Pro: Accommodates different size people Con: Could cause shoulder strain if work surface is still too high Opportunity: Height and angle adjustable work surface

Casters

Pro: Allow for easy movement along floor Con: Make stability difficult when exiting chair Opportunity: Give casters operable locking mechanism that would allow user to lock casters in place before exiting seat

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CLEARANCE Clearance is the amount of space an individual requires at any moment. Clearance is based on more than the size of an individualâ&#x20AC;&#x2122;s body; range of motion should be taken into consideration. Our study found that range of motion varies depending on the room required for the activity, comfort level and physical ability level of the individual. The study explored different activities that observed these factors and varying space required, and took into consideration the opportunities that developed from some of the findings. Architecture 509 | Design Analytics for Ability in Architecture 46


CLEARANCE Study 1_Golf Swing

Range of motion is observed when swinging a golf club versus a tennis racquet in a stationary position. A comfortable range of motions is established and measured to find variances in the two activities.

RANGE TO LEFT FROM CENTER

RANGE TO RIGHT FROM CENTER

SUBJECT D

17”

27”

SUBJECT Q

19”

21”

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CLEARANCE Tennis

RANGE TO LEFT FROM CENTER

RANGE TO RIGHT FROM CENTER

SUBJECT D

33”

17”

SUBJECT Q

25”

17.5”

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CLEARANCE Study 2

Physical ability and limitations are observed when standing on a single step stool and measuring the furthest point of reach

52” 43.5” 46” 41” 45” 44”

38” 33”

37” 34.5”

32” 29”

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Subject D Subject Q

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Design Opportunities

Tall ceiling, but proportional to room width so as not to feel too small

Spherical room to give perception of uninhibited movement

Making stair wider for increased stability

Taller handrail to grab and lean against

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ACCESS Individuals in wheelchairs see the world much differently than able bodied individuals. Small tasks become big challenges. Designers and architects have the responsibility of making these tasks easier for people with varying levels of abilities. Current accessibility trends often act as band-aid fixes and do not actually address or give a complete solution to the issue. Our role as designers is to question existing accessibility guidelines to see if there is a better way to accommodate these individuals. Architecture 509 | Design Analytics for Ability in Architecture Architecture 509 | Design Analytics for Ability in Architecture

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ACCESS Study & Findings The study focuses on a number of tasks that an individual bound to a wheelchair might have to complete during the day to discover what complications exist and what opportunities there are for improvement.

Measurements Subject P

56” 65” 56”

46.5”

42.5” 41” 28.5” 20”

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Activity 1 Drink water from the third floor fountain closest to public restrooms

Observations Water fountain is only 10” from floor, and does not allow for a wheelchair to fit underneath, so water is not accessible Fatigue; studio space is often encumbered, the best option for an individual in a wheelchair would be the faculty corridor, but the building is long and the corridor is too narrow to turn around, so individual must make a commitment to travel down the entire length of the corridor, or back out

May be easier to turn around if legs swivel in both directions Incorporate wider areas as “turn around zones” Corridor not wide enough to turn around in a wheelchair

Water fountain is only 10” above floor, not enough clearance for a wheelchair to fit underneath to access water

Incorporate wider areas and more access areas into larger space for “escape routes” Long corridor makes for fatigued arms

Make all fountains accessible A less expensive option may be to provide a dispenser stocked with disposable cups

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Activity 2 Accessible bathroom, transfer to shower and toilet

Observations Entry door is difficult to open Grab bars are not helpful, user cannot avoid using toilet to support/transfer Difficult to turn around in some parts of the room, particularly around the sink area Difficult to wash hands - water is just out of reach, soap is inaccessible Shower wand is adjustable, but last user left it too high, so it is impossible to reach for an individual in a wheelchair Individual must lock both wheels to transfer to the shower or toilet, but once transferred the far lock on the chair is too far to reach, so chair cannot be moved Threshold is difficult to maneuver

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Location of toilet in relation to shower wall makes turning around at this location impossible Cut out wall section for foot room Soap dispenser is too high and inaccessible Mount soap dispenser here instead

When taller individual uses shower and does not replace wand in lowest position, wand becomes inaccessible A pressure controlled wand might be an appropriate solution, where while the water pressure is on, the wand stays in place. Once water pressure is off, wand slides down to lowest position

Grab bars are difficult to access and awkward to use. Front approach is not possible Grab bars on either side of toilet for maximum support

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Activity 4 Greet receptionists

Observations Carpet is difficult to wheel over Receptionist A is easily accessible Receptionist B has a high transaction counter that makes interaction awkward

Carpet is difficult to wheel over

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Niche is a good way to mitigate the distance

Distance of interaction is a little far

Transaction counter is too high for individual in wheelchair. He/She must travel to end of receptionistâ&#x20AC;&#x2122;s desk for interaction

One panel of the receptionist desk should be dedicated to a lower transaction counter for a more comfortable interaction

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Activity 5 Experience Courtyard in center of building Observations There are two doors that access the courtyards, only one of which is powered. The ramp is difficult to wheel up when there is snow on the ground 2â&#x20AC;? threshold makes it difficult to enter back into building

Ramp is steep and difficult to wheel up

Rubber mats may be used to gain traction

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Loss of traction in snow


Forced to use handrail

Handrail is used as a tool to pull individual up ramp, can be cold in winter

Plastic coating on metal handrail may not be as cold for userâ&#x20AC;&#x2122;s bare hands

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HANDLES + HANDRAILS For able bodied individuals with five digits, the world is fairly easy to navigate. Individuals who do not have the use of their hands or fingers have a challenge, especially when it comes to a seemingly simple task of opening a door. If an individual is challenged in this way, doors with levers are slightly easier to open than those with twist knobs, but as our study discovers, even this can be difficult depending on the dimensions of the lever, the pull force on the door, and the height of the handle. Stairs in public buildings are required to be equipped with a handrail for safety. Although, as with the door knob, if the handrail is not at the proper dimensions or height, they too can cause problems. Architecture 509 | Design Analytics for Ability in Architecture 62


HANDLES + HANDRAILS Study & Findings The study focuses on difficulty of opening doors and potentially improper handrail dimensions existing around Taubman college, and offers potential solutions to the opportunities we discover.

Current ADA Compliant Guidelines for Handrails

1 1/4" min 1 1/2" 1 1/2â&#x20AC;? max

mounting height 34" min 38â&#x20AC;? max

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HANDLES + HANDRAILS

3"

3 3/4"

12"

34â&#x20AC;?

8 1/4"

2"

Handrail is too wide to grab comfortably; there is excess material on bottom half of handrail

Handrail is too far from the wall, an individual relying on the handrail for support could have their arm fall through the gap and not be able to lift it

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Opportunities_Handrail Cut off excess material from bottom of wooden handrail, use material to cut out shape and attach to rounded handrail to close gap between rail and wall

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HANDLES + HANDRAILS Current ADA Compliant Guidelines for Doors

lever handle

30” min 48” max

5 lbs. max pulling force

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Entry Door 36-48” height

9.3 lbs. pull force

Pull force is too heavy

Courtyard Entrance 1” diameter push lever 35 5/8” height 14.4 lbs. pull force

Push bar diameter is a little too small, could cause problems for someone who has limited gripping capabilities; Also, the pull force is too heavy

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HANDLES + HANDRAILS

Entrance to Offices Twist knob handle 38” height 14.4 lbs. pull force

Twist knob is difficult to open for an individual who does not have full manual dexterity Pull force is too heavy

Entrance to Auditorium (2104) 10.9 lbs. pull force 1 1/8” diameter pull 1 3/4” distance from door

Pull force is too heavy Push bar diameter is a little too small, could cause problems for someone who has limited gripping capabilities Distance from door is too much, it requires awkward manipulation and use of other muscles to open

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Current ADA Compliant Guidelines for Door Lever

3/8"

2 3/4"

Entrance to BT Lab 6.1 lbs. pull force

Lever does not allow enough clearance for an individualâ&#x20AC;&#x2122;s hand to pass through Pull force is too heavy

Opportunities_Doors Install a plastic tube around push bar to make it thicker and provide a more comfortable grip for user For lever handles, install wider lever higher on door to allow for operating the handles with the elbow Pedal or handle located low on door to be operated by the foot Architecture 509 | Design Analytics for Ability in Architecture Architecture 509 | Design Analytics for Ability in Architecture

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SIGHT + SENSORY DEPRIVATION With old age comes the decrease in many of our sensory abilities; most commonly, our eyesight and sensory perception in our hands.

Study & Findings The study focuses on understanding the experience someone might have who suffers from failing eyesight and poor manual sensory perception in performing seemingly simple tasks to an able-bodied person. Architecture 509 | Design Analytics for Ability in Architecture 70


SIGHT + SENSORY DEPRIVATION Macular Degeneration Individuals living with macular degeneration have their vision impaired by what appears to be a spot in the middle of their view. The spot might range from small, partially blocking their vision to large, blocking their entire vision. To replicate the condition, we used swimming goggles with soap rubbed on the center to impede our sight and large rubber gloves to impede our manual sensitivity

Indicates difficulty of activity

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SIGHT + SENSORY DEPRIVATION Moderate Macular Degeneration and Sensory Deprivation Study 1 _ Stringing Beads The study looks at how an individual with moderate macular degeneration and sever sensory deprivation might handle a task that requires detail work by finding beads with letters to spell out our names and then stringing them onto a pipe cleaner wire

Observations - Because the macular degeneration simulation was only moderate, it was difficult to see directly in front of me, but I was able to rely on my periphery vision to read the letters on the beads -My movements were slower, more controlled and focused on the task -Difficult to pick out small beads in a small bag -Pouring the letters out was difficult because I could not feel the weight of the bag change as I tipped it, so where I had intended to pour only a few letters out, the result was an empty bag and a big messy pile of letter beads -Stringing the letters onto the pipe cleaner wire was relatively easy, the only challenge was finding the hole and then maneuvering it between my fingers to match the hole to the wire -At times it was difficult to see the difference between the hole and a letter

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Opportunities -Make letters different color than black so as to visually differentiate them from the hole -Make beads larger and give them some amorphous shape to make them easier to hold onto -If bead size/shape cannot be altered, provide a mechanism that would clamp to a flat surface and hold the bead while the user strings it

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SIGHT + SENSORY DEPRIVATION Moderate Macular Degeneration and Sensory Deprivation Study 2 _ Assembly/Disassembly The study worked in teams with one person disassembling a tool with smaller tools nested inside. The other team member would then assemble the parts. Subject Q was the assembling team member.

Observations -Relatively easy task -Found ways to use the table to support the tool while assembling -Task may have been more difficult if pieces were scrambled, or had I not been able to see my partner disassemble it

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Moderate Macular Degeneration and Sensory Deprivation Study 3 _ Screw into Wood The subjects are given a block of wood and a small eyehook screw and must observe their experience of manually screwing it into the block of wood.

Observations -It was difficult to feel the tiny screw between my fingers, I had to really on my vision to know that I was holding it correctly -I had to find an alternative technique to screw in the eyehook, I held the screw steady and turned the block of wood because the wood was easier to grasp -Task was made easier by finding an existing divot in the wood and using that as a starting place to screw in the eyehook

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SIGHT + SENSORY DEPRIVATION Severe Macular Degeneration and Sensory Deprivation Study 4 _ Adding Numbers The study worked in teams with one team member looking at numbers written on the board, reading them to team member 2. Team member 2 would then enter the numbers into a calculator in order to add the list of numbers.

Observations -Seeing the numbers on the board was difficult, I had to concentrate and squint to read them, contrast against the board was good, but size of the font was too small -Writing the numbers was easy as this was a learned/ repetitious task that I did not need to fully see to know what I was doing -The calculator user, it was difficult to push one button at a time, as they were too small and did not register an action -Had to look at the screen to know that a button was actually pushed, but contrast in screen was low, so numbers on screen were difficult to discern -Shape of calculator was difficult to hold -One position caused buttons at perimeter of calculator to be depressed -Another position covered the solar register panel causing the calculator to shut off

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Opportunities -Larger font -Provide a contoured base that would snap onto a flat calculator that would be easier to hold while using the calculator -Larger, high contrast screen

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SIGHT + SENSORY DEPRIVATION Severe Macular Degeneration and Sensory Deprivation Study 5 _ Drawing Domino The subjects are given a domino to replicate through drawing.

Observations -Had to position myself close to domino to be able to discern number of dots -The domino itself was relatively easy to see, if a bit blurry -Also had to move close to paper to see what I was drawing, but even then I had to guess the proper locations of the dots -Fine pen line was difficult to see

Opportunities -Use a thicker pen -Make dots raised so user can count the number of dots by feeling

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Severe Macular Degeneration and Sensory Deprivation Study 6 _ Shapes The subjects are given a variety of shapes made of different materials and colors and asked to record observations on their experience visually and manually.

Observations - Size of the shapes did not make a difference in ease of visibility -Material did not make a difference in ease of visibility -Color is the leading factor in distinguishing one shape from another -Bright colors were easier to see, dark colors were nearly impossible to see

Opportunities -Important text or diagrams should be in color to gain attention

Normal vision

Simulation of severe macular degeneration Architecture 509 | Design Analytics for Ability in Architecture

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MEMORY Memory is the ability to store and recall information. The ease of which we recall is based on many factors, to include age, familiarity with the subject, emotional association with the memory, etc.

Study & Findings The study focuses on observing the differences between short term memory and long term memory by recalling two locations, the first, the subjectâ&#x20AC;&#x2122;s current residence, the second, the residence the subject grew up in. In addition to mapping the location, the subjects were asked to recall smells and memories associated with each location. Architecture 509 | Design Analytics for Ability in Architecture Architecture 509 | Design Analytics for Ability in Architecture

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MEMORY

Short Term Memory The subject is to recall his/her current residence, mapping the plan view and any sights, sounds, or smells associated with the space.

The smells recalled are mostly those associated with soap in the bathroom, kitchen smells of spices and garbage. The subject recalls pausing to look at the clock to monitor the time, the dresser when searching for clothes, and a last minute glance in the mirror before leaving for the day. Sounds associated with the space are the alarm clock, traffic outside the window, the subjectâ&#x20AC;&#x2122;s roommate talking on the phone and sounds from the shower in the adjacent room. These are routine sensory experiences that do not evoke much emotion, or much memory, the subject observed that mapping something seen every day and in fact that very day, is actually quite difficult.

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Memory Sound Sight

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MEMORY

Long Term Memory The subject is then asked to perform the same exercise for the house in which he/she grew up. The memory is surprisingly much more vivid. The subject chose to draw his/her grandmotherâ&#x20AC;&#x2122;s home, a summer vacation location. The smells recalled are associated with her grandmother cooking in the kitchen, of the lake, the fireplace, her grandmotherâ&#x20AC;&#x2122;s perfume, and the mint candies her grandmother keeps next to the lounge chair in the living room. The subject recalls pausing to look at family photographs hung on the wall, and the view of the lake out the window. Sounds associated with the space are the radio which was always on announcing the score of the Tigerâ&#x20AC;&#x2122;s baseball game, the sound of things cooking on the stove and also the sound of game shows coming from the television. The memories from this space are far more detailed and specific, possibly due of the emotional attachment to the house. As designers perhaps this is something we can take from this exercise, that if we create an emotional connection to the space, the viewer will have a more specific and detailed memory associated with it.

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Memory Sound Sight

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WAYFINDING Wayfinding is the ability to logically navigate a space either intuitively or through the use of signage and visual cues. Wayfinding is particularly important in high stress or large and complex environments, such as a hospital; it is important that a patient be able to quickly and safely move from one part of the hospital to another. Family members visiting an ailing loved one do not need the extra stress of being lost in a maze of long corridors. Likewise, doctors need to be able to quickly access different departments, for them minutes mean lives. Architecture 509 | Design Analytics for Ability in Architecture 86


WAYFINDING Study This week’s study was an on-site visit to the University of Michigan Hospital, looking specifically at the new Mott Children’s Hospital that opened in December 2011. While at the hospital, the doctor giving us the tour received a call and had to go into emergency surgery. We were fortunate in that this allowed us to observe other people attempting to navigate the hospital.

Observations Despite the hospital’s recent opening, we observed several ways in which the hospital could improve their design, in terms of wayfinding.

In Public Accessible Areas: -We did not see an overall map of the hospital which would have given us a better sense of where we were located within the building -Corridors were long and lined with identical doors with little indication of what designated a hospital room versus an office, or even what department we were in

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Signs were placed on a high ceiling with small text and oftentimes were covered by another sign

Due to lack of signage, different departments are making their own modifications, adapting their environment to fit their needs and accommodate their visitors

In this image the department is changing to a season based naming system for the different sections to help visitors more easily find the room they need. This is temporarily achieved by a printed page displaying the season, the room numbers and a graphic representation of the season pasted over the existing sign.

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In Privately accessible areas: -When our doctor received the page, we were on the floor above where he needed to be; we rushed to find a way to get downstairs. Even he struggled with trying to figure out how to reach the elevators; and once we reached the elevators it took some time to wait for them to reach our level. An alternative mode of transportation (stairs) were seemingly nowhere to be found. While waiting outside the ICU unit, we observed other doctors coming and going through the elevator bay and observed their reactions

No signage above the door, this would be helpful at least when the user initially exits the elevator to get their bearings

Every elevator bay in that circulation core looks the same

They might benefit from color coding the floor directly outside the elevator as is found in more public areas

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It is obvious there was no signage initially as someone place a print out of some basic directions to departments, but that was not enough because someone else handwrote cardinal directions for additional clarity

Maps and clear signage become crucial in helping doctors work more efficiently, and the more efficiently a doctor can work, the better care he/ she is able to give their patients.

Although the public accessible areas of the hospital are challenged in their wayfinding, the private areas are far worse. These are the areas that require real attention. It is not unusual for a doctor or a nurseâ&#x20AC;&#x2122;s shift to last 16 hours. The hospital becomes a second home to these individuals, which is why the thinking in designers needs to shift to a doctor-centered design rather than a patient-centered design.

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BUILDING APPS As the culmination project of our studies and research, we organized a guerilla project where we stuck labels around the University of Michigan Art and Architecture building with the intention of improving wayfinding and providing general clarity to the building, while informing users of ways in which the building could improve accessibility Architecture 509 | Design Analytics for Ability in Architecture Architecture 509 | Design Analytics for Ability in Architecture

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BUILDING APPS

These stickers label the sections in our gallery space. Named after the color model, each section is made up of an identical white wall space made available for students to pin up their work. There has always been confusion as to which wall corresponds to which letter. We wanted to clarify the situation

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We made sure to label the width of the faculty corridor. This is important for people who might be carrying wide material, so they know the maximum dimension they can feasibly carry through, but maybe more importantly, so an individual in a wheelchair knows that upon entering the corridor, turning around is not an option

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Another point of contention is general wayfinding around the building. Each corridor looks very similar and students initially become easily disoriented. We provided floor signage that would give direction at important corridor crossroads and at the base of stairs

These signs give direction to faculty mailboxes and the media center, and are placed on the far right of the corridor, indicating which side of the corridor each are located

These signs indicate locations of the auditorium and main office

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Giving direction to the location of the elevator

A reminder to wear closed toe boots when entering the woodshop.

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BUILDING APPS FEEDBACK After project completion, we spoke to students and faculty around Taubman College to get their opinion on our work and to gauge its effectiveness Architecture 509 | Design Analytics for Ability in Architecture 96


BUILDING APPS FEEDBACK

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On general building navigation -The way the building is organized, the corridors on each level run different directions which can be disorienting -From the studio, I never seem to be able to go down the right stair to reach my desired destination, whether that’s the parking lot, the auditorium, Media Center, or whatever, so I usually end up just wandering around until I find it…I probably waste a lot of time doing that -I hate when there are reviews taking up the entire CMYK and you are forced to walk through that long skinny hallway (Faculty Hall), it’s really intimidating -Emergency exit map cuts off part of the building so it’s even confusing to look at a map to try to figure out the building -Terrible! The building was so confusing when I first got here! Now I understand it, but it’s not intuitive.

Have the icons helped in wayfinding? -Definitely! Love them! -I wish there were more -The wood shop icon should maybe be an image of sandals crossed out instead of the boot -The icons are great, I think they’ve been really helpful, and I think they should be more embedded into the floor -It would be cool if at the entrances there was an icon key saying what each icon meant -It’s been fun watching them pop up -At each corner of the building it would be cool if there were icons of cardinal directions -I think they’re great, but I don’t understand the roller skate [woodshop shoe]

On CMYK and East and West Printers -Honestly, I didn’t notice the CMYK stickers until you pointed them out. -I never really had a problem knowing which side the printers were on -More permanent CMYK icons -I wish they were the actual colors...and bigger -A strip of the color above each pin up space would be cool

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MIC SUMMIT The 2012 Medical Innovation Center Summit centered around discussions on funding, current topics in the field of healthcare, and instrument design for pediatrics. Architecture 509 | Design Analytics for Ability in Architecture Architecture 509 | Design Analytics for Ability in Architecture

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MIC SUMMIT Scott Merz of MC3 was the initial speaker; he discussed how innovative partnerships and approaches are crucial for the design, engineering, and fundraising of pediatric products. He also discussed the benefits and challenges of international collaboration. The benefits being access to capital, and an increased market size. The challenges are that it is expensive and difficult to coordinate activities.

MC3 James Huttner, Don Hannula, Gene Parunak, and Paul Zwirkoski were members of the next panel. They spoke about manufacturing approaches to pediatric product developments as well as silicone innovations. In terms of product development strategies, James Huttner spoke about the importance of focusing on a single idea and developing that thoroughly; otherwise you are just coming up with new ideas and â&#x20AC;&#x153;making more paperweightsâ&#x20AC;?. Some tips he gave for developing ideas included the need for a strong process and that with each step you must show the process and progress to understand where you came from and the direction you need to move. He also addressed the importance of team development and drawing on the strengths each team member provides. These suggestions do not apply only to healthcare product development, they are very relevant to a multiple of fields, including architecture. Architects need to develop a strong process and show this process with each step of project development. They also need to have a team of resources that they can draw upon to make a project even stronger

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Don Hannula from Specialty Silicone Fabricators spoke about the technical challenges in pediatric care; for example, the human heart is about the size of his/her fist, imagine working on the heart of a 1 week old infant. This necessitates properly sized equipment that can navigate something that small, but also be large enough for the doctor to easily control. He gave the example of blood tests and how for children, doctors only need a small drop of blood to run a blood test, but for adults they take a vile to perform the same test. This raises the question of the possibility of using on adults equipment and processes that are currently used on children. He also shared an innovative silicone device that can aid in the healing of a rupture in the small intestine of a child. This device can be inserted into the lesion and allow the waste to bypass the area while the surgeon works on the affected area. The development of this device is the perfect example of a successful result of the process that James Huttner promoted.

In order to understand healthcare design, it is important to be aware of changes and developments in the field. While much of the conversation was aimed at an audience of doctors, and sometimes difficult to understand, I appreciated being able to learn about the innovations, direction and concerns that doctors have for the future, and can incorporate this knowledge, or at least have a base knowledge when dealing with healthcare professionals.

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PATHOLOGY The Pathology department is responsible for studying and diagnosing disease. A visit to the University of Michiganâ&#x20AC;&#x2122;s Pathology department revealed some design opportunities, particularly within Histology, the department responsible for preparing tissue slides for study. Architecture 509 | Design Analytics for Ability in Architecture 102


PATHOLOGY DEPARTMENT VISIT At the precipice of the digital age We spoke to a doctor who addressed the current trend digitizing files and questioned what that means to the future of hospital design.

Why Digitize? The glass slides used today travel around hospital but also to hospitals around the world, can be risky and requires resources to complete these tasks

Benefits

-Eliminates need for slide storage space -Send tissue images anywhere in the world in a matter of minutes -Ability to manage, organize, and retrieve information more efficiently

Drawbacks

-Itâ&#x20AC;&#x2122;s slow, large file sizes slow down computers and image regeneration; microscope are much faster in manipulating slide image -Use of microscope is currently faster and therefore, the more cost effective option -Something tactile is lost in the digital translation

Image from WebScope http://demoimageserver.secondslide.com/H_E_40x.svs/view.apml?

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What does going digital mean in terms of design? Consider... -How does a digital hospital communicate with a hospital still living in analog age? -How do you design for a future you cannot envision? -What does that mean in terms of the pathologistâ&#x20AC;&#x2122;s office? -Does he/she still have a microscope? -Office might require multiple monitors, one for slide and one for clinical data -How do you work with and teach interns looking at a monitor rather than a microscope? -Theatre seating in a conference room? -Although conversation is easier with multi-headed scope, because table is circular and everyone sits around and can look at slide and discuss

Image from WebScope http://demoimageserver.secondslide.com/H_E_40x.svs/view.apml?

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HISTOLOGY The Histology department is responsible for preparing tissue slides for viewing and analysis. After an initial visit to the U of M Hospital, a return visit clarified the whole process. Architecture 509 | Design Analytics for Ability in Architecture Architecture 509 | Design Analytics for Ability in Architecture

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HISTOLOGY Process 1. Doctor obtains tissue sample from patient and preserves tissue in container with fluid

2. Tissue is dropped off at histology lab

3. Histology technician will trim a sample from the tissue and places it in embedding cassette; remaining tissue is stored for 3 weeks

7. Ribbons are mounted onto slides and baked, removing excess water and melting paraffin

8. Slides are stained by automation

9. Slides are organized by patient and department

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4. Tissue in cassette is embedded into paraffin

5. Paraffin block is trimmed as necessary

6. Paraffin and tissue are sliced into thin ribbons and placed in water bath

10. Slides are taken to reading room where doctors analyze the tissue

11. Remainder of paraffin embedded tissue is stored indefinitely

12. Liquid and solid waste is disposed; liquid is recycled, solid is strained and taken by OSHA to be incinerated

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RYAN GILES M.Arch Candidate 2012 I AIA Associate

Ryan is an M.Arch candidate in his final semester of the two-year graduate program. Originally from the west suburbs of Chicago, his proximity to such a major urban center at a young age served as an inspiration for his pursuits in understanding and shaping the future of the built environment in changing economic and cultural climates. He did not fully discover his interests in architecture until his first year of college unlike many of his peers; however, being a pre-medical major upon entering the University of Michigan as an undergraduate, his experiences working as a research assistant fostered his interest in the spatial environment of health care, an architectural focus he maintains in his pursuits to this day. His recent thesis work has also sparked an interest in shifting thresholds between programs in the urban environment and the interstitial space that results from the friction between them. While these varied interests may seem like separate focuses, they have all shaped his search in architectural design for exploring the potentials of new design technologies and innovations for the shaping of space that is both sustainable and reflective of the needs and uses of its occupants, both in the immediate and distant future.

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Understanding Goals for Adaptive Design


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001 What is Universal Design? Universal design has had a somewhat muddled identity over the past few years, primarily due to confusion over what the term refers to. Recently, universal design seems to have become synonymous with accessibility, design for handicap accessible spaces that rely only on codes for a metric against which the success of a design should be measured. While ADA design certainly falls under the realm of its goals, universal design can and should aim to be much more than that. While current design codes make provisions for users how deviate from a standard “normal” person and their capabilities, universal design instead recognizes that such a standard cannot exist. Everyone exhibits different physical features and capabilities based off of anything from injury to age. A space that truly implements universal design, then, should seek to provide use and accessibility in all aspects to the greatest possible range of users, implementing this understanding through proper design thinking rather than merely trying to satisfy basic code requirements. In order to begin to operate on these parameters, designers can begin by understanding common abilities and possible

limits of the human body - either physical, mental, or perceptual - that influence how users can interact with the environment. From ergonomics to carrying capacity, these influences on design apply to the entire environment - from object and interface to entire spatial configurations. While it is impossible to design for all possible capabilities and situations, considering anything outside the definition of “normal” is a start. In this way, codes such as those laid out by the ADA begin to be an asset, though by no means should they be an end goal. Like any other type of design, universal design must be an iterative process then. As spaces are designed and challenges to user capabilities are better understood, design should build on past examples to widen the range of users that the space is open to. Feedback can also be used to reshape the codes. There is a tendency for the codes to be the minimum requirements that many firms use to satisfy that they have attempted some form of “universal design”. If the outcomes of past projects and research can be used to reshape these requirements, ensuring that universal design becomes more fully integrated into design.

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Physical Constraints

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002 User Clearance: Physical Versus Perceptual

Much of what has been observed in our study of constraints and modes of use for constructs such as the ladder, the table setting, and space for swinging golf clubs or tennis rackets, seems to be a function of not only the physical space available to the user and the biomechanical limits of the individual, but also the perceived limits of movement, which are afforded by the space itself weighed against the individual’s mental perception of their own capabilities. This perception arguably plays a much larger role than the physical in determining how an individual can interact with a designed space or object and, more constructively, how these constructs should be designed - an individual’s experience is ruled by what they’re willing to do versus what may be physically possible. These perceptual constraints were

observed in all three exercises and all seemed to boil down to a desire for comfort. In the case of the step ladder, the length of a subject’s reach was heavily influenced by the stability offered by the size and supports of the ladder itself. While it is true that one would be able to reach farther with the ability to step farther out beyond the step’s width to move one’s center of gravity, there is nothing to say that any of the results of our tests were the actual limits of how far one could reach before tipping. One simply stretches till they reach the limits of their comfort, which with a step as narrow as 1.5 feet, is more limiting than it could be. Another prime example is the club / racket exercise. With a given arm length, biomechanical bending limit and club or racket dimensions, the size of a space for the use of these objects should be simple to design. Yet, as was

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Perceived Limits

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discussed in class, elements such as the durability of the material of the space and the amount of room located behind or in the periphery of oneâ&#x20AC;&#x2122;s vision - areas that are harder to perceive - begin to influence how far one thinks they can swing around without danger of hitting a wall or ceiling surface. The same goes for the table setting. Standard dimensions are in use for where objects should be placed, distances between chairs and the table, etc. Yet these elements are in a state of constant change once a meal has begun, since each person has different perceptual comfort levels in terms of proximity to the table and other diners, making the design of the table environment a dynamic flow between designed objects and users who will differ from event to event. Recognizing that comfort may be the largest driving force in

the design of clearance limits for objects and spaces, then perhaps the goal is not pure standardization, but more to provide additional elements that introduce flexibility from the established baseline. As we have already discussed, standardization has its pitfalls as no two people have the exact same physical capability. But larger than that, the perceptual capability that we all project for ourselves is more complex and dominant, calling for further openness from design. For the ladder, this may mean an adjustable base width or height. For the table and club/racket space, this may mean more available buffer space or materials that suggest decreased confinement, such as mirrors. Whatever the case, it is clear that clearance design is not merely a function of the physical, but a mitigation of the variations in the perceptual.

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003 Work Zone: Nuances of Understanding Through Design

Within the past few decades, much consideration has been given to the usability and accessibility of the spatial organization and design of everyday work zones, from entryways to bathrooms. The goal of these considerations and the subsequent design standards that have emerged from them, has been the creation of objects and spatial constructs that are accessible and available to the largest constituent of users, regardless of limitations or differences in capabilities. Our class exercises exploring use and interaction of various areas within our own building while confined to a wheel chair offered us a glimpse of what these particular design standards have offered in terms of accessibility and, more importantly, what shortcomings still exist in how the standards have been applied. Below are three critical observations regarding work zone design, tied to the surrounding diagrams.

1. Before looking at some of the fallbacks of these design standards, it is important to note some of the more successful design measures. Areas such as drinking fountains (1a) have taken the constraints of apparatuses such as wheelchair in to account, allowing the environment to adapt to the user, as opposed to the other way around. Small changes, such as the 1.5 foot clearance underneath the fountain for foot room and the angle and contoured profile following the form of a personâ&#x20AC;&#x2122;s legs positioned in the chair create a completely accessible design that minimizes stress on a person in terms of body movement from the chair, while keeping the design changes subtle as to not designate object as only for those with disabilities. This is also present in the design of elevators and the narrow third floor office corridor, which have enough buffer room to allow for arm movement (1) through a subtle widening of entryways.

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Work Zone Clearances + Design Suggestions

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dictating the design of a bathroom, for example, allow for an overlapping of defined usable zones within the space (3). This is understandable as it allows for a the bathroom to be more efficient 2. A notable observation that arose in its use of space and can be an during our time with the chairs was intelligent design measure when implemented properly. However, how the design of the chair itself could change to aid in accessibility. it is important that designers test During a part of the exercise where the real world implications of these we had to reach for a mailbox, it overlaps; our exercise showed that the while the zones allowed was noted that the range of oneâ&#x20AC;&#x2122;s reach was a function of both arm for enough room, placement of appliances or walls to close to one length and the perceived comfort of how stable the chair would be in another (3a) lead to difficulty in terms of use and maneuverability supporting oneself while leaning. By integrating an armrest that could within the space. While these areas are not impossible to use, they be manipulated to extend (2), the create unnecessary difficulties that chair could begin to facilitate new other users do not have to deal ways to enhance or augment the with. Further considerations as to userâ&#x20AC;&#x2122;s capabilities from within the chair pertaining to the environment. door accessibility and even signage regarding where these accessibility 3. A final area that needs measures have been implemented addressing from our in-class are further minimal measures that exercise was an understanding could aid in creating more usable of the consequences of spatial work zones that service the largest arrangement in dealing with public possible. accessible design. The standards These elements demonstrate that the considerations can be simply integrated into design while not being an overpowering element or complex constraint.

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Usable Hand Positions With Limited Thumb Use

Issues in Building Rail

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004 Opposable Thumbs and Other Limitable Conditions: Designing for Multiple Approaches

The past week’s exercises regarding the impact of limited hand mobility shed light upon aspects of design that generally garner far less attention from designers in comparison to other issues of accessibility that seem more obvious. While the exercises that were observed (2a-b) limited subjects’ capabilities in an extremely direct and, in some ways, absurd manner, the reality is that hand or appendage capabilities are an extremely prevalent and constantly changing issue that almost everyone undergoes on an almost daily basis; conditions ranging from stress injuries, arthritis and carpal tunnel to something as simple as limitations of use due to the objects a subject may be carrying limit or change the ways in which one can manipulate and interact with different interfaces and constructs in their own environment. While design standards have again been laid out to begin to recognize and work with the existence of these issues, our exercises suggest further ways

in which these constructs can be changed or adapted to allow better accessibility across a range of situations for the largest number of people. A number of these suggestions arose out of a number of observations within our own building. For example, the hand rails along our stairwells work within the design standards as written, yet still create a number of new issues based off their implementation. The rail along the wall side of the stair (1) follows the requirements of the guidelines for the most part: the rail has a diameter of 1.5 inches and is only 1.5 inches from the wall to avoid instances for injury. However, the rail is only 32” off of the finished floor, which is 2-4 inches shorter than the guidelines prescribe. This is not the major issue however; where the stairwell conditions became interesting was the wall side’s rail in comparison to the inside rail. The inside rail is made of an entirely different material (for aesthetic reasons)

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Door Handle Conditions + Design Suggestions

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which changes not only the feel of the rail, but its dimensions. It is a full 38â&#x20AC;? from the floor and 3â&#x20AC;? thick, creating a rail that is much taller and harder to grip than the wall sideâ&#x20AC;&#x2122;s rail. While the stairs are wide enough that it is unlikely that one would be gripping both sides at the same time, the differences in rail design mean that there is a distinct difference in usability for each side, placing subjects one side in a far less accessible or usable position than the other. These stairwells were discussed as places where multiple design interventions could be introduced - rails that changed height to accommodate different capabilities, moving trays for carrying goods, etc. - these changes could be as simple as standardization of rails within the stairwell so that users on either side could experience the same level of safety and accessibility. Another potential zone of design intervention discovered within the building was a redesign of door activators based on conditions of

manipulation. While the building has its own issues of still using a number of knob handles that require pinching or grasping motions due to its age, even the lever-based handles could be considered for redesign. Aspects such as the addition of a cupping point for an elbow and the lengthening of the lever itself could allow manipulation by other body parts besides the hand, addressing limitations from physical and psychological conditions resulting from strain injuries or carrying loads. The design of handles that push inwards or out, rather than rotating could also help alleviate some of these issues. A recent Organic Modeling workshop (3) emphasized simple design changes to the form of the lever that could increase comfort and access at a very basic level. While these interventions may seem small or trivial, the limitations they deal with are extremely prevalent and hard to ignore when designing an accessible environment.

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Vision With Macular Degeneration

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005 Visual Impairment and the Environment: Design for Variety in Use

A great deal of what the exercises that the class has performed to this point have suggested are ways in which people can adapt to a wide range of impairments, rather than merely how these impairments inhibit their reactions with the built environment. This adaptability is especially relevant for those with visual impairments; while these disabilities range from the mild blurring of untreated nearsightedness to full-blown blindness, subjects have found ways to allow their other senses to compensate or provide new pathways with which to understand and visualize their surroundings. However, designers cannot rely on this adaptability alone as the solution. The world still provides a number of unpredictable factors that these sensory perceptions cannot easily overcome; for example, with macular degeneration, vision is only impaired in a small central area, meaning moving objects and people can suddenly appear and disappear from a personâ&#x20AC;&#x2122;s vision, creating unforeseen risks in terms

of their environment that may cause inadvertent injury. While designers cannot overtly control the actions of people within the environment, a great deal of design interventions could be enacted based on a solid understanding of the range of visual afflictions, their affects, and how other senses may be used to interact with buildings. A good example of how this understanding can influence design arose during this weekâ&#x20AC;&#x2122;s exercise. In simulating the effects of macular degeneration as way to understand its limiting effects, subjects were required to wear goggles that had been obscured with a soap film. As a further limiting measure, subjects were also made to wear gloves that limited their tactile interactions, forcing them to rely on sound and their limited visual capacities as their primary senses. A common observation during these exercises was how much the reduction of tactile senses and dexterity influenced the subjectsâ&#x20AC;&#x2122; understanding; however, it was

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Design Interventions + Visual Rules

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the adapted visual capacities that were most revealing. Subjects discovered that while overall clarity was impossible to achieve and objects had to be viewed at a much closer distance to be recognized, the contrast between objects and their surroundings determined how much distance was actually required for recognition. It seemed that the higher the contrast between the object and its field, the farther the distance at which one could identify the object. As a corollary to this, darker objects also seemed easier to perceive than lighter ones; yellow cubes on a wooden table were almost missed entirely. With an understanding of the implications of this exercise, designers could begin to apply a new set of visual rules to design that allow for safer environments that reduce injury and create safe paths of travel; for example, creating bright contrasts at door thresholds and projected objects into hallways would allow visually impaired people to perceive objects that could potentially injure them at a greater distance and allow them to identify paths of egress

more quickly in the event of an emergency. Another corollary to these rules could be the reintroduction of the tactile sensory range as a further way to aid in design for the visually impaired. With limited vision, it seemed that touch was the best sense to begin to understand oneâ&#x20AC;&#x2122;s surroundings based on the exercises. Understanding this, designers could begin to create small scale interventions that would go a great distance in providing rapid recognition and understanding to the built environment for the visually impaired. One example of such interventions that was discussed was the simple addition of a braille or similar pattern to the rear side of a door activator. While often stigmatized towards the completely blind, the introduction of a pattern to the handle could create instant feedback for a user as to what was on the other side of a threshold; braille seems to be an obvious choice as the word could be printed easily on the other side or applied with tape to existing handles.

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Typical Hearing Assistance Device

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006 Mental and Auditory Impairment: Visual for Simple and Quick Understanding

Much focus has been given to design for visual and motor impairment in both the application of design guidelines and the classâ&#x20AC;&#x2122; study at large. However, much like visual disabilities, impairments such as mental or auditory conditions are surprisingly common and must be considered in the design of spatial environments. As humans age, a myriad of impairments of varying intensity can begin to develop due to anything from injury to normal wear and tear and, much like in the visual realm, tend to worsen as time goes on. While advances in technology have allowed for the creation a number of treatments and augmentation devices for aiding both auditory and mental dexterity - a common example being the hearing aid - these devices are only temporary fixes and should not be considered cure-all solutions that require no changes within the designed environment to help those afflicted by these impairments. In considering ways that spatial and object design can provide interventions on behalf of these

constituents, it is important to also consider their interrelatedness. Much like pure, high contrast visual cues can help those with visual problems better understand their environment, ensuring the availability of highly visible and easy to understand signage within these constructs can work to create a system that mediates aid for those with visual, mental, or auditory impairments simultaneously in a single, well-designed object. Experiences affected by auditory impairments can be augmented through relatively easy-toimplement solutions. Aside from personal devices such as hearing aids, many people rely on direct communication aids, especially text, to create more immediate ways to understand their environments. Likewise, those with mental disabilities often have difficulty filtering or separating out important information from extraneous in environments with multiple activities going on and require clarified systems to understand their environment so

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that they can focus on information in small, easily digestible parcels. As was mentioned above, this requires signs and signals that are not only highly visible, but also easy to understand quickly in case of an emergency; for example, emergency egress maps should be clear enough that someone can understand their exit path quickly and easily. These maps can uses systems such as color-coding of paths and commonly used

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symbols to convey their message. In the interest of also creating interventions that service multiple possible disabilities, signage should also be high contrast in order to maximize visibility as well. The addition of strobe lighting with fire alarm systems is also an important aid for the hearing impaired, while most people can immediately react to and recognize the meaning behind an auditory alarm, the implementation of a


Example Design Innovations - Mental Acuity

visual cue along with it allows for faster response times for those who would otherwise not be alerted by the alarm. While many of these interventions are already in existence and have been implemented in most public buildings, it is important to understand their necessity and reasoning behind their creation. Advances in personal aids may cause designers to neglect the

needs of those people with these impairments or to consider their needs already taken care of; however, the reality is, the more clearly the built environment can provide ways in which to understand it, the more accessible the building is to the largest number of people. After all, people should not have to adapt to their environment if the environment is capable of being designed to adapt to its users.

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Evidence of Poor Signage and Possible Site for Intervention

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007 Communicative Languages: Spatial Understanding and the Built Environment

Last week’s class offered a revealing look at the aspects that are considered in the design of usable environments, specifically in terms of the measures put in place to negotiate users’ understanding and navigation through communicative devices and which constituents tend to be favored in terms of their application. While our case study shadowing doctors working at the brand new Mott’s Children’s Hospital is a small sample with which to consider these decisions and their application, its relevant design and the users it seeks to inform make it extremely relevant and raise an important question: in the design of a hospital, who is the environment trying to aid most - patient or doctor? This question arose due to a number of glaring issues discovered during our time observing the environment and

questioning its users, both doctors and nurses. We found numerous cases where signage was lacking (either in readability/accessibility of the information device itself, or in being blocked from view entirely), hard to understand, or ambiguous as to where exactly something was. For example, directories on each floor were in tiny text and had no map with which to apply the information as an adequate wayfinding device (in fact, no map of any floor was found during our visit, for fire egress or otherwise). As a way to mitigate this, makeshift signs were put in place by the users to aid in wayfinding, with arrows directing visitors either left or right. However, once the direction was followed the aid stopped there, dumping the follower in a repeatable hallway where they would be left to wander. In one case, cardinal directions were even added to the sign, as this layout of infinitely repeating hallways

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Temporary Signage as Usersâ&#x20AC;&#x2122; Attempt to Aid in Spatial Understanding

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causes one to lose all sense of direction in relation to the exterior world within its interior â&#x20AC;&#x153;urbanismâ&#x20AC;?. And this meager attempt at spatial understanding only exists thanks to the efforts of the spaceâ&#x20AC;&#x2122;s users; the wayfinding devices in place from the designer would have one far more disoriented.

Dr. Steven Bebevski received an emergency code and lost a precious minute in responding due to the lack of wayfinding devices - on his own floor. He suggests something as simple as digital monitors above major doorways which could provide constantly updated navigation information in a bright, easy to understand While discomforting, it is interesting format. Whatever the solution, in the case of the hospital it is clear, to observe how the users of the space have adapted their signage navigation should be a priority for systems to aid in spatial navigation, the doctors, not the patients. The with anything from additional privilege of aesthetics and public signage to grouping rooms by areas in the new building meant too season. However, true design little time spent on the areas behind means the space adapting to the the scenes that truly matter. And user, not the other way around. perhaps that is the key lesson for And in the case of Mott, too much designers - know your users and focus is given to the wrong user. design form for function, not over The easiest areas to navigate function. are public access; however, the patients; primary territory is their room. It is the doctors and nurses that need a well-laid out and easy to navigate flow in order to deliver efficient and immediate patient care in situations where every second counts. During our visit,

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008 Spatial + Sensory Memory: Bridging the User and Their Environment

As a funny addition to the topic, I initially forgot to write this entry following our discussion of it in class. More importantly, however, this weekâ&#x20AC;&#x2122;s discussion provided insight into the relationship an occupant creates with a space and how accurately a space can be recalled over varying lengths of time. Interestingly enough, this memory, regardless of how long ago it was, is heavily influenced by our other sensory inputs aside from the strictly visual. The class began by having as draw a floor plan of our current apartment or home - a relatively simple task considering how recently most of us had occupied this space. However, as we began to draw the space and identify common sounds, smells, and tactile memories we had from the morning, it became clear that the spaces people remember most clearly from their surroundings are tied to aspects that interact with regularly on a direct sensory level; as these action become more repetitive or take on a distinct sensory feel, the memory begins to be translated from a static, temporary visual construct to a dynamic, long-term version.

This became further clarified when we began to sketch floor plans of our childhood homes. As we drew, the spaces that we could draw with the most accuracy (to be clear, this accuracy is relative, since even our freshest memories get distorted by time and our perception - what we perceived may not be what actually was) tended to be places with which we had the strongest sensory or experiential memories tied to them. This information goes beyond simply how space is remembered - it provides insight into how users perceive space and relate to it on a daily basis. Knowing the importance of senses beyond the visual in building connections to a particular spatial construct, it becomes clear that universal design should begin to address challenges some users may have in building these connections. Issues such as hearing or tactile impairment completely changes the perceptual character of a space and as such, a space should be designed to build these connections in other ways.

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009 Occupy. Access. TCAUP: Documentation, Reflection, and Feedback

Our guerilla exercise prior to spring break consisted of a combination of paper and vinyl signage meant to increase awareness of the configuration and various pathways visitorâ&#x20AC;&#x2122;s must take to aspect parts of the building, in ways that apply both universal access - elevators, handicap-accessible doors - and not - helpful wayfinding devices, ranging from the media center, to which gallery is which within CMYK. These small scale interventions had a surprisingly larger impact than I wouldâ&#x20AC;&#x2122;ve anticipated, based on my own experiences and the feedback I personally received both during and after our two days of installation.

each zone takes up and the order of the spaces seemed to changed based on how acted like they were in charge that day. By installing a simple, out-of-the-way demarcation for these spaces, I have heard only positive feedback. At least once daily, someone notices and comments on how they wished they were up sooner, signifying an obvious unstated desire that was fixed with a single letter. Consensus seems to support that these should remain as a more permanent fixture - mission accomplished.

In terms of the signage pertaining to universal access concerns, I had a number of personal encounters that further supports the success The first and most impactful of our humble, small-scale project. intervention to myself and fellow The door signage that was created students seems to be the signs generally garners at least a double denoting the galleries within the take every time I see a student use CMYK space. Since the space the door and the email account doubles as a hallway as well as a created to give us a longer-term crit space, the gallery is not wellmeasure of engagement with the defined - during my 5 years as a project has already received a student, I have witnessed numerous few emails; people are noticing arguments over how much space and they are interested. However,

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the most interesting piece of feedback I received came during the installation of floor vinyls on day 2 of our project. I had already received feedback from a classmate saying they had noticed the ‘office’ vinyl we placed on an existing signage directing people upstairs, saying that they had never noticed the original sign before; apparently, the vinyl had consciously activated its presence with a small 4” x 4” graphic. Following that, I was approached by a student asking what had inspired the project. She then told me that she had recently been asked where the elevator was by someone confined to a wheelchair and that she had found trouble in relating exactly how it could be accessed to this individual. The student wished she had had the signs to refer to and wished us luck.

While these are small and momentary case studies, the previous conversation supports or claims - that the building needs ways to raise awareness of and provide wayfinding devices for the building in general; whether it was simply where gallery spaces are defined to someone who actually needs help accessing different spaces, many of the buildings occupants are at a loss when they think about the space, from their first time to their hundredth time. While the project itself is temporary and simple, it’s amazing how profound an impact even this small set of interventions have become based on the feedback I’ve received.

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Typical Consult Environment in the Pathology Department

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010 Pathology Department: Streamlining the Hybridization Between Digital and Analog

Looking back on our conversations with members of the pathology department this past week, it became clear that the scope of our project boiled down to finding away to seamlessly integrate both the existing analog and rising digital methods for clinical and anatomic pathological practice as one continues to change how cases are studied, while the other remains a valuable and irreplaceable means within the medical institution overall. While it is clear that the digital environment is the future and will only become more prevalent, design should not ignore the analog completely in favor of the digital. In terms of the analog, these methods are so integral to how pathological cases are studied that complete removal of these interfaces would only work to harm the practice. Physical samples still need to be taken from tissue to produce the digital samples regardless of the study method, meaning the pathology office

environment still needs physical constructs to archive the samples themselves for background data and further study. Also, since the university is considered to be an early adopter of digital methodology in their practice, cases that are sent from around the world to their offices for consult would still need analog spaces for multiple users to be able to view, compare, and consult, over traditional slides. Combined with the fact that digital images tend to distort a 3D object into a 2D image (changing the fidelity of the viewing and the ability of a pathologist to accurately diagnose a case), it is clear that the question is not the phasing out of the analog, but perhaps a hybridization of the analog with the digital. For instance, an ideal signout room would be one with an analog scope with multiple heads, allowing traditional viewings, but perhaps integrated with a camera interface that projects the image onto a flat work surface or wall

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Typical Slide Documentation and Archive Flow

for group discussion. While the traditional scope allow multiple people to view the same sample, the experience is still very isolating, making it hard to discuss certain aspects without a frame of reference. It is important to note that that isolation is in some ways desired, however - the viewing

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apparatus of the scope and the tactile experience of manipulating the image with the dial gives pathologists an immersive experience through both visual and tactile methods of control that block out the outside world and allows a more direct connection with their diagnostic environment


- something that mustn’t be lost in the conversion to digital. The hybrid environment, then, would allow analog immersion with the ability to pull back from the analog and give everyone the same frame of reference with the digital - highlighting certain things one doctor may have observed on screen and allowing a more open discussion where everyone can view the same image. As the digital begins to be hybridized in this way, new avenues for its implementation begin to be suggested. One would be the creation of a digital archive of all samples ever digitized for the university’s study. This would allow instant access to the “slides” across the medical complex / departments without physical transit, a problem that has led to lag in inventory, loss of samples, and longer lead times for diagnosis on the whole. If this digital archive could become searchable through a tagging system through the pathology department, the hybrid analog/digital consultation environment would take on a whole new dynamic. While referencing certain parts of the image on these digital work surfaces as a group, doctors could also pull up historical examples of tissue precedents instantly from this searchable archive and put

them alongside each other for comparison immediately - without having to remove themselves from the consult. This means only good things for pathology through hybridization - faster diagnoses and more open discussion, without the loss of the tactile and personal immersion each pathologist gets through working through analog apparatus. However, while digital becomes more and more integrated with the workflow environment, some constraints still exist that may change the physical environment. While the need for physical slides will decrease, storage space must still exist - not only for the original samples, but the digital files as well. Due to the high resolution required for the fidelity of these images, files sizes are becoming more and more unmanageable, meaning that the pathology environment will likely need dedicated server rooms and IT processing just for their databases. It is likely that certain parts of the new facilities are more likely to follow the design of technology centers rather than medical institutions as these hybrids continue to develop.

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011 MIC Conference Discussion: Criticality of Communication in Process

The panel discussions that the class was able to observe during our visit at the MIC Conference were interesting not because of their direct applications, but because of the overall themes that arose over what collaborative aspects were critical to the efficiency of innovation. While the discussions we observed focused mainly on the production and feedback systems for the production of medical appliances and clinical trials, one resounding point seem to continually arise: maximization of the points of communication throughout the process are vital to the success and expediency of the project at large, be it early prototyping for feedback

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in appliance design, to creating the best criterion for a clinical study. While neither of these operations fall under the realm of our design in reconsidering the pathology environment through the hybrid digital-analog path, the points made at the MIC panels, compared with our feedback from members of the Pathology department, indicate the communication remains a critical aspect of what these environments should promote in the interest of proper collaboration and diagnosis. As was discussed in my previous entry, one advantage the digital environment offers that the current digital environment in pathological diagnostics does not is the ability


for several doctors to view the same image simultaneously and to discuss it in an open forum. While the current immersive and tactile aspects of practice should not be lost, it is obvious that the capacity to openly communicate and collaborate on these case studies is vital both for the education of new doctors as well as expediency in providing diagnoses or feedback across departments and institutions nationwide. While the number of checks and balances along the process may be minimal in comparison to device design or clinical trials as discussed at the conference, due to condensed time frames and involvement at a much smaller scale of people, it is hard to deny the need for an environment that not only facilitates but also promotes maximized conditions of communication through its spatial qualities. What does this mean then for the design of this new spatial environment? As an initial scheme, one could imagine a formal configuration that promotes as much cross-space visibility and accessibility while promoting efficiency of the process itself. For example, the spaces could

take on a linear assembly, with sample processing / treatment and administrative areas at the front. This would be followed by a central open space consisting of several digital / analog â&#x20AC;&#x153;consultationâ&#x20AC;? spaces (discussed in the previous entries), slightly separated by divider partitions to maintain some semblance of immersion in the environment, while promoting openness across the space through the removal of permanent walls. This central space would be surrounded by the offices of the departmentâ&#x20AC;&#x2122;s doctors, maximizing accessibility and visibility between the doctors and the staff at all times. The spatial flow would then proceed to and terminate with archival spaces, both physical (for the hard samples and slides) and server rooms for the digital files, separated for security and environmental control. While this spatial flow remains a diagrammatic pass at the potential configuration of the office environment, it begins to seek out the primary aspects for what is critical to success - in this case, communication, collaboration, and efficiency.

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Current Spatial Configuration Detached Offices from Sample Flow and Analysis

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012 Reshuffling Detachment: Analysis of the Current Office Configuration

As a part of our design process approaching a new architecture for the hybridization of the digital / analog pathology environment, our group began a more in-depth analysis of the current office configuration as it pertains to the workflow between sample archive, viewing and storage. While the slides and samples that are processed within the pathology department are connected to cases from departments all over the hospital, there still seems to be a lack of spatial flow between the samples themselves and the offices of the pathology department itself, which oversees the production of the slides and facilitates connections between samples and their departments. This physical detachment represents a weak link in the process that is far too critical to the process to be ignored and could be easily removed by spatial reconfiguration. The layout of sample processing and archival space (the red box on the image) makes a lot of sense

in terms of its spatial qualities in relation to case flow. The space is centrally located within the department and has partitioned windows for slide mail and delivery, separated by department for which the outgoing samples are marked. Itâ&#x20AC;&#x2122;s hard to imagine this sort of central processing model being removed or reshaped in a new design - the simplicity of the model is only enhanced by its process efficiency. The strangeness of the current paradigm, however, stems from the spatial disconnect of the doctorâ&#x20AC;&#x2122;s offices from this central space. Since all slides must be checked and passed over several pathologistsâ&#x20AC;&#x2122; desks for approval and consultation before distribution to other departments, it seems strange that the pathology offices and administration (who handle the documentation for the delivery process) are physical detached. This leads to a longer step between sample prep and case consultation and makeshift workflow spaces

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Sample Queue - Generic System for Office / Case Flow Interface

(the image above) that represent potential points of complication in the diagnostic process, one which generally prides itself on accuracy and efficiency. It makes sense, then, that in the design of a new

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pathology environment, the spatial configuration should be streamlined to promote accuracy, efficiency and accessibility for all parties within the process in search of better patient care.


013 References

H. Dreyfus, Designing for People, 1955, 26-43 H. Dreyfus & A. Tilley, The Measure of Man and Woman, 1993, 10-32, 44-51 S. Joines & U. Vance, DVR Technical Packs, Center for Universal Design Tech Pack North Carolina State Building Code, Accessibility Code R. Lichez & B. Winslow, Designing for Independent Living: The environment and Physically Disabled People, 1979, 61-128 T. Davies & K. Beasley, Fair Housing Design Guide for Accessibility, 1992 Cohen & Williams, Holding on to Home U.S. Dept of Housing and Urban Development, Fair Housing Act Design Manual, 2008 Panero & Zelnik, Human Dimension & Interior Space, 1979 Ernst and Peter Nuefert, Architectâ&#x20AC;&#x2122;s Data, 2000

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KAREN HENDERSON M.Arch Candidate 2012

Karenâ&#x20AC;&#x2122;s interest in architecture stems from her background in fine art, specifically print making and ceramic sculpture. She loves the intense process of print making and the tactility of ceramics; however, she was frustrated by the lack of integration of digital tools. It felt like the art she was learning was not interested making itself relevant in a digital age. She became enamored with architecture while in Spain, and its explicit interest in using the latest tools to maintain its cultural relevance. Architecturally, she is inclined toward simplicity, sustainability, and accessibility.

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Beyond Compliance

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DIGITAL INVENTION

We wrapped tape around our hands and thumb to simulate a loss of dexterity then tried to do several simple tasks like opening doors, drinking from a mug, and putting on sweaters. With this exercise, we gained some understanding of mobility issues associated with hand use that might accompany losing an opposable thumb, joint stiffness, and decreased hand strength. We used a block of wood drilled with random holes to help us brainstorm new solutions for the problems someone might face with decreased use of their hands. One of the ideas we came up with was to design a coffee mug with finger holes in the mug. This would help alleviate the wrist pain associated with the pinched grip of a standard handle, and requires less hand strength than gripping the whole mug with a wide grip. Cups are a great way to spread the message of universal design because they are used with frequency and they come with the comfort of holding a warm cup of tea or coffee.

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Re-thinking the coffee mug What else could be re-designed for people with diminished hand strength? -Appliances -Books -Brooms -Drawer Pulls -Doors -Food Containers -Handbags -Trash Cans -Phones -Water Bottles Architecture 509 | Design Analytics for Ability in Architecture Architecture 509 | Design Analytics for Ability in Architecture

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COMFORT ZONE

Dining is an activity that is both universal and highly designed. With this exercise, we tested our comfort zones by acting out different dining scenarios and taking key measurements. The goal was to gain an understanding of how standardization in dining came about in order to find places where the standards could be adjusted. This diagram documents our findings for dining side-by-side. The most interesting distance is 34â&#x20AC;? which is both the comfortable distance between people seated at a table, and the distance from the back of the chair to the end of the table, this suggests a general comfort zone of 34â&#x20AC;? square. This comfort zone is somewhat flexible based on culture and familiarity between diners. Also, the measurement of 18â&#x20AC;? came up twice, as the distance from the center line to the edge of the table, and from the back to the center of the plate. These measurements are most likely the result of the space required to move your arms freely and could be adjusted based on the size of the person.

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Taking measure of the table What governs comfort in the dining experience? -Culture -Comfort Zone -Relationships -Body Dimension -Chair and Table -Place Setting -Plate Size -Silverware -The Senses

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WHEELED ABILITY

For this exercise we looked at the code in a critical light to think of new solutions for accessibility problems centered around the wheelchair. We tried several everyday tasks in a wheelchair including drinking water from a fountain, interacting with people behind counters, and using the accessible restroom. Using the restroom was the most eye-opening because it is a basic part of a personâ&#x20AC;&#x2122;s independence. The accessible bathroom at TCAUP has many problems that I would not have noticed without this experience. The door is heavy, has no automatic opener, and the raised floor transition is a hurdle. The biggest lesson is that the code really only delivers the bare minimum. The drawing above right proposes an alternative bathroom that provides three different approaches to the toilet: front, left, or right. There is also additional room behind the toilet for an assistant if needed. The door is also wider to reduce the risk of hitting your fingers upon entry. Lastly, the sink is shallower and at an angle to make it easier to reach.

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Exceeding the minimum Acceptable bathroom according to code: - Barely wide enough for the chair. -Requires a more difficult 90째 transition. -Sink has to be accessed sideways. -No room for an assistant. -Potential to get stuck between toilet and wall. Architecture 509 | Design Analytics for Ability in Architecture Architecture 509 | Design Analytics for Ability in Architecture

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BEYOND COMPLIANCE

We examined the railings and doors in TCAUP and checked them against the code. What we found was that many of the doors require a force between 10 and 17 pounds to open, but code stipulates that the force should not exceed 5 pounds. There are also many doors with knobs which are not to code because people lose strength in their wrists with age. The handrails in the main stairwell are also not to code. The handrail on one side is too wide to grip forcefully at a width of 3 inches. The handrail on the other is the correct height and width, but is installed 2 inches from the wall. The maximum allowed width is 1.5 inches, any wider and a personâ&#x20AC;&#x2122;s arm might slip between the rail and the wall during a fall causing further injury. One solution for making the stairs more accessible is to design a device that allows a person to support themselves with their forearm instead of wrist, this would enhance stability and comfort.

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The stair helper Are there simple ways to make common routes more accessible? -Doorways -Elevators -Escalators -Hallways -Ramps -Stairs -Walkways Architecture 509 | Design Analytics for Ability in Architecture Architecture 509 | Design Analytics for Ability in Architecture

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CALCULATING TOUCH

This investigation was about diminished eyesight and sense of touch. While wearing goggles with fogged lenses and heavy gloves we tried several operations that required fine motor skills such as: making a bracelet, taking apart a tool, and operating a calculator. The calculator was very difficult to use with our impairments. The main problem is that without visual and haptic cues, it is nearly impossible to know whether or not the operations are actually being carried out. We also found that we immediately began to compensate for our diminished abilities by bringing the calculator closer to our faces and pushing the buttons harder. This shows how natural it is for people to compensate for their diminished abilities, even for many years before seeking any medical correction. This is a huge issue because the use of touch based hand-held devices is growing exponentially. These need to be designed with accessibility in mind so that people can enjoy them for many more years.

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How can this tool be made more accessible? -Fingers might accidently cover the solar panel, use a battery for backup. -A larger screen with at least two lines of data helps you track the operations. -High contrast buttons and screen is important. -Buttons should be larger. -Buttons near the edge should have a small guard that keeps them from being pushed while the calculator is held. -Buttons need to make an audible sound, provide haptic feedback, or light up to reinforce the interaction. -It should be made of an easy to grip material that stays on the table top.

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ENDURANCE ROUND

We had the opportunity to follow some doctors on their rounds and look for design opportunities. The hospital was full of instances where the necessity of the work inspired ad-hoc solutions, each of which can be re-imagined through design. Some things we noticed were: temporary signs, colored tape on the floor designating zones, white boards for patient information, and plastic bins. However, what really stood out that day were the mobile computer workstations. As you can see in the photograph they are large and clog the hallway. They keep the doctors from standing close enough to hear each other and the standing itself is tiring, making it harder to listen. One way to fix these problems is to change the method for disseminating the information. Since the doctors are not directly interacting with the patients on these rounds, they could meet in a wellequipped conference room instead. Additionally, the mobile stands themselves could have a slimmer profile, and an on-board battery pack.

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Daily rounds at the hospital Architecture 509 | Design Analytics for Ability in Architecture Architecture 509 | Design Analytics for Ability in Architecture

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MEMORY RESOLUTION

To explore the influence of memory on accessibility we drew two memory maps, one of where we currently live, and another of somewhere we lived in the past. This exercise helped us to understand the difference between recent memories and old memories. The main difference between my two maps was my ability to clearly remember things in sequential order. In the drawing of where I am currently living, I could remember minute details of what I did that morning, and the exact order in which I did them. In the drawing of my childhood memories, I could remember many events, but not the exact sequence in which they happened. This got me to think about the difficulties one might encounter while navigating a complex environment without a strong memory. In this case, it is important to include strong visual cues at regular intervals to aid in memory map generation. Regular signage and other orientation cues such as North arrows and south-facing windows will also help keep people from getting lost.

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Types of Memory:

Short-term memory

Task Step 1

Step 2

Step 3

Step 4

Step 5

-Episodic memory The long-term memory of events.

Long-term memory

Location

Event

-Working memory Short-term memory that helps us complete specific tasks. -Long-term memory Memory that lasts for hours, days, years or a life-time.

Complete!

Event

-Short-term memory Where information is held for a minute or less.

Event Event Event

Event

-Semantic memory The long-term memory of facts and concepts. -Procedural memory The long-term unconscious memory of skills. Source: UVAmagazine.org

Memory across time Present: Time is Sequential Past: Time is Collapsed

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INTELLIGENT INEXPERIENCE

To spread the message of universal design, we conducted a project where we installed additional signage in TCAUP to help people navigate the building. To determine problem areas, we surveyed people within the building. We asked them to recall moments when they were lost or confused within the building. From this survey, we formed a list of places to intervene with signage. The average respondent said that they were confused for the first few days, but then were fine after that. With that in mind, we asked them to try to recall their first interactions with the building. This way we leveraged their memories of inexperience to gain useful information. A few of the responses were: the classrooms are hard to find, the hallways don’t correspond between floors, the bathrooms are far away, the division between art and architecture isn’t clear, it is difficult to get across the building, room numbers with four digits are confusing, it is hard to find specific desks, and I’m not sure which printers are East and West. Solving these issues became our goal.

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Directing first encounters Some icons for easy navigation: -Elevator -Mail -Right Arrow

-Office -Drinking Fountain -Ahead Arrow

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ACT FEEDBACK

For the intervention, we compiled a series of signs that responded to some of the problems we uncovered in the survey. We used the Zund knife-cutter to cut the signs out of vinyl and then installed them in appropriate locations. The image on the right shows three signs: one pointing toward the auditorium, one for the main office, and one for the mailbox. They are installed on the ground in a heavily trafficked intersection in the building. This is a good location because it is a point where people will be deciding where to go next. The signs are placed on the ground to make them more visible since people usually look down when they walk around. The icons are simple, graphic, and recognizable, which helps them communicate at the speed of someone passing by. The responses to our signage was largely positive, “Why didn’t they do that sooner?” Other responses revealed where signage is still missing, “Where is the bathroom?” Overall, it was a successful project and we learned a lot about what makes effective signage.

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Installed navigational icons

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PATHOLOGY SURVEY

Collection -doctor collects sample from patient Preservation -sample is contained in formalin and labeled with the patient’s name. Accession -sample is brought to Histology where it is given a reference number, corresponding cassettes are printed with the number. (Interfaces with other departments) Gross Examination –sample is inspected, dictation is recorded, and photographs are taken. (Biohazard, refrigeration required, and the floor is red so it is easier to see dropped tissue) Cassetting –samples are placed in cassettes and labeled either NS (specimen not saved) or SS (specimen saved) depending on how large the sample is. (This station needs supply shelf access and a large work surface to accommodate machinery. All trash is saved. Large specimens go to storage for 3 weeks) Processing -samples are infused with paraffin inside of a machine that is 3’ x 4’ x 3’. (This takes several hours, and the Xylene gets recycled) Embedding -Samples are oriented in a paraffin block at a pace of 20 per hour (Trash is saved, floor is red) Trimming -Excess wax is trimmed from the blocks by a cutter. (Trash is saved, floor is red) Block Distribution –Checkpoint for the blocks to see that everything matches up. Cassettes are color coded: yellow-standard, orange-rush, green-special stains. Flags are added: green-earlier than expected, pink-have to be seen. Sectioning -Slices are taken from the block and placed on labeled slides which are placed in a rack. The cutter is notified when the task is complete and the information goes to office for statistical purposes. (Checkpoint, trash is saved, floor is red)

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Oven –The racks of slides go into the oven for 15 minutes. This removes the paraffin and adheres the tissue to the slide. (A white board is used to keep track of how long slides have been in) Storage –Cassettes go to temporary storage for a week, and then to permanent storage indefinitely. Staining -Slides are removed from the oven and stained in their racks using an automated stainer. This is a large machine 3’ x 4’ x 6’. (Chemicals get recycled, fume hood required) Cover slipping – acetate is placed over the slide. Glass cover slipping –glass is placed over the slide Special Staining -Some slides are stained in small machines or by hand. A lot of counter space is needed. (Chemicals get recycled, fume hood required) *Slide Scanning – In the future this could be a point where all the slides are digitized. However, the technology is currently too slow. It would have to be able to digitize over 2,000 slides a day to keep up. Slide Distribution – slides are checked, labeled, and organized on trays. Slides are either transported to the correct department, or placed in a room for review by a pathologist. Slide Review – This is a separate room with several microscopes and computers. The diagnosis is recorded here. (Re-cutting may be requested) Storage -Slides are placed in a slide library indefinitely Disposal –All trash generated from the process is saved for a week; chemical waste either gets recycled or goes to the chemical dock downstairs. Recycling -Machines that recycle chemicals are approximately 3’ x 3’ x 6’ and need to be in a fire-proof room with good ventilation. There is also a large chemical cart to transport the chemicals for re-stocking.

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EXPERIENCE BASED LEARNING

This class was centered around experience based learning. Each day was split into three parts: lecture, physical experience, and think-tank discussion. The lecture was useful in setting up the terms and introducing the subject, the experience portion was instrumental in cementing the lessons, and the think-tank helped us come up with ways to apply our findings to design. All three methods work together, and enrich the learning in different ways. The experience portion was especially important because, similar to the way you donâ&#x20AC;&#x2122;t notice a tool until it is broken, you wonâ&#x20AC;&#x2122;t understand the challenges people with limited mobility face until you are forced to overcome the issues yourself. Only after trying to wheel myself around the building and hoist myself onto the toilet from a wheelchair did I better understand some of the challenges. Now, I think more critically about what accessibility means. It is not just about wheel-chair width requirements, it spans a wide range of issues and includes entire constellations of impairments.

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Lesson reinforcement What are some things that are better understood through embodied experience?

Lecture

Experience

Think-Tank

-Building a cabinet -Pouring concrete -Painting a painting -Having an argument -Making a pizza -Giving advice -Having a baby -Parenting -Giving a hug -Using crutches -Treating an injury

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YOONHO LEE M.Arch Candidate 2012

Yoonho is a graduate student, a master of architecture candidate 2012, at the University of Michigan. He spent most of his life in Korea until he graduated from Yonsei University, majoring in Housing and Interior Design. He is very interested in the relationship between people and space, and its influence to people. He sees architectural design as one of the most powerful tool that can influence peopleâ&#x20AC;&#x2122;s lives, and wants to be involved as a positive thinker in all design process. He is also very interested in the use of digital design as one of the powerful techniques in contemporary architecture. He has not only explored the possibilities of digital design, but also strived to rationalize the design effort through digital fabrication techniques.

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Handheld Issues

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001 Understanding Universal Design

Universal design is not just defined as designs for the disabled, but the designs for all including both able-bodied and disabled, children and elderly people or men and women. Therefore, understanding the differences between people is critical for universal design. In the first research session, we have discussed about the general concept of universal design, and measured dimensions and angles of experimenters to understand the different limits of our bodies. There were, unsurprisingly, quite a lot of differences in dimensions and angles between experimenters. Even in one experimenter, a body of one person, many different limits were discovered between left and right side of body, different direction, or even depending on his muscular development. The Think Tank discussion with several actual objects- including a drawer, a portable drafting table, a desk chair - was good opportunity to test the limits of individuals. Particularly, a desk chair (shown above) was a good example of both possibilities and limitations. The chair has an adjustability of its height to provide various options for people with different sitting height or length of legs. However, the armrests were fixed without any possibilities of adjust, resulting uncomfortable position for people with different length of arms or different shoulder spinning angle. All in all, the first Think Tank discussion was great opportunity to understand that universal design does not merely mean meeting ADA codes but also a understanding differences of individual. Furthermore, the research of universal design potentially can be stretched to enhance the performances of its users, if we have comprehensive understanding of the differences, limits and possibilities.

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002 UD and Human Body After understanding of differences and different limitations of human body, we discussed about the applications to architectural design. First step was to test limitations with three different objects step ladder, dinner table and sand wedge. The issue with the step ladder was several limitations with movement which was related to both research objects’ limitation and the ladder design itself. For example, the ladder was too narrow which limits horizontal movements. As the photos shown above, the reachable range, of almost every research objects, to the horizontal direction was much shorter than the vertical directions. Even with the vertical range, the step was too low to maximize the reachable distance. Adding at least one more step can help to increase the vertical reachable range. Furthermore, considering the situations that the ladder is moved while people carrying stuffs with their hands, some design features, such as foot holds, could be a lot helpful. While the discussion about the step ladder was about the limitations, dinner table settings and sand wedge provided great opportunity to think about psychological limitations and boundaries. Even if people feel comfortable with the height and width of the dining table, every research object has their own preferences with the table settings - distance between the body and the plate, distance between their neighbor person, distance between person who was sitting in front of them, or distance from the edge of the table. These distances were vary depending on the situations. For example, the research object T tend to sit closer from the edge when there is a person next to him compare to sit alone. In other words, W would rather have more distance to the next person even if he loses his actual space on the table. Comparing the result of the Research Object W, Object T’s distance to other person was longer. It shows the Object T’s psychological boundary was larger than Object W’s, and obviously, the psychological distance is also vary depending of individuals. One other thing what also might be interesting is the psychological comfort zone not only of the object itself but also the distance affected by the other person. One other design possibility for the dining table is its flexibility for the different task. As picture shown right, if the table is adjustable in its height and angle and easily movable, it can perform several different task. This would not only help to save space but also to increase people’s workability and profitability. After understanding of differences and different limitations of human body, we discussed about the applications to architectural design. First step was to test limitations with three different objects - step ladder, dinner table and sand wedge.

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01

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01 Drink Fountain - the drink fountain near the restroom on the third floor was impossible to access without cups or water bottles since it does not have a room under. 02 Mail Box - from the hall way the faculty mail boxes were quite easily accessible with wheelchairs if they are reachable height. As the photo above shows, however, some of the mail boxes were too hard to reach from wheelchairs. Moreover, it was even more difficult from the inside of the faculty room since people has to approach to the front way while it was much easier to approach side-way in the hall. 03 Media Center Table - the tables have two designated spots for the wheelchair access. The space was enough to easily access and to move around, and the table has was relatively proper height. 04 Restroom - even if the restroom was 184


003 Wheelchair Experiment

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handicap-accessible, there were a lot of difficulties to use with a wheelchair. First of all, the door was too difficult to pull on the wheelchair since you have to pull it with one hand holding the wheel with the other hand. There is also a threshold which makes even harder to get in. 05 Elevator - the room was big enough to easily access and to spin for one person, however it gets difficult with more than 2 people. The buttons were located low, in a reachable range from wheel chairs. However, they were designated for the straight access to the front, which could be better with additional buttons on the side. 06 Flyers Shelf - the shelf near the north-west entrance was fairly reachable for just grabbing flyers. However, it was actually too high to see the flyers without grabbing it first. Architecture 509 | Design Analytics for Ability in Architecture

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Handrails in Architecture Building

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Possibilities for the handrails


004 Hand Held Issues

The 4th exercise was about handicap with fingers. Particularly, people with disabilities with thumbs have problems mainly related to grabbing actions. For example, round-shaped door knob was much difficult to rotate than levers. As photo on the right shows, people have to grab door knob to rotate while levers could easily rotated without grabbing actions. Especially, for the people with finger disabilities, it was almost impossible to open doors that requires more than 10 pounds of opening loads. There were also several issues of doors with levers. First of all, height and angle of lever were important. Since it is usually easier to operated door levers downward for most of the people, pulling action is harder if the height is not high enough. Moreover, for people using wrist, not fingers, to pull levers, the clearance between the lever and the door is important. If it does not have enough space, their arms might stuck which make the operation more difficult and even might result dangerous injuries. There are some possibilities for lever designs. If the lever can be operated with less rotation degrees, pulling action would be easier since people can grab the lever with comfortable angle to their wrist. Another possibility is the idea of door push bars. If the door handle can be open simply with pulling levers, instead of rotating, it would be much easier to pull since no additional operation is required. Similar issues were observed from the handrails of staircase. Since the required wrist angles for upward and downward using are different, the handrails should be considered in various ways. Current handrails in the architecture buildings have only one angle. It is relatively easier to hold when you are going up, but it is very hard to hold it stably when you are walking down. As the photo shows below, if the handrail is response to different angles, it can provide much more comfortable, stable and safe environment.

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005 Impaired Vision

The exercise in the 5th class was a task of small objects with impaired vision. By wearing goggle that was scratched by soap and rubber gloves, we experienced and performed several tasks including screwing small bolt, assembling alphabet blocks, redrawing dominos and using calculator. The main issue was visual distinguishment of objects from the background. As photos shown above, lower contrast makes distinguishment much harder in impaired vision. For example, the dark top of the table helped to distinguish alphabet blocks. Similarly, drawing on the bright paper with black pen was also relatively easy since they had higher contrast. However, the objects were very small which makes the tasks difficult even with the familiarity of tasks. To perceptible information but only color contrast but also a contrast in shape and size would be required. For example, drawing domino with fine lines was much difficult than configuring dominos or drawing it with thick pens. Different textures on the object surfaces were also very helpful. For example, the different textures on the tools make to assemble and disassemble process much smoother, while using calculator was much difficult due to its less-distinguishable buttons. If the buttons were in different texture or brailles would be very helpful to reduce errors of the task. Moreover, low contrast of the screen made reading difficult. Higher contrast in color or sound support would be very helpful. The lessons from the tasks can be extended to architecture and interior design. High contrast concept can be applied to certain danger spots or aid devices.

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Universal design continues to influence product design and this years Builders Show was no different. We saw a number of great products but one of our favorites was the Elevance Bathtub from Kohler. Unlike other universal design bathtubs the Kohler Elevance uses a rising wall entrance feature instead of a swinging door style. This provides more room and ease for someone to enter the tub. There is no step over and you can simply slide your body into the bath and then raise the wall and fill with water. The tub also drains twice as fast so you arenâ&#x20AC;&#x2122;t sitting in water for a long time before lowering the wall to exit the bath.

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006 Inclusive Bathroom Design

Bathroom design is especially important from the universal design point of view since it causes many incidents due to the slippery surface. From the overall design consideration to the detail material researches are necessary for the universal design. And all of the possibilities and solutions are required from all phases of design process to maximize the accessibility. For example, considering the location of the handrails is not enough for all people. Its material, texture, color and dimension should all be considered to respond all different kinds of possibilities. As the photo shown below, higher color contrast helps to maximize its visibility and to inform possible danger in advance for not only the visual disabilities but also for all people. Furthermore, universal design is not only for providing safe environment but also for better accessibilities for all people. As the photo shown above, operable bathtub can provide easy and safe access for the elderly people as it could be lowered.

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The universal design for hospitals is critical since it is a space for patients with many different kinds of disabilities. We could learn a lot of good examples from the field trip to the University of Michigan Hospital. First of all, as the photos shown above and below, every corner and intersection has round shape mirrors on the ceiling to provide visibility for people who are approaching them. This is especially helpful to prevent incidents at the intersections considering numbers of emergencies at the hospital. Other noticeable design factor was high contrast signs. Every sign, particularly the ones for danger information, has higher color contrast with bigger proportion to make it noticeable as much as possible. Most of them were dark color, such as red or blue, as background color was mostly close to white to provide clean and safe impressions to

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007 UM Hospital Visit

Round Mirror

- Helps to increase visibility at corners and to prevent accidents caused by blocked sight.

Double Handrails

- Provides more ranges of height responding different conditions of patients.

Lower Countertops

- Countertops are lower enough to access from wheelchairs

High Contrast Sign

- Signs are designed with highcontrasted colors for better cognition.

patients. Higher danger information signs use higher contrasts in color, as the photo shown below, with black fonts on orange background. Also, handrails were different from the normal building. Usually, there are two rails on each wall to provide more height ranges for people with different conditions. They also have noticeable color contrast from the wall, but not with neutral color to yield higher levels to the danger signs. One possible development for the handrail is different properties of its thickness and wider distances from the wall. As we discussed at week 4, handrails could be more accessible by providing different properties and thickness. While most of the aspects were very helpful for universal design, we could also find possible improvements. For examples, signs were usually located to higher for elderly people and people who has disabilities with neck or back. It may be difficult for them to look up. It would be very helpful If same signs could be locate on the floor or lower part of the wall.

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008 Guerilla ACT

The 8th exercise was a group action to make the Art and Architecture building more accessible. First of all, we have located spots, particularly important ones for visitors who have never visited the building, such as the deanâ&#x20AC;&#x2122;s office, the media center, mail box and the auditorium. To maximize visibility, bright-highlight orange and green colors were chosen as most of the background color is dark. As the photo shows at the top, the color works very successfully on the buildingâ&#x20AC;&#x2122;s floor, comparing similar signs at the Glass Pavilion in Toledo, OH. Besides the color contrast, the locations of signs were also critical. Most of the signs were located at the eye-level and on the floor for better visibility. Particularly, signs were located on the floor near the area around staircases as people tend to look down for their safety.

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The result of the survey. during and after the â&#x20AC;&#x153;universal design act,â&#x20AC;? shows that the guerilla act was quite successful to deliver messages of Universal Design. Most of the respondents answered it was very noticeable as they were exact right spot where people look unintentionally and the colors are eye-catching. Particularly, architecture students were very happy with the CMYK gallery signs, as they have been confused all the time. However, There were also feedback that some of the signs were needed to be more clear. Many students also responded that some of the signs were too abstract to understand such as the office and media center signs. These signs were asked to be more clear and straight forward as they possibly could cause more confusions. Through the universal design act for the Art and Architecture building, we could learn many obstacles and limits of the building. It was a great opportunity to see the building from a different point of view and to think about design better environment for all people.

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009 Guerilla ACT - Analysis

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Typical Unit for Sign-out and meeting

Signing-out samples and cart

Frozen Lab Unit

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Sample Storage

Sample slicing process

Signing-out process


010 Pathology Department Visit

Department of Pathology People 130 Faculties, 800 Staffs, 48 Residents & Fellows, 22 Ph.D Students

8 Divisions Anatomic Pathology, Clinical Pathology, Education, Finance & Administration, Informatics, M Labs, Sponsored Programs, Translational Research

Some of the labs need to be located close to surgery department, even though the digital technologies can provide remote discussions. The relationship between Surgery department is very important. (Possible future relationship between the Cancer Center and other multiple disciplines should be considered) Ability to host other department is important in the future

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MATHEW SCHWARTZ M.S. DT Candidate

Mathew is a student in the post-professional Masters of Science in Digital Technology program at the University of Michigan. During the time of the Architecture 509 Universal Design Class he was the graduate student research assistant of Professor Sean Vance. Mathew documented the class activities as a way to better understand the method in which designers translate the intrinsic knowledge from doing in an attempt to inform his research in developing design tools. His past work as a research assistant is heavily focused on human physiology. Utilizing computer simulation software and immersive virtual reality systems he has worked on way-finding, acoustical, and lighting projects. In his Masters research, Mathew has been studying the effect of spinal cord injuries on reach ability. The observations conducted in the Architecture 509 class have informed his research on developing universal design tools that can be incorporated into the current designer workflow. The tools being developed are aimed at alleviating the disconnect between the designer and the user during these unique situations in which the designer and user have very different mental or physical ability.

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During April 2012 a survey was sent out to the College of Architecture at the University of Michigan. The survey was designed to correlate how respondents viewed themselves with key aspects of design. The questions targeted the way in which participants approached design by questioning the tools they use and the preference they have in realizing their design. The survey also questioned the participant on various fields and subjects related to universal design. These questions were used to chart how important different aspects of design were to the participants. There were 44 usable responses split into three groups.

Architects as Respondents The first group consisted of 14 participants who identify themselves only as Architects. The second group consisted of 18 participants who identify themselves only as Designers. The last group consisted of 12 participants, none of which considered themselves an Architect or a Designer. These groups were chosen in order to clearly see differences in the mindset of someone who identifies with design or architecture. As there is an increasing trend towards multi-disciplinary design and education, this type of small survey would be difficult to analyze as many people identify themselves in various ways. As such, the 23 participants who identify as being more than just an Architect or Designer were left out of the analysis. There are five topics included in the following pages. Each topic consists of multiple questions and is comparative between the three subject groups. The information presented here is being interpreted as a thought provoking question on pedagogy and not a definitive analysis. It is meant to inspire the reader to evaluate their own work and question how they can improve design, albeit through education or practice. “This Survey was definitely interesting. I think the purpose was to identify areas that could be incorporated into our design education.” “Made me think about trends in my work habits and production of projects”

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01 Creative Workflow

Each participant was surveyed on their preference during their creative workflow. The question was designed to gauge what the best way to convey information on universal design for an architect or designer and at what stage in the process. Q1: I prefer to use physical drawing tools to realize my design Q2: I prefer to do my final work on the computer Q3: I prefer to do my ideation on the computer Q4: I prefer to have a physical full scale model to visualize my design Q5: I prefer to have a physical scale model to visualize my design Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree

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02 Tools

Each participant was asked to check which tools they use. This question was used to better understand the tools that the majority of architects and designers use. This information helps decide what types of programs information can be given. One clear trend is the use of 3D Modeling tools by both Architect and Designer categories. Q1: 2D Physical Tools Q2: Other Q3: 3D Modeling Tools Q4: 3D Analysis Tools Q5: Programming Q6: 2D Modeling Tools Q7: 2D Analysis Tools Q8: 3D Physical Tools

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03 Form / Function / Accessibility

A main inspiration for this survey was to see how architects and designers view the importance of accessibility in their own work. This question traditionally is usually limited to form vs. function, with many arguments for both. The addition of accessibility makes this conversation more complex. Both function and form are tied to accessibility, and as such you truly cannot have one without the other. Even so, it was a question of interest and as the result show, the participants in the purely Architect group were evenly split among accessibility being the most and least important. Q1: Accessibility Q2: Form Q3: Function Highest Importance Middle Lowest Importance

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04 Target Audience

As a way to narrow down the importance of accessibility compared to interest, participants were asked to rank the following by importance to their work. The graphs show the mean values in which the participants ranked the topics. The most noticeable difference is between the Architect group and the Non Architect/Designer group. The topic of other was not important to the Architect group while the Non Architect/Design group found the work they do dealing with other topics than the ones listed. This is the strongest evidence in the survey that the groups and questions were appropriately categorized. Q1: Lower Limbs Q2: Upper Limbs Q3: Other Q4: Children Q5: Teenager Q6: Adult

Q7: Elderly Q8: Visual Q9: Tactile Q10: Auditory Q11: Mental

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05 Expertise

This final analysis was targeting a very specific mindset. The question was created to see how important advanced knowledge of specific fields work. The inspiration for this question came about during the Architecture 509 class when students were asked to complete specific tasks while using a wheelchair. It was clear that the students had not known how specific parts of the body work and how that translates to someone with a disability. The question then is; how much knowledge does someone need in a specific problem in order to design for it. These questions targeted universal design and the advanced knowledge of people and how the body works. These graphs show an interesting difference in the responses. While the colored graph represents the percentage of importance ranking on each subject, the blue is the mean result of the topics. This shows that while the mean was similar in all cases, the Architect group was much more consistent in their answers, almost all being that the subjects were neither important nor Unimportant. Not at all Important Very Unimportant Somewhat Unimportant Neither Important nor Unimportant Somewhat Important Extremely Important

Q1: Touch (Haptics) Q2: Movement (Kinesiology) Q3: Auditory (Audiology) Q4: Optometry

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06 Documentation

Each week the Architecture 509 class became physically involved in the subject matter. While each student wrote about their own experiences, the entire class was documented with various videos and pictures. This documentation helped inform the creation of the survey and gives an inside look to the obstacles and learning experienced during the class activities.

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â&#x20AC;&#x153;This survey is tiptoeing the line of insipid. Let's ask heavily reductive questions of the design process. Who created this thing? And why was it sent to us? What is the point of always generating surveys?â&#x20AC;?

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DOUGLAS SHARPE M.Arch Candidate 2012

Douglasâ&#x20AC;&#x2122;s interests in the discipline of architecture lie primarily in the realm of digital production and the development of projects through methods that include digital fabrication, parametricism and rapid prototyping. He is fascinated with the creative talents that architects possess, and also with the fact that through the advent of new technology architects are able to extract their ideas from the purely digital computer model and rapidly produce a physical object that they can then study, analyze, or simply have available to convey their concepts to others. He believes there is massive potential for the rapid production of objects to improve the quality of the built environment, and a perfect example of this potential occurred in our own Universal Design course. He thinks that through the collective talents of the class, we were successful in our desire to quickly realize a series of concepts and witness the immediate positive impact that occurred, accomplished with the aid of digital production and rapid prototyping.

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Equally Experienced

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1.1

What is Universal Design?

My interpretation of Universal Design is the careful consideration to design a space, product or device to be equally occupied, experienced, or operated by persons with all abilities, disabilities, or limitations, alike. The course that we have opted to enroll in has introduced us to basic concepts of Universal Design which will encourage us to explore its potential and to be critical of situations where there could be a stronger presence, such as with products that we examine in class or through examples found in our own building. Our task this week was to measure the human body of each of our classmates and to then test our capabilities with a series of objects and products. We were focusing on the difference in body types being able to handle the rigors or complications posed by different objects. Examples include a taller person having less difficulty lifting a portable table, a person with smaller fingers being able to penetrate more holes in a wooden block, or somebody with a longer arm could reach further into a drawer. One device that was more accommodating for all users was the adjustable rolling chair, which allowed for a user to make adjustments as needed to allow for a more comfortable working environment. The difference in the chair compared to the other objects was that users were able to adjust it on demand, while the other objects were permanent in their dimensions/ weight and required that the users operate them as-is with no exceptions. This seems to reinforce the theme of Universal Design, to provide an object that is flexible which can be adjusted by users to fit their individual body types.

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Folding Table - posed challenge to shorter people

Wood Block - posed challenge to larger hands/fingers

Desk Drawer - posed challenge to shorter arm length

Adjustable Chair - accommodated all users

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2.1

Range of Motion

In an effort to test and document range of motion of the human body, we were tasked with comparing the range/extents of our classmates performing different activities with a variety of equipment and utensils. At the first station we recorded the extents of a person swinging a tennis racket and a golf club. The conclusion we found with these items is that different people have a different posture with their swing, as well as different techniques in holding the racket and club. The difference between holding a tennis racket and golf club is that on the approach swing that my partner, Research Subject ‘Q’, held the golf club 19” away from her body’s center, and the tennis racket was 25” from center. On the follow-thru swing, the golf club was at 21” away from center and the tennis racket was 17.5” from center. The measurements indicate that different devices require the body to adjust itself relative to the proper motion of the swinging device. The next station was standing on a ladder that faced a wall, and then measuring the distance that our partner was able to reach in all directions. The results from this test proved that there is a limit at which point a person becomes uncomfortable while standing on the ladder and reaching out, but the greatest factor in determining the distance a person can reach is based on their height. However, there was an exception with reaching underneath the ladder – everyone, regardless of height was reaching in very close proximity. The picture provided on the next page represents the full range of motion of Research Subject ‘T’, while also providing visual reference to the extents of other test subjects. The ladder presented its own set of drawbacks and the most notable issue is the bar that extends upward, which we assume that this bar functions as a handle used for carrying the ladder when it is folded up, or moving it after being unfolded. The bar was an issue for when the user was trying to bend down and reach low, causing the user’s knees to collide with the bar. If the bar is intended to prevent the user from being able to maneuver themselves into an unsafe position, then there could at least be some padding on the bar to soften any impact that occurs when the user’s body comes in contact with the bar. Another topic of discussion for the ladder is to implement more forms of stabilizing or allowing for the user to gain better balance. If the low-rising bar were to come up higher, that could allow for the user to grab onto it for support. This support could also allow for the potential of improved performance as the user may be able to reach out further without worry of losing his/her balance.

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Research Subject â&#x20AC;&#x2DC;Tâ&#x20AC;&#x2122; on Ladder

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3.1

Wheelchair Experience

Roleplaying is a useful method to experience a routine through somebody else’s perspective. The exercise for this week required us to perform routine tasks in the architecture building; however, we were also required to experience those tasks while in a wheelchair. The purpose of this exercise was to make us – as designers of space – more aware of the possible hardships that a disabled person may encounter as opposed to the daily routines that abled bodies take for granted. We were given several tasks, but in this section I will reveal the tasks that deal with a wheelchair user’s limited line-of-sight, the restrictions of being able to reach certain heights, and noting the adequate/inadequate surfaces to perform tasks such as writing or working on a laptop while in a wheelchair. The tasks included engaging with faculty in the admissions office, checking a faculty mailbox, and the final task of fetching a newspaper from a media rack. The first task, meeting with two faculty members in the dean’s office, revealed the difference in a desk that was more wheelchair friendly than the other. One desk, occupied by Laura Brown, proved to be more ideal due to the fact that she sits at eye level with somebody sitting in a wheelchair, while the desk itself is low enough for a wheelchair user to be able to read papers on her desk and be able to write on a sheet of paper if needed. The other desk, occupied by Stacey Shimones, while proving that somebody in a wheelchair could see and talk to her, he/she would not be able to read a paper lying on the desk, nor would they be able to write at her desk because the surface is too high to perform those functions. The flaw in Stacey’s desk is evident, and the concept of Universal Design would suggest that a simple solution would be to lower the height of the table surface. In the pictures on the adjacent page, the dashed blue line indicates eye sight from wheelchair user, Research Subject ‘Y’, to faculty, and the red highlights the desk heights.

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Research Subject ‘Y’ at Laura Brown’s Desk

Research Subject ‘Y’ at Stacey Shimones’ Desk

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3.2

Wheelchair Experience

The second task required us to check our professor’s mailbox. Based on the observations during this task, we agreed that the height of the mailbox was reasonable for someone in a wheelchair to access; however, the other mailboxes on the upper levels were impossible to reach. The person’s line-of-sight was also restricted to mailboxes that are slightly above eye level, but any higher and the person cannot see if there is any mail in the box or not. The simple solution to this could be that a faculty member in a wheelchair would be assigned a mailbox that is in an ideal range, but that would change the method of alphabetizing the mailboxes and could make it difficult for an unknowing person to be able to locate the mailbox to deposit mail for the faculty member. There is also a problematic scenario that if the mail were to be put in the wrong box, the faculty member in the wheelchair would not be able to search other boxes that are out of his/her range. An additional consideration to note is the ability to approach the mailboxes, where in the hallway a side approach is possible which allows for the disabled person to be closer to the mailboxes. In contrast, the mailbox area on the other side allows for only a front approach due to the tight space and clutter that had accumulated on the ground – this reduces the reach of the wheelchair user. In the pictures on the adjacent page, the dashed blue line indicates eye sight from wheelchair user, Research Subject ‘D’, to our professor’s mailbox, the yellow highlights the sight range for reading other mailboxes and/or checking for mail in those mailboxes, and the green highlights the reach extents of the wheelchair user. As can be witnessed from the images, a person in a wheelchair is not able to see or reach other faculty mailboxes. Also, the limited approach could make it very difficult for the person to be able to reach towards the very bottom to retrieve a large package. Think about another potential scenario where the person delivering the mail was bound to a wheelchair - the mailman or a student. Would they be able to perform their job or accomplish their task of delivering mail at the existing faculty mailboxes?

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Research Subject ‘D’ at Mailbox Front Wheelchair side-approach is possible

Research Subject ‘D’ at Mailbox Rear Wheelchair front-approach only

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3.3

Wheelchair Experience

The final task was to retrieve a newspaper from the media rack that is at the main entrance of the architecture building. Access to this area of the building is not difficult and is made even easier with the use of a push-button that automatically opens the door to allow for a wheelchair to pass through. There were two notable issues demonstrated by the media rack. The first is that the rack is too high for a wheelchair user to be able to see what newspaper he/she is grabbing. The solution would be to display the current newspapers on the wall to reveal which stacks of newspapers are in the unviewable pile. That brings up the second issue, there is a wall available for this; however, the display wall is only used as a bulletin board littered with flyers that have no affiliation with the newspaper stacks located beneath the bulletin board. The pictures on the next page reveal the issue with the height of the rack highlighted in red, and the blue highlights the bulletin board that has the potential to improve the situation if newspapers were on display here. Some additional thoughts in regards to the shortcomings of the architecture building include the types of water fountain fixtures and the location of the elevator. The third floor has two types of water fountains that proved to be very dissimilar in that one of them is wheelchair accessible and the other was not. The water fountain that was not accessible was impossible for somebody in the wheelchair to use, as was witnessed by the futile effort of Research Subject ‘Y’ to be able to drink from it, which lead to noticeable frustration and ultimately succumbing to defeat. The location of the elevator in the building was brought to our attention the more we needed to use it. Most of our tasks occurred on the west side of the building, while the elevator is located completely opposite and on the east side of the building. Having to travel many times from the east to west side proved to be excessive which prompted us to imagine how much more convenient – less travel distance and time saved – that an elevator on both sides of the building would be for a disabled person. To conclude on our experience, after performing tasks from the perspective of a person in a wheelchair, this gave us a new way to think about designing spaces for users of all types. The lessons learned while participating in this roleplaying exercise allows us to gain direct insight in how wheelchair users experience the world – and as we learned, it is certainly different than what we are used to. Universal Design can be better understood and addressed while taking on the perspectives of the wide range of users who inhabit and/or interact with our designs and creations.

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Research Subject ‘D’ at Main Entrance

Research Subject ‘D’ at Newspaper Rack

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4.1

Does This Comply?

This weekâ&#x20AC;&#x2122;s exercise required us to document the doors and handrails in the Art & Architecture building and determine if they meet ADA compliance. Our team was assigned to the second floor and we focused on the doors and handrails on the architecture side of the building. Documenting doors and handrails certainly raises our awareness to the challenges posed to users who are disabled, and an additional component to the exercise was that we were to tape our thumb down and then try to operate the non-compliant ADA doors. The doors in the Art & Architecture building are equipped with two different types of door handles â&#x20AC;&#x201C; one is ADA compliant while the other is not. The handle that is compliant is a lever style handle which was relatively easy to open even in unconventional ways such as using a fist and elbow. With our thumbs taped and not available for use, we were still able to open the door with using only the four fingers. The non-compliant handle, which was a round knob style, was not nearly as user-friendly to operate, and to our amazement we documented dozens of these doors just on the second floor. The images below are a collection of the door hardware that can be encountered on the second floor of the A&A building.

Door Handle Types. Knob, Lever and Push-button

What we learned from the knobs is that they were impossible to operate without the use of our thumb. We could also assume that a person without a hand would have even more difficulty to operate, and the solution would be to replace all knob doors with levers. The majority of the doors with knobs were found on the doors of faculty offices, and all mechanical room doors appeared to be equipped with knobs. The problem is that users, not just the faculty but anyone who could come into contact with these doors could have a difficult time operating them. This would include students who meet with a professor, visitors to the building, and even custodial 246


workers and maintenance persons who are required to enter these rooms. The school has not been required to replace all of the doors with compliant handles and there seems to be no logical pattern as to why some doors have levers and some have knobs. Perhaps this is because some of the knobs or the entire door has been replaced over time due to wear and tear. Should there be a concerted effort by occupants of the building to deliberately break the knobs so that they would all be replaced with compliant door handles? Is this the only way for the building to become fully compliant, by damaging the existing hardware in question? There are other benefits to providing lever handles – not just for use by a disabled person – but for being able to open the door while carrying objects in your hands. The knob always requires a fully functional hand, and instead the lever could be opened by extending just one finger while carrying objects such as toolboxes or architectural models and materials. The sets of images on the next two pages are all of the doors on the second floor which are ADA non-compliant – 32 in total that we located, but there are many more on other floors and sections of the building. Another task that we were given was to test the force required to open the doors. All interior doors were in compliance by not exceeding 5 pounds of force; however, the larger exterior doors – required to not exceed 8.5 pounds of force – had some that passed and some that failed. We did notice that the exterior doors that required more than 8.5 pounds of force were equipped with a push-button that would automatically open the door, shown in the image below.

Exterior Door with Push-button

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4.2

Does This Comply?

Non-compliant ADA Doors on Second Floor

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Non-compliant ADA Doors on Second Floor

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4.3

Does This Comply?

The other part of the assignment was to document the handrails that were located in the building. We found two unique handrail conditions on the second floor that did not appear to be code compliant. One handrail was at a ramp in the urban planning computer room and the other rails are those on the stairs. The handrail in the urban planning area appeared to have two features that did not meet code specifications. We measured the handrail at a height of 32” above the floor, but the code requires that the handrail be at height no lower than 34”. Another issue with this handrail is that it is 2” in diameter when the code requires that handrails do not exceed 1-1/2”. The image below shows the ramp handrail in question.

Handrails in Urban Planning Computer Lab

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The other handrails in question are those located at the stairs in the building. There are two completely different types of handrails at the stairs, with one being a large wooden handrail and the other is a typical metal circular handrail. Beginning with the wooden handrail, the height above the floor was okay with a measurement of 35”, however the top of the handrail that is used for grabbing was 3” in width. If somebody were to try and grab the handrail in an emergency, we could only imagine that it would be too difficult to grab and would lead to disaster. The other handrail at the stairs has multiple issues, and the first is that the height is more than the code allows, at a measurement of 32” above the floor. The other issue is that there is a distance of 2-1/4” of space between the wall and the handrail. This could cause a serious injury if somebody were holding onto the handrail and ended up slipping on the stairs. The person’s arm could end up sliding between the wall and rail, which might lead to a broken arm or something more serious. The images below show the handrail conditions at the stairs.

Second Floor Stairs

Wooden Handrail

Metal Cylindrical Handrail

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5.1

Sensory Deprivation

Everyone, at some point in their life, will experience some type of deterioration of their senses. This weekâ&#x20AC;&#x2122;s exercise required us to simulate the experience of sensory deprivation while performing a series of tasks. We were asked to wear very thick and loose gloves which would prove to be a challenge with grabbing objects or pressing tiny buttons. We were also asked to wear eye goggles that were fogged up with soap and this was to hinder our ability to see the tasks at hand. Each task posed unique challenges and the sensory deprivation allowed us to experience how certain disabilities affect people while they are performing tasks that are considered ordinary. The tasks we were given required a very high level of precision to accomplish, however the gloves and the goggles made things much more difficult. One set of tasks were especially difficult because of the lack of feeling in the fingers. Those tasks included stringing beads with letters onto a piece of pipe cleaner, twisting a screw into a block of wood, and taking apart and reassembling a multi-piece instrument. The pieces of these tasks were very tiny and the oversized gloves were giving everyone issues because we were not able to know if we were properly pinching the objects or that we had a sure grip on things. Sometimes if you would grab the piece, the excess material of the glove would not allow for the object that was between our fingers to be put into another object. Pieces were difficult to pick up and sometimes without the proper grip we were constantly dropping the objects, only adding to the frustration. The previously mentioned group of tasks was done with a smudge in the center of the goggles which made vision a little bit more difficult. The way we adapted to the visual impairment was to look through the sides of the goggles using more of our peripheral vision since looking straight forward was not an option. The visual impairment was a lesser factor to the difficulty of the tasks, while the gloves were much more difficult to adapt to, making successful completion of the tasks extremely difficult. One task that was different than the others was using a standard calculator while wearing the gloves. My partner was the one punching in the numbers but I was able to witness the challenges and frustration that he was exhibiting. He was not able to feel the buttons, and the gloves would sometimes hit buttons he did not intend to push. He was also having difficulty seeing the output display, but he was unable to pick up the calculator to adjust the angle so he could see the display. The gloves were the problem when he tried to hold it as the calculator became unstable, and he also unintentionally covered up the solar power bar which made the output display shut off.

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Another task different than the others was to look at the face of a domino and draw it on a piece of paper. With the fogged up goggles, I had to put the domino to my face to make out all of the dots. The toughest part of this challenge was drawing the domino on paper. I was not able to put my face as close to the paper as I could with the domino – the paper had to stay flat on the table in order to draw on it. The final result of the drawing was not pretty, the profile lines were not very rectangular and the dots were not drawn in alignment. Because I was not able to properly see what I was drawing, I was relying partially on memory and the resulting drawing indicated that there were issues with the artist’s abilities. Some lessons learned from this exercise is how people are affected by loss of senses and how it could affect their daily lives. I believe that people who work in manufacturing would be the most affected by deteriorating vision and problems with losing feeling in the hands. Now that we have firsthand experience, I do not have to imagine what somebody who is assembling small components would be going through. Somebody in this situation would probably be required to have corrective eye surgery to fix the blurring issues; however, I cannot think of a way to alleviate the hand situation as I would assume that it would be caused by irreversible nerve damage. There might be other occupations that would prove to be a constant challenge for individuals whose senses are declining. A response to these issues from an architectural standpoint would begin with how people with vision problems might be able to navigate through a building. One solution might be to provide some sort of color contrast on the surfaces, such as a bright strip on a white wall, or floor, that could help somebody navigate from one space to another. In addition to high contrasting colors, the walls could also include strips of a texture that a person can use to feel their way to the desired room. The implementation of an accent wall at key locations of the building – this could be exterior or interior – such as a lobby or entry, or main gathering area on the interior, those walls may act as a beacon for a person to be able to easily distinguish from other non-important spaces or areas. Even if a person has blurred vision, they will know the location that they can walk to and perhaps meet up with a receptionist or help desk, where they can then be given further instructions or offered assistance to help them get to where they need to go inside of the building. Consider the next series of images which represent the difficulty that an individual might have with their vision and being able to find their way through a hospital. The first type of way-finding device is the typical signing with text and arrows. Depending on the severity of loss of eyesight, an individual might be able to make out some of the text, very little, or none at all. Compare the text and arrow method to the next series of images, where the way-finding system is a very bright color scheme on the floor which directs patrons to different areas of the hospital. Notice that even the most severe eyesight disability is still able to differentiate the colors which provides for successful navigation to a desired location.

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5.2

Sensory Deprivation

Text Based Signage for Way-finding

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Contrasting Colors for Way-finding

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6.1

Spatial & Sensorial Memory

Memory serves us well, and this week’s exercise required us to create drawings of our current home and also of a home that we grew up in as a child. In addition to the line drawings we were also asked to represent sensorial experiences – sound, smell, sight – and document where those occurred in our drawing. In our current home, we were asked to document the sensory stimuli that we had experienced that morning, and in the drawing of the home that we grew up in, we were to document the locations of sensory stimuli that were the most prolific and easily recalled from our memory. The ability to abstract objects and space is unique to humans, as we can recall a place or event from our past and be able to communicate the memory through many outlets such as speech or drawing. Some may be better than others in their ability to reveal an abstract idea by being a good story teller or an accomplished artist. In our exercise, because we are all architecture students, we were able to develop images that made sense in our lexicon of representational methodology, such as a basic floor plan with the inclusion of symbols for doors and furniture. I knew my classmates would be able to understand my floor plans, such that they could tell the difference between my bedroom and a staircase, and that allows them to know the basic layout of my domicile without actually being there. However, since they have not been there then my classmates lack all associated sensorial qualities that could only be experienced on location. How we choose to represent our own domicile could differ between all people, with one major factor being which room you choose to start with when asked to draw an entire floor plan, or which rooms you draw in detail, or which ones you draw more accurately. My method for this exercise was starting from drawing my bedroom first and then the rest of the rooms came in the order of adjacency to my room – this was the case for both current home and childhood home. Since I have many more personal memories and more time spent in my bedrooms than any others in the house, those might be reason enough for why I chose to start by drawing them first. I would hypothesize that my classmates may have chosen to begin with their bedrooms first, and would go further by assuming my roommate would start by drawing his bedroom first and that my brothers would draw their bedrooms first. Recalling spaces in this manner could reveal how we experience spaces and buildings, for example if you ask somebody to draw plans for a building that they visit for the first time, would they start with the progression that the moved through the building and draw the foyer first and the last occupied room would be drawn last? I would probably do just that. And what about the details? We would probably be able to recall more details of a room that we spent more time in, such as the details of cabinets and tile patterns in a waiting room, but might not remember exactly the paintings hung on the walls of a corridor that we quickly moved through. These are mostly the visual aspects of experiencing space, and the same could be applied to other sensorial data collected from sound, smell and even taste. 256


In regards to our exercise, we began by drawing our current home and also indicated locations where we remembered a scent, heard a sound, and spent time looking at something. I live in a 2-storey townhouse that includes a basement in the Northwood IV area at the University of Michigan. After drawing my bedroom first, I then drew the rooms in which an activity occurred, such as the morning routine that occurs in the bathroom and also spending a short period of time using the computer in the office. Based on the sensorial experiences I revealed in the drawing, one could probably put together a timeline and determine that I was describing a typical morning routine since I listed the sound of a radio, the sound and smell of a shower, and looking into a mirror. There is one ambiguous activity of looking out of the window, and only a further description of why I was looking out of the window or what I was looking at â&#x20AC;&#x201C; it could have been for many reasons. I was looking out of the window to see what the weather looked like so that I would be properly clothed when I left the house for the day. I would say that everything else noted on the drawing is obvious as to the activity that was occurring just based on the smell, sound and visual descriptions.

Floor Plan of Current Home and Sensorial Recollection

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6.2

Spatial & Sensorial Memory

The second part of the exercise was to draw out the house that we grew up in. I lived in a single-storey, 3 bedroom and 2 bathroom house in Tampa, Florida. It took me a while to recall the layout and be able to draw it because I have not lived there since 2001. I was also having a very difficult time recalling any sensorial memories associated with my house, and the ones that I eventually did recall seemed fairly random. Some of the items included noises where the television and stereo were, and where my brothers would make a lot of noise and wake me up. The smells were very random, and included where we kept the garbage cans â&#x20AC;&#x201C; it was my chore to take care of trash â&#x20AC;&#x201C; and also the smell of cleaning supplies in the bathroom because that was another chore of mine. Other smells included our pool that had a distinct chlorine smell, and even though I spent many years in my bedroom, the only distinct smell I can remember is where I had pet hamsters and gerbils. One very welcoming smell was from the kitchen where Mom was always cooking for the family, and the dining table I labeled as the smell of Thanksgiving because we only used the dining table once a year and it was for that special occasion. In regards to viewing, during the exercise I was not able to think of where I spent a majority of my time looking at something. But now that I had some time to think, I would put a viewing cone in the living room where I watched television, and I would also put a viewing cone at the southern window where I would look to see if my ride had arrived to pick me up for school, swim practice, or to go out and have fun.

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Floor Plan of Childhood Home and Sensorial Recollection

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7.1

Hospital Routine

Doctors have a unique way of working, and this week’s exercise required us to visit the University of Michigan hospital to witness first-hand the environment in which medical professionals operate in and the facilities that are provided for their patients. Our group was assigned to the SICU (Surgical Intensive Care Unit) and we arrived during a period in which a group of doctors were evaluating each patient in their unit. There was a definite hierarchy in terms of experience and decision making, and the distinction came down to doctor, resident and intern. The method in which they perform their duties was that they were all working on machines that they refer to as a ‘COW’ (Computer On Wheels) and they would move those machines to the entrance of each patient’s room while they discussed the condition of the patient and possible treatments for further surgeries. Each patient had an attending nurse, so at when arriving to each individual patient the doctors would include the nurses in on the discussion. The nurses provided crucial information such as the patient’s vitals or perhaps how the patient responded to treatment or a prescribed drug. The COWs are an essential tool that each doctor was using to enter information to a real-time database. If one doctor typed in information, it would then update for each doctor to be able to read it immediately or be able to refer to it at a later time. The COWs are a vital tool for the doctors to perform their duties; however, the machines were very bulky, they cluttered up the hallways and in some cases the COWs needed to be plugged into a wall or it would lose power. Some machines had longer battery life than others, so priority for a wall outlet went to the machines that were known to lose power quickly. The picture on the adjacent page shows the COW machine and its user.

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COW Machine and Users

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7.2

Hospital Routine

Notice in the first picture on the next page that we are in the hallway and the doctors and machines are now completely jamming up the hallway. This space is needed to wheel patients to/from surgery and to their room, and to also allow patients to walk from their room to other locations as needed. At one point, I witnessed a patient being escorted by a nurse, while using an assistive walking cane, having to be detoured through the nurse’s station. The nurse’s station that is against the wall is narrow, and is a gauntlet of hazards from chairs, electronic devices, power cords, supplies, etcetera all posing a risk for anyone to navigate – making this a very dangerous route for the patient to have to maneuver through. There is difficulty in proposing a solution to this problem because it appears that the technology of the COW has been fully adopted and is the only method for the doctors to perform their duties. It would be impossible to justify that the entire unit would need to be gutted and redesigned just because the roving equipment does not fit well in the space. Even if the space were to be redesigned, who is not to say that a few years down the road there will be a different type of COW – whether it be bigger or smaller – which would then once again render the space as inadequate. Other areas of concern that I witnessed were the signage that was haphazardly placed throughout the unit. One instance is a warning sign that was placed on the floor which reminds anyone who enters to clean themselves before they interact with patients. The fact that the sign is telling people to be clean before entry is a justifiable reason to have the sign in the first place; however, the issue is that the sign itself is constructed using materials that could pose a threat. The blue tape, for instance, could end up being peeled away after it has been stepped on or been cleaned, which may lead to a sticky surface being exposed. Somebody then walking on this sticky surface, or coming in contact with shredded pieces of tape, their foot could become unexpectedly stuck and cause the person to trip. It would only seem reasonable that a world-class facility like University of Michigan’s hospital should have a better solution for ground floor signage instead of using blue tape and a sheet of paper for their warning signs. Refer to the second image as a testament to my proclamation for better signage.

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Doctors and Equipment Congesting the Hallway

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8.1

Guerilla Project: Access TCAUP

We need to make a statement about the issues found within of our very own building if want to have any credibility for calling ourselves architects that care about occupants of the built environment. The task for this week was to implement our concepts of way-finding and accessibility throughout the Art & Architecture building. The entire class participated in what we proclaimed as our Guerilla Project, and the purpose was to raise awareness to some fundamental issues that currently exist within our building. We felt that awareness was crucial because most occupants of the building do not even realize that there are issues that exist â&#x20AC;&#x201C; even our own class was surprised by the problems that we uncovered through our initial investigations of the building. The first major focus of the guerilla project was to create and display signage that had to do with accessibility. This included a sign at the buildingâ&#x20AC;&#x2122;s northwest entrance front door, a very prominent and highly traveled entrance, which displayed the distance that the nearest elevator was located relative to the entrance. For somebody who requires the use of an elevator, from a wheelchair to a walker, the distance that they are required to travel is absurd; additionally, there is not even a sign that reveals where the elevator is located. The sign is not just about telling people how far away the elevator is, but there is also an indirect message that there should be another elevator located much closer to this main entrance.

Elevator Location and Distance Signage

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Another type of signage that raised awareness for accessibility was used on the doors throughout the building. We created door placards that were hung from the handles of the doors throughout the building. The placard had either a check mark or an ‘X’ on it, indicating that the door was either ADA compliant or if it was in violation. The doors that had lever handles received a check and the doors that were equipped with spherical knobs were given an ‘X’. At closer inspection of the placards, one could read the reason why the door was in violation, indicating the relevant ADA code. There was also a written challenge which asks them to make a fist with their hand and then attempt to open the doors that were equipped with knobs. Between the colorful placards and the challenge, we believe that awareness had been raised in regards to the amount of doors in violation while also revealing why some building occupants may have difficulty opening doors in our building.

Door in Violation

Door in Compliance

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8.2

Guerilla Project: Access TCAUP

The other major component that we emphasized in our Guerilla Project was wayfinding and navigation throughout the Art & Architecture building. Most people are familiar with seeing the floor plan of a building with a “you are here” text, but it may be difficult to find the places where you need to go on the floor plan and if the destination is far and on a complicated route, it would be easy for people who are unfamiliar with the building to become lost along the way. Consider the image below, it is an evacuation plan, it is not located in a prominent area, and it is one of the few way-finding devices provided within the school. If one is fortunate enough to even find this sign, they might be able to figure out where they are but anything further such as finding his/her way to a certain room will prove to be difficult. As a testament to insufficient way-finding devices, often many people will approach students and ask “How do I get to _________?” If people are relying on the method of asking students where to go, then how useful is this sign and how successful are the building’s way-finding methods as a whole? To further emphasize a point, ask a current student where this sign is even located and you may get a blank response. I found the first and second floor evacuation plans by accident, and I assume there is one on the third floor of our building but I still do not know where it is mounted.

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Second Floor Evacuation Plan

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As a response to the buildingâ&#x20AC;&#x2122;s insufficient way-finding devices, our class purchased plastic vinyl sheets and cut out symbols for destinations, which we placed at the main entrance of the building and throughout the building at major intersections. The destinations depicted by the symbols included the architecture main office, lecture hall, media center, faculty mailboxes, and we also included numerals that pointed to the areas where a range of room numbers are located. We feel that our efforts were only the beginning of how to properly implement wayfinding strategies in a building, while also raising awareness for the accessibility related issues. The response from our fellow classmates was positive and we were encouraged in knowing that they were curious about our project and once they were informed of the buildingâ&#x20AC;&#x2122;s issues they fully supported our efforts. I felt satisfaction in knowing that we did raise awareness, and perhaps our methods will be embedded in the minds of the future practitioners that our architecture program is sending out into the world.

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9.1

Lesson in Pathology

The exercise for this week was to research the medical profession of pathology at the University of Michigan Hospital. Our class was provided very valuable insight into pathology by meeting with one of the tenured doctors of Anatomical Pathology, and we were even given the opportunity to tour their facilities which helped us understand the sub-specialties that are associated with the discipline of pathology. The basic definition of pathology is that it is the study and diagnosis of disease. While we were meeting with the doctor, he explained how the profession has evolved over time and that a major shift has occurred in how pathologists perform their diagnoses with new technology. We understand that pathologists mainly deal with slides that contain samples of bacteria, which are dyed with color for contrast, and are observed through a microscope. This is a traditional method and as the doctor explained, this is gradually being replaced by more digital methods for analyzing samples, where slides are essentially scanned and saved as a digital computer file.

Digital Image of Specimen

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Digital files replacing the slides and microscope has its advantages, such as a digital file cannot be lost or damaged during transport, and the scanned sample will not deteriorate over time. There are also inherit disadvantages with digital files and the first issue is that the size of just one file can reach over one gigabyte in size. The reason for such a large file is because the sample is scanned with a very high resolution so that the pathologist analyzing the sample can zoom in on the image while not sacrificing quality of the image. The issue with the file size being so large is that it will require a large database to store the files, or require remote access to a server that hosts the file. If a pathologist loses internet connection or if the remote server goes offline, then it will be impossible for the pathologist to perform his or her job until a connection can be re-established. Another issue with digital files is the output device, currently this is a computer monitor, which is not an ideal situation for a pathologist to analyze a sample. All pathologists are used to the traditional microscope from its visual interface to the ability to rapidly zoom and focus with its dials. There is a completely different methodology that occurs when the pathologist attempts to recreate a similar experience by using a mouse and computer monitor.

Traditional Microscope and Specimen Slide

Multi Viewing Microscopes

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10.1

Pathologyâ&#x20AC;&#x2122;s New Home

The final project for the course was to document the existing conditions of the Pathology Department with the intention to design a new facility for the department. The class was divided into multiple groups and our group focused on documenting the overall hospital and for locating all individual pathology departments. We were tasked with obtaining hard line drawings while also taking notes on a more personal manner of how far, and how much time is required for a pathologist to travel between locations such as offices to specimen labs, and to other points of interest that are common in their daily routine. The initial investigation for our task was to document the University of Michigan Hospital in a broad context, noting the locations of other major hospitals throughout Michigan and the neighboring states. Another map was created to indicate a 200 mile radius, with Ann Arbor as the center, in which the medical evacuation helicopters, known as the Survival Flight Services, will travel to transport patients from the scene of an incident and deliver them to the hospital. The 200 mile maximum travel distance of the Survival Flight Services is equivalent to the geographic distance between Ann Arbor, MI and Chicago, IL.

Other Hospitals Relative to University of Michigan Hospital

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Survival Flight Services Helicopter

200 Mile Radius of Survival Flight Services

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10.2

Pathology’s New Home

Satellite Image of Hospital Complex N

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300’

600’


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10.3

Pathology’s New Home

Our investigation of the overall hospital and the current conditions of the pathology department has led us to the development of an analysis diagram, displayed on the next page. The pathology department is completely fragmented and is comprised of two major components - offices and frozen section laboratories. There are currently three locations for the pathology offices, and three locations for the frozen section labs. During our interview with one of the department heads, we were able to understand their daily routine, beginning with the pathologists arriving at the parking lots, indicated with a ‘P’, which is where the majority of the Pathology Department commuters park their cars. From the parking lot, the journey to either the offices, marked with an ‘O’, or the frozen section labs, marked with an ‘F’, occurs and throughout the day it is common for those in the department to travel from office to office, or from the office to the frozen section labs. The diagram indicates the typical routes that one would take to travel from one location to another. Also consider that the frozen section lab located the furthest to the north handles the creation of the specimen slides, and those slides are then distributed to the offices or other frozen labs for examination or for storage. In addition to the pathologists having to travel long distances, the inner-office deliveries, such as the carts used to transport the cache of slides and other specimens, are also required to travel those long distances. Other points of interest on the diagram are the orange section marked with an ‘H’, which shows the location of the Survival Flight Services helicopter pad, and the teal section marked with an ‘N’, which is the location for the new building that the Pathology Department will be relocated to. After discussion with the department head, she indicated that the new facility should include all of the offices, a prominent frozen section lab, and an abundance of flexible space. The benefit of having offices near frozen section labs is that if a doctor needs to reference a specimen, or have another examination of a specimen, he or she can do so without having to travel to other locations or to request the specimen to be delivered at a later time. This will also allow for a specimen to be available for a panel of doctors to view samples or case studies and discuss the results immediately in unison. The request for flexible space is obvious - as witnessed by the existing layout - that if the department needs to grow, it can do so without having to fragment offices or labs throughout the entire hospital complex. One final note for discussion in regards to the overall context of the hospital is the daunting task of way-finding throughout the facility. Through our research, we were only able to uncover very generic plans that had been posted on the hospital’s main website; however, those plans are very shortcoming with providing detailed information and, in our own experience of navigating and documenting the hospital with only these plans, they are not a reliable device. The difficulty occurred mainly from interpreting what the plan conveys as compared to the actual conditions. A sampling of these plans have been provided on the adjacent page. 274


O

O P

O

H

F

F

P F

N Diagram of Existing Conditions

Floor Plans Provided by the Hospitalâ&#x20AC;&#x2122;s Website

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Pathology The immersive investigations from this yearâ&#x20AC;&#x2122;s course included the Pathology Department in a dialogue of considerations for how universal design thinking and techniques could be incorporated into future decision making in campus design. Students took part in exercises at the hospital, as well as exercises in our building and the resulting work engaged people outside of the course on the design opportunities related to human physicality, ability, and the spatial syntax of progression in a specific environment. The investigations provided location and documentation of the challenges in specific hospital environments for those who are physically disabled based upon travel distance, door handle type, weight of door system, and way-finding icons that we uniquely called building apps. The study includes documentation of existing conditions in the hospital and the variety of locations the Pathology department occupies in the hospital.

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Interviews AT THE DEPARTMENT OF PATHOLOGY

The class would like to thank Dr. Jeffrey Myers and Christine Rigney for their time and insight in helping us so thoroughly understand the needs and framework of the pathology department. It has been essential in our design process thus far.

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001 Interview with Dr. Jeffrey L. Myers, M.D. The following interview was an initial opportunity to sit down and discuss the future of clinical pathology and the work environment as the practice becomes more and more digitized. Dr. Jeffrey Myers provided several valuable insights into how he sees this transition taking place and what future pathologists may need out of their environment in order to practice and education.

Sean Vance: The goal of this conversation is for us to ask questions about the laboratory facilities, how the equipment functions, the relationship between your department and other departments, with the intent of digitizing that process. Dr. Myers: Okay. How many of you know what pathology is? So pathology, broadly speaking, is the discipline that provides diagnoses and laboratory results. Conventionally, pathology is divided into two main camps: something called clinical pathology, which is where blood and urine tests go...and that’s not what I do. And then there’s anatomic pathology, which is where they send tissue biopsies, its where they send cytology samples - cytology is the field of pathology that looks at single cells. So, pap smears are cytology specimens. And anatomic pathology also does autopsies. So anatomic pathology is biopsies, surgical specimens, cytology, and autopsies. So we’re only going to talk about anatomic pathology. The way we make diagnoses, in the case of large specimens, are to examine them with our eyes without 278

a microscope - and we can learn a lot. Small biopsies, not so much; cytology - definitely not. Now autopsies - obviously visual inspection is a big part of what we do. So some of what we do we call gross examination - just being present, looking. By the time we get to a microscope, which is what this is, we have to convert those tissues into specimens, or cells in the case of cytology, into something we can put under a microscope. And these are glass slides with a little slice of tissue on it. If you put a slice of tissue on a piece of glass, you can’t see it - tissue is colorless, more or less. The reason it looks colorful is because we’ve stained it. Tissue gets sliced, those slices get processed and put into wax to make them hard enough to cut into thin sections. They’re cut on special machines and those thin sections are put under a piece of glass, they’re stained and covered for protection - by then I can look at it on a microscope. So historically in pathology if you want to do your work, you have to manage a lot of assets - the tissue itself, the wax blocks from which slides are prepared, the slides themselves - so there is a bunch of stuff


traveling around in any pathology practice. And we’ve done that for generations, so it’s not that no one has figured out how to do that. In geographically dispersed sites like ours, where you have a pathologist over in this building, you have one over in this building, one out at east Ann Arbor...moving this stuff around becomes a major challenge. It’s risky for one thing - we lose stuff. It also takes resources to move samples, it’s not a value-added activity. But a lot of this stuff gets moved around the world all the time. For example, we provide about 10,000 consultations a year - meaning a pathologist sends us a case and says “What do you think?” Those get FedExed from... well I just got one yesterday from Bermuda, from California, from Florida - so this stuff gets moved around. So people have wondered for awhile - how can we do this digitally where we wouldn’t have to move this stuff around? There are now devices that are a disruptive innovation. They really aren’t quite ready for prime-time, though they’re right at the precipice - they’re still kind of slow. But there are now devices where you can stick this slide in the device and it converts it to a very large file that, on my computer monitor, functions more or less like a microscope - it isn’t perfect and I don’t think it’s ready to replace the microscope because an experienced pathologist with glass slides and a microscope is really fast. And they’re very efficient - it’s a very cheap way to do diagnoses. The digital images are just not to a

place where you can manage them as quickly. If I have a tray of this many slides, I can pick them up and put them on my scope and move them off really fast. Digital images- you’ve got to launch one, you’ve got to wait for it to load, and they’re gigabytes in size - so we’re not there yet. But we will be. So the challenge that we’ve had is, knowing that we’re at the precipice of the digital age in what has been an analog business for generations - how do we design a building that will almost certainly open its doors to a digital age that we cannot yet envision? So you could say, couldn’t you go somewhere and see - has anyone adopted, where are the early adopters? Really, no place has fully implemented a digital workflow because the devices really aren’t quite there yet. About 3 or 4 years ago, to digitize a slide like this probably took about 4 or 5 minutes. They’ve now got that down to about a minute. But we generate 2,000 slides a day. So 2,000 slides times 2,000 minutes that’s not going to work. But it will. And by 2016, there’s reason to believe that those devices probably will be functioning at a productionready level. So we’re trying to figure out - how do we design for that? So what does that look like for my office - is there a microscope still in here? I’m not sure. Probably - in part because we have a consultation practice. These devices are really expensive - so while the University of Michigan might be able to afford to go to a digital workflow, the three-person

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practice in Florida that sends me cases every week probably won’t. They’re going to send me slides. So I probably can’t abandon the microscope, but for the University of Michigan patient work I may not be using it. You’ll notice this microscope has multiple heads that’s because when I sign-out, I’ve got a fellow here, I’ve got a couple of residents here - I teach. What does it look like to teach from a monitor in a digital age that we can’t yet envision? I don’t know. If we go into our conference room, and I think we should, I can show you what a giant microscope looks like with twenty heads on it. That’s traditionally how we teach now. By 2016, I don’t think our conference rooms are going to look like that. We’re going to probably be looking at large monitors with full-slide images, would be my guess. It’s a little bit of a guess. So the risk to us is, if we design for what we know, we’ll probably open our doors to a building that doesn’t work. So the challenge is - how do you design for what you don’t know? As we’ve thought about this question, the institution that at least is selfproclaimed to be the closest to having a fully digital workflow in anatomic pathology - much of clinical pathology is already digital because those are instruments. The tests in clinical pathology don’t require as many people. In anatomic pathology, you need a pathologist to determine what’s going on under the microscope it’s very different. So we’re really talking about one slice of 280

pathology. The University of Toronto claims that they’re just about to go completely digital in the anatomic path. I know the chair there very well, so I asked can we come look and see what it looks like? Because we need to be thinking about the future. So we went sometime in the fall - November I think. And what we learned was that they are nowhere close, so it’s an aspirational goal - but we got a glimpse. For example, one of the things we saw was, in all of the offices they had two or three monitors. On one monitor they could pull up radiology images, on one they could pull up clinical data, and on the other they could see the digital conversion of the slide. So their workstations looked different, but they still had a microscope. We notice that they had two conference rooms with the large sorts of microscopes that I might be able to show you in our conference room, but in both of them the lights were out. Nobody was in there. And they told us that they were probably going to move those microscopes out because they have pushed the digital technology to their conferencing. Their conference rooms look different - they’re almost a theatre-type setting. I don’t know how well that facilitates communication - that was my thought. They might be able to look at the image, but they can’t look at each other. The whole reason that pathologists look at cases together in conferences is to exchange insights and ideas - I’m not sure theatre seating in a conference


room serves that purpose. It makes it easier to see the image, but the purpose is to share ideas. So how do you design conference rooms in a digital age? It’s easy actually on a multi-headed scope because its circular. So you all sit around and you talk to each other - how do you do that digitally? I’m not sure. As Chris gives you a tour, you’ll see what our sign-out rooms look like now. So we have many peer institutions - we’re a very large department and we can afford to have sub-specialty sign-out, meaning the biopsies and the re-sected specimens that have to do with genital/urinary pathology go to a genital/urinary sign-out room. Breast pathology goes to another room. GYN pathology goes to another room. GI pathology to another. So we have these rooms where people sign out specimens based on their organ of origin - all the stomach specimens go to the GI room, all the prostate biopsies go to the GU room. And as you see those sign-out rooms, you’ll see how we work in an analog age. The question you should be thinking about is, “I wonder what that looks like when they’re not sitting around a microscope anymore? I wonder what that looks like when they’re using digital assets?” And as you’ll see in those rooms, the process is complicated. You’re not just looking at the slides - you’re looking at the slides, you’re having conversations, and then you’re looking at a computer monitor to see the preliminary report that a trainee has dictated. You’re revising the report

as necessary based on whatever the attending’s viewpoint is, and then you’re releasing the report so that it can be available for patient care. So you’re doing more than just looking at the microscope, you’re processing information and you’re porting that information to an electronic medical record. And what does that look like in the digital age? I don’ t think it looks like theatre seating. Is it likely that that the process of putting the information into an electronic report and releasing it will happen on the same monitor with which you’re looking at the image? It’s hard for me to envision, because even though our workflow may be oldfashioned - as you’ll see, it is unbelievably efficient. As I’ve said for as long as I’ve been in the business - I’ve been doing this for a long time - the microscope’s day is not over. And the reason it’s not over is it’s really efficient. So we’re trying to plan for a digital age when it becomes as efficient as this, and have no clue what it looks like. So that’s why you’re here. That’s the opportunity. Nobody has done this before, so there are no exemplars. We get to kind of get it right or get it wrong and it will probably be a little of both. We’ll design some things and, in retrospect say, “Well, it made sense, but it’s probably not going to work.” And we’re likely to design other things and say, “Wow, this is really cool. This is better than I imagined.” So I just wanted to make sure that we started in the same place in terms of what we do in pathology and why we’re

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nervous about planning for a future that we can’t see. And I’m happy to answer any questions. Chris is going to give you a tour so that you can see some of the things that I’ve described to you. I’ll tell you, by the way - I do some of my cases digitally now, but they’re not University of Michigan cases. So there’s a large reference laboratory in California that has already adopted this technology, but they’re a very different sort of practice. They’re not a hospital-based practice - it’s a for-profit business that recruits work from pathologists all over the country. They then export that work back to the contributing pathologists as digital images. Occasionally they get cases that are outside the expertise of their own small faculty, so they send them to people like me digitally. I can show you what that looks like if that would be of value, but I’m not sure that it would. I’m not sure it’s what the future looks like, but it can give you a sense of how digital slides look different from the analog.

yesterday saying they want me to download a new application, so the workflow will be different. But this is how we’ve dealt with digital assets so far. As you can see, you get a lot of things from going digital. I’ve emphasized efficiency, but there are some real gains by going digital in terms of information management that you can’t do with the analog stuff. It may be that we’ll sacrifice efficiency for those gains. I don’t know that this will ever compete, but just in loading this portion, I could already be done with a small case. Some cases are really fast, so already this feels slow to me. You don’t have a frame of reference, but after you walk around, you will have. They provide me their case number that I input - I can handle paper way faster than this. That’s why there aren’t a lot of early adopters - doctors will look at this and say, “This is going to slow me down.” But that’s true of any disruptive innovation - at the beginning, you sort of sell to the low end of the market because high-end users say that won’t work for them. But eventually it does. Matt Schwartz: Is there a user So there it is - I now click “Launch interface? How are you viewing Virtual Microscopy”. I usually them? I’m interested in what it looks move the image over here so I can like. keep the clinical data to one side which some idea of how I think the Dr. M: Sure. Let me see - I don’t workflow will look like, where the think that I’ve deleted the case they image is over here and the other sent to me. So they send me an associated laboratory data over email that basically says that you here. See how long it takes for this have a case. I go to their website image to load? I could be slapping where it lives on their server. The a lot of glass on my scope in the image doesn’t travel - they’re time it takes this image to even load too big. They sent me an email up. Now I deal with that image - it 282


allows me to scroll to navigate and change magnification just like I can at the microscope, but notice the time that it takes for that image load as I shift magnification. But that’s what virtual microscopy looks like. These are kind of early generation solutions, but by 2016, which is our move-in date, we want a building that will serve our needs for the next thirty years - this will for sure be how we do much of our work. I don’t know if it will be all of our work, but it will be how we do much of our work.

sure of how many others, so we will for sure be an early adopter, but we won’t be alone. Patrick Brinnehl: By the time, once everything gets loaded - Is there a major difference between using the digital and using the analog?

Dr. M: Great question. There is - of the cases they send me digitally, I can confidently solve them probably eight time out of ten. It might be nine times out of ten I haven’t kept the data. But one or two times out of ten - actually, Ryan Giles: I think that would be this case - the glass slides will be the major question, at least for arriving by FedEx today because I me. Seeing as how you guys are couldn’t figure this out. And then I going to be the early adopters have to make a judgment call - is it and that there are going to be that I couldn’t figure it out because quite a few cases that are going it’s a case that I won’t be able to to have need for microscopes - is figure out no matter what? There the priority here, for you, to get as are plenty of cases like that. Or is much efficiency between this sort of it a case where if I could actually analog-digital hybrid? see it at a better resolution, which becomes very limiting here, that I Dr. M: That’s a great question. I could solve it. And I decided that I think the answer to that is yes. think I might be able to solve this - I My guess would be that much - I don’t know if I will or not - so send don’t know if all - but much of our me the slides. I think that problem internal work, which is about 2/3 will also be resolved. When we of our work will be digital. And I were in Toronto, we saw a different think much of our outside work will platform for both imaging and still be analog. I think by then we user interface. It was faster and will not be alone, for sure. There the images were of higher quality. are many institutions that are very The week after that, Sony came close to getting in with both feet. I by to show us what they’ve done mentioned the University of Toronto with their PlayStation controls as - and they were clearly close while a way to manipulate slides which we were there, they just weren’t looked way faster because this is there. The University of Pittsburgh pretty clunky. I think there will be has been the leader in this, and some iterative innovations that will they’ll be there before 2016. I’m not make this better than it is today. Architecture 509 | Design Analytics for Ability in Architecture

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But today, I think that’s a great question. We can’t always solve it with these. But there are certain kinds of cases where I know as soon as I see it, I will be able to solve it. And I always tell them to send me the glass. I’ve told them certain criteria - there are certain kinds of cases where, in these circumstances, send me the slides because in my experience I won’t be able to solve it digitally. That’s why I say I think all our work will be digital, but we might discover more of those things certain circumstances where it simply can’t keep pace with the analog. Or that the return on whatever you sacrifice in efficiency doesn’t really give you a payback - a sufficient one.

is going to happen. What we think will happen is that much of this will be automated, so that when the slides come out of the machine that puts the cover slip on, they’ll go straight into a device that will digitize them, using a barcode identifier to automatically aggregate them in the right place and then alert the pathologist when a case is ready, much like how I get an email now, allowing me to view it digitally. All that transportation goes away, but you’re absolutely right - slide preparation stays the same. There will be a different way to image the slides and then they’ll go right into the archive where they go now, but only after this part of the process is done. As you look around, you’ll see stacks of trays which are often PB: So you still have to make all the cases idling to go back to the files glass slides... after this part has happened. All of that will go away in sense - they’ll Dr. M: You still have to make all the still have to be archived, but they glass slides, which I think creates won’t travel first. The glass slides a different set of challenges. That won’t go away. will change the workflow in the laboratory that prepares these MS: What benefit do you get from slides. And what we imagine the microscope aside from being is something like what they able to zoom in very quickly? imagined in Toronto, where what happens now - and Chris will Dr. M: I can see things in that image show this to you - once the slides that I can simply not see here. are prepared, they have to be manually aggregated into cases. SV: Would that be the result of Hundreds of slides come out of maybe a stereoscopic perception of the machines, and then a human the slide? being has to say which slides go with which sot that they can be Dr. M: Some of it is. So as you delivered to the pathologist in a watch a pathologist work, as you way that makes sense - one patient go from room to room, you’ll see all put together. The slides are then them moving this little knob a lot, transported to wherever the work focusing up and down. Because 284


even though this is a thin slice of tissue, it’s got three dimensions. Meanwhile the digital is simply a two dimensional image. Now some of these manufacturers are trying to figure out how to give it a third dimension so that you could actually focus up and down on a digital image like you do here, but they haven’t solved that. Even now, these are pure flat images - they’re gigabytes in sizes. If you start to add a z-axis by scanning multiple times through this thin slice, they become terabyte size files of which we turn out thousands a day. One of the things that you get from a microscope is an ability to view a sample in admittedly thin, but still, three dimensions. Resolution is better as well - but that might get solved eventually. For example, there are certain small structures that, even when I know that they’re present on a digital image - and I’ve done this - I can’t make them out. Those are the sorts of cases where I’ve said, by those criteria, just send them to because I know I won’t be able to see it. But I can see it in analog.

what the architecture will be, but you’re exactly right. In fact, it was interesting - when we chose an architectural firm for this building, what ultimately helped us distinguish between the top two candidates was not their experience in building laboratories. We actually abandoned the firm that had far more experience in building laboratories as we know them today. The other firm had more experience in building data centers. We thought that’s really the competency of the future, because right now people point to radiology as the place where you have huge demand for IT. Our image sizes are much larger than their CT scans, MRIs...Pathology will eventually dwarf the demand of radiology, and nobody has solved that yet. But you’re absolutely right- that’s a huge technical and engineering challenge.

RG: I feel like the higher resolution images that you’re hoping to get to are just going to increase that file size and I imagine that’s going to reconfigure how we think in terms of archiving this information. There’s going to need to be dedicated servers even for individual groupings based on organ almost.

Dr. M: Absolutely - great observation. In fact, we actually have a large informatics group in our department. Recently, they made the front pages in the informatics world by developing just such tools. They have a really cool tool that you could master in five minutes that can be taught to recognize certain things such as cancers. And it could begin to reproduce and

Dr. M: It is. And I don’t know

Karen Henderson: I’m curious if digitizing the files will lead to some diagnosis done through the computer, using computer programs to diagnose conditions.

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re-perform at that level. What I think will happen is that those will be computer aids to diagnosis. I don’t think they’ll replace, but they’ll help us be better. Those are absolutely creating those sorts of opportunities. So we might sacrifice efficiency, but we might end up being more accurate.

on the immersive nature of the microscope?

Dr. M: That’s a great question and I don’t think we really know that. The vendors make a big deal about the user interfaces they’ve constructed and they always say these look just like an airplane cockpit or just like what the radiologists are KH: You might not have to go doing. When I hear that, I always through every single sample if think, “Yea, but that’s now what the computer goes through them we do.” You may be appealing for you and then you look at the to a subset of the population that tougher ones. wished they had been fighter pilots, but that’s not actually Dr. M: Exactly - you’re so ahead of me. Something happens at a us. So what are the advantages of microscope that is hard to explain. digital? One of the key advantages Clinicians don’t get it - they think is transportability. This image it’s just capturing an image through is living on a server in southern these eyepieces. But talk to any California. The reason this company experienced pathologist and they’ll went to this model was their FedEx say that something happens with costs. It’s a for-profit business and the way I move a slide. The way I they were looking at their costs and think is different - my brain works saw that their FedEx budget was differently, and that’s absolutely unbelievable. They wanted to figure true. The extent to which that will out a way to ship less glass. And get lost in translation is unknown, they did. So that’s one advantage: but I can tell you the experience for Portability. So if I have a colleague me. For example, I have struggled over at Kellogg Eye Institute - there with cases like this, and ultimately are a couple of pathologists over said send me the slides. As soon as there - if they want to consult a I put it on my scope, its solved and case, the barrier is so huge. Even I think, “Wow - what was different?” though I can see it out my window, I don’t know what was different. a lot of those patients just don’t get And it happens. seen like they should. It becomes, “Screw it - this is probably close SV: I think that some of it is what enough.” But another is digital happens when we begin to look image analysis - that’s a huge at the city as a whole and the opportunity. experience of right outside of a storefront or right outside the door. SV: How much of the impact of the When you’re back at a distance, perception of the slide is based you’re capturing the entire picture, 286


which can be good - you know, with the distance that we’re at, we’re seeing the entire slide. But there’s something immersed in the proximity of one or two cells and how your brain accepts the perception of that environment...

see them using a mouse. When we were in Toronto, the strong advocate for this migration, their chair, was using a mouse. Which was disappointing to me, because I think we all feel like there is going to have to be a different user interface than a mouse. One Dr. M: That’s really insightful- when of her colleagues I noticed used I’m looking through the scope, a unique trackball. And I asked both eyes are here, I’m not seeing him about that and he said that anything else. It’s not possible to it was much better for him than a do that with a monitor. I’ve got light mouse. He could think differently. from my window, I’ve got whoever What I noticed as he was using it comes through the door, I’ve got was - you know, you can only scroll the distraction of someone walking like this because you only use it by in the hallway, and I will tell a few time a day. If you do that all you that when my eyes are glued day, you’re going to have repetitive in here, I don’t think I see any of motion problems. Actually, I was that. I hear things, I certainly notice very interested in Sony’s solution. if someone walks in my office The whole PlayStation interface. and yells at me, but visually it’s a Which looked, to me, a lot more different experience. And I don’t viable. Because pathologists will know how much that will impact the tell you that there’s something way we work. tactile that happens that is lost in this translation. So whatever the RG: Well, and this might fall interface is, it has to somehow outside our role, but I feel like how capture that. Now, you could say, you described walking by any well you’re just capturing it to try pathologist tweaking the knob and hang on to something that constantly, there’s got to be some feels like the good old days. But I sort of tactile dimension to it. think something changes in the way you think. I absolutely think that. Dr. M: There is - there absolutely is. KH: I think the lag when you’re RG: That level of control is going zooming in could be a big problem. to be very important to your Because that keeps you from immersion. making the whole picture in your mind. Dr. M: There absolutely is. In fact, one of the things that pathologists Dr. M: It is. But I think that will who have been thinking about go away. I think some of those these things a lot say is that with technical limitations today will be most of these digital tools, you’ll solved. I’m less comfortable that Architecture 509 | Design Analytics for Ability in Architecture

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we’ll fully understand the thing [Sean] is talking about and how that changes our work. But it’s real. So they’ll say, “Okay, look at this user interface. You have three monitors, looks like a jet cockpit.” And I always think, “Well, so what? I’m not flying anything.” And I’m not sure that will recreate the experience. People say that that way you can have the X-ray and the clinical data up? Well, I can pull those up now, but what I don’t do is to look at it all at the same time, which is maybe an advantage. Do I really want all of that in my visual field at one time? I don’t know. So that’s really the issue: How do you design for all those unknowns?

let the future be what it is. Look at those guys, what are they doing? (laughs) SV: Look at those guys taking their goggles on and off all the time, I don’t know... Dr. M: But those are great points. That may be as likely as people currently envision how we’ll work ten years from now. I don’t know if anyone’s working on those sorts of innovations. PB: Is that a camera on the microscope so that you can project the slide? Dr. M: Yes.

SV: I find it interesting that nobody has asked the question of putting a set of goggles on you, as opposed to looking at computer screens. To give you the full immersion and to give you something that’s more of a rolling joystick, like the “space navigator” mice. It’s a device very similar to the microscope knobs, but it operates three-dimensional space. And it’s very particular in certain programs, but it giving you a set of goggles with a space navigator would be different than looking at a computer screen. It would give you that immersive quality - you could take the goggles off and talk, put the goggles back on, so that it’s immediate to you. Dr. M: Yeah. Pathologists are stigmatized so much already. And that scares me, how people will view us if we use that. You know, 288

PB: My question, then, is...well, I’d automatically go towards the opposite. Make this a hybrid machine itself that produces digital images. You’d still have the same effect - you could put a digital slide over it and have all the same control, but it’ just using a threedimensional stand-in and projecting the image based on that space. Dr. M: So the user interface for the digital images looks like a microscope or works like one? PB: It can work as a microscope too, so that way you have the functionality of when you get analog slides for the other cases. Dr. M: You should patent that idea right away. (laughs)


MS: What percentage of the time do you actually know where you’re looking? Or what resolution you tend to use?

Dr. M: Yes.

Dr. M: I would say most of the time. Although, for many problems, you kind of need them all. If you walk around and watch pathologists, they’ll be flipping through these objectives pretty fast. And they need them all - you always start at a very low magnification and form ideas. Some of these ideas you’ll solve at low magnification, but many you won’t. You’ll quickly go into a certain spot and say that’s what I needed to know, and then go back up and look around to find another spot where you zoom in and say, “Ah, now I’ve got the whole story.” So it’s variable. If you said, on an average day, which of those objectives has the longest dwell time? I don’t know probably one in the middle. Most pathologists don’t spend a lot of time at really high magnification. That does vary a little bit by specialty. Hematopathologists, for example, who look at blood and lymph nodes and lymphomas and things like that - they spend a lot of time in very high mag. They use high magnification that doesn’t even exist in my office. I don’t need it for what I do - they do. So it’s somewhat specialty dependant.

Dr. M: I use them mostly for teaching, and then I will compare them to slides. If I have a fellow, and we might be signing out a case that he hasn’t seen before or it might not be textbook perfect, I might pull one of those off the shelf and say, “Let’s look at a few more examples.” Now, we’ve already created fairly substantial digital archives for education, so I think those sorts of assets will no longer exist in an office. In fact, where this sort of technology has already made an impact in a lot of places, including Michigan, is in education. For example, medical students they used to get a box of slides that they would look at in their labs. Now those are all digital slides and can be viewed wherever they want, whenever they want, as long as there is sufficient bandwidth. This technology has changed education and things like that are old-fashioned, and will go away.

SV: So sometimes you are comparing those slides?

SV: The reason I’m asking is that you have the attribute of the paperless office contributing to a new workflow in the office itself. What does a slideless office contribute to positive workflow for a pathologist?

SV: I’d be curious about the rest of your office. I see that you have Dr. M: What it would contribute is storage of slides - those are historic a way to manage the information precedent? more efficiently and effectively. So, for example, you’ll see some of the Architecture 509 | Design Analytics for Ability in Architecture

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boxes have a lot of cases in them and it may take me awhile to find exactly the case that I remember. I can imagine with digital tools that I can tag them differently and I can curate them and retrieve them more effectively. It can take several minutes for me to find the slide that I want to show my fellow and I can imagine that, in a digital age, I can simply manage that information more effectively.

on the specialty. For example, a certain gastroenterologist and clinicians who take care of patients with liver disease - they love to see those slides. Right now it means they have to walk somewhere, somebody has to pull the slide, make sure that it’s in the office when they arrive. They have to look at it with a pathologist. Nephrologists, who take care of people with renal disease, they love seeing their renal biopsies. PB: Personalized curation. They almost never miss a chance to see a biopsy from their patient. Dr. M: Exactly. That’s exactly right. They all troop down to the sign-out room where we do renal biopsies SV: Will each pathologist have a at a certain time of day so they can different way of documenting them, see them. I can imagine, with digital or are these documented based assets, that becomes very different. upon - I see Hodgkin’s Disease, They could look at them real-time primary and secondary - terms that and sometimes they provide insides are common to all pathologists? that one could miss. So I think in So if you had a network that had addition to education and how we a bridge of other slides from other work, how we communicate with departments, other inventory, there others and share information will are going to be pathologists that be significantly impacted. In fact, have unique slides or conditions we’re exploring how to do that now. that they find... This won’t all wait till 2016. We have a large device now that we Dr. M: We have a common use for digitizing slides, primarily language in terms of diagnoses for research and education. We’re that translates across all of looking at buying a production pathology and communicates device to use in the practice in a to non-pathologists. So there is couple of ways, as a starter. One a common nomenclature and of them is for those biopsies where language, but you may have a clinicians have an interest so that slightly different variation on that we can do away with all the wasted common theme. You may tag that walking and transporting that we do differently than others. I should now. mention that non-pathologists in any practice, certainly in ones as SV: Okay, I’m going to ask not large as Michigan, also have a a 2016 question, but a 2052 strong interest in slides, depending question. It has to do with real290


time investigation of a patient, as opposed to the investigation of a slide. Do you foresee the potential of examining patients as a slide, or examining patients as an intervention in a patient through a scope?

and is there the training in the infrastructure of pathology to respond to things alive?

Dr. M: That’s a great question. You guys must have been reading up on this stuff because that is actually starting to happen in some specialties. Especially with various forms of endoscopes, there are now next-generation versions that have the capability of doing very high resolution, high magnification images. In those specialties, people are starting to ask, “How do we learn to do real-time pathology during this procedure, in the procedure room?” And the initial stabs are that they’re going to have to bring pathologists over so that they learn to look through these scopes and help us know what they mean. Other clinicians are saying, “Screw it - this is a billable activity. I’ll learn to do this and we won’t have to send pathology anything.” So I think there are details to work out about how that will happen, but it will happen.

Dr. M: Yes - but that will change. And I’ve heard lots of responses from the pathology community that this is really at a very, very early stage - investigational at this point. But it’s clearly a part of the future.

Dr. M: No. SV: So there’s an isolated cell.

SV: It’s the movement from forensic to determinate. So you are changing the way that pathology perceives itself through this. Dr. M: Yes. KH: I’m wondering if there’s a way to digitally scan somebody and make a three-dimensional representation...

Dr. M: Not yet - that I know of. So maybe that’s 2052. Could be. But I think that’s a lot further off. I think the sorts of endoscopic tools that allow you to look at high magnification, high resolution images - they’ll certainly be around SV: The reason why I ask is by 2052, they may be gone by that there’s a series of imaging 2052. That will happen. I think resources now that will determine much of what we do now will look the body’s sectional properties and similar, but be digitized. With what spit you out a section of the body kind of interface? I don’t know. in real-time. I’m wondering if that might be a way of investigating the PB: What about the digitization of body in motion, you know, how the gross examination? cells are responding at that point, how the fluids are responding, Dr. M: Yeah - that’s a great Architecture 509 | Design Analytics for Ability in Architecture

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question.

SV: It’s interesting because I actually went to the wrong PB: It makes more sense in this department when I first came here scale to me, than it does examining - I went to the medical school. And an entire body. I don’t know. when I was walking around in there - their stations are set up with six Dr. M: So I don’t know that much is heads. happening in that space. It may be my own naivety, I don’t know. The Dr. M: And you’ll see those here only thing that’s happening in terms too. So each of those people that of digitizing gross examination at were in those rooms with six, they this point is that there are practices also have an office that serves the that have the ability to webstream same purpose, where you’ll see their images in real-time allowing they have a personal microscope you to get a consultation from afar. as well. What you saw were the But someone still has to be there sign-out rooms that I was talking with their hands on. It doesn’t solve about. So we have conference the problem of having to have rooms with lots and lots of heads, someone present to manipulate the and then the sign out rooms I specimen, cut the specimen, etc. talked about - breast, GI - you’ll see smaller multi-headed scopes SV: Okay. I think that gives us a because they tend to be smaller good doorway to get started and teams. But they’re variable. the outcome of this will hopefully lead to a sort of posturing on the SV: Did you cover what those process and maybe even the group sessions do? Are you sort equipment or the spatial qualities in of verifying as a whole what you’re response to the equipment - how to seeing or... get you the immersive environment. Maybe it’s a suggestion on a Dr. M: So we call that sign-out. change to the equipment. Each The way our workflow is - in the of them I think will have their own upfront part, specimens come in, unique modification on this and they get grossed. That’s usually then hopefully we can use that to done by residents and/or pathology take this on further. assistants - you won’t see many faculty in there grossing specimens. Dr. M: I’m excited to see what you Then the slides from those come up with. I really firmly believe specimens get processed in the lab that what you see now in terms overnight, the slides come out and of having traditional offices that they go back to the resident. The divides, with us working in here, resident looks at the patient and, as having to walk out there - I think part of their educational experience, that should look different. dictates a report as if they were an attending. It goes into our computer 292


system. And then we go to those rooms and we sign out. What happens is I look at the case, I see what they’ve written and I either agree or disagree or a little of both. I then change their report and we release it. So what’s happening at that time is I’m checking their work, but it’s really an educational and a clinical exercise.

can’t we bring all the expertise to the table at the right time and the right place? Where they were sitting in the big warehouse, they did that very effectively. What really was compelling to me - what we’ve talked about is conventional workflow. But there’s another thing we do that allows us to do much faster diagnoses and we use it to support the operating room. So if SV: So there is some group someone encounters something verification - it’s almost as if this is in the OR and says, “Oh my God a judging chamber. So it should be - I need to know what this is.” We something that is more centrally can’t say, “Just send it to us and located to allow people to come we’ll process it tonight and get back and populate and then return. to you tomorrow.” They need to know now, so rather than process Dr. M: Absolutely. In fact, I saw the tissue in the usual way and a very interesting model that put it in wax so it’s hard enough to contrasts with ours a lot when I was slice, we freeze it. Those are called at Johns Hopkins. They have this frozen sections which are stained huge warehouse-like room where and then put under a microscope. all of the individual sign-out rooms No pathologists get afraid because we have in their own private spaces there’s a lot of artifact when you were all in that warehouse space. freeze something - it doesn’t look I think for many of us, you’d walk as pretty. But you can make a lot in and say “Oh my God. how can of diagnoses. What struck me at they work in all this noise?” After Hopkins - so when pathologists are spending some time in there, I nervous about that and want help, realized that this is genius because in our practice there’s one person they can reach across those silos sitting down there. I promise you and tap in to other experience and - whoever you see down there, expertise. That’s very hard to do they’re nervous at some level. here. It turns out that separating Worried they’re going to get a patients by source of specimen frozen and they’re going to have no where this came from a bladder, clue. What I saw at Hopkins was, so it must be a bladder problem - it they have one person doing frozen might not be a bladder problem. sections. But that frozen section It might be a lymphoma problem. microscope has a camera that can Then it gets murky about what project an image onto this giant expertise is most appropriate. monitor in that warehouse room, What pathology is trying to figure and all of a sudden you have twenty it is why we have to decide - why experienced pathologists looking Architecture 509 | Design Analytics for Ability in Architecture

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at the same image. Somebody’s going to know the answer. And if nobody knows the answer, it’s probably not answerable. And that was really powerful for me. We can’t do that very well here. We have a camera on our frozen section microscope - I can look at the image on my monitor, but it’s not a very good image. If it’s easy, I can help - but if it was easy, they probably wouldn’t be asking for my help. So thinking about how pathologists can work together to solve common problems, that’s a great thing to think about. And you’ll see - we’re not designed for that now. SV: And that’s actually, I think, the advantage of the slideless office - you get more people into that conversation. Right now we are nine people in your office, but we could be nine people gathering around a slide or nine people in an immersive environment where we’re looking at the slide all the way around us and we can look at individual details.

Dr. M: Maybe doing that with informatics tools of the sort you talked about to be able to query this tool and say, “Show me things that have this in common.” And it can do it digitally - that will be powerful. SV: Yeah - to be able to isolate a particular area and pull that off and discuss that - either pulling it from the wall back to the microscope or from the microscope to the wall and saying, “I want to talk about just this component right here.” And having that group session go from a group session to individual immersion - the freedom of back and forth discussion is the opportunity. KH: I have a question about this package you get. The cells on it are they all from the same part of the body?

Dr. M: Yeah - so this is the slice of a lung biopsy. We got a piece of lung and sliced it up and but the slices in little plastic carriers we call cassettes. They get processed overnight so they can RG: Well, I think that’s actually be embedded in wax and then that where digitization is really going to block of wax goes to a technician help because I see, as more of this who makes this thin little slice into becomes digitally archived, the way a slide. people tag them could become a searchable thing, where you could KH: I guess I’m just verifying that have it all on...if you’ve got certain everybody has a specialty and that people thinking it might be one specialty is based on the body part. thing...I could see people pulling So it’s not like you would ever be up side by side case studies in the looking at kidney, lung... background of what you’re looking at. And it’s instant comparison. Dr. M: You might be - you might do that on autopsies. From one patient 294


that’s unlikely but it happens. And that’s actually where organ-based sub-specialty breaks down. We actually still have a general service - it’s a smaller piece of the pie than it used to be. We get in trouble when you send something to a sub-specialty service based on what most of it is, and part of it is something else. And they flounder. And that’s when you start walking around.

very likely they’ll get various things sampler over their lifetime, but each one will be parsed individually to a sub-specialty. SV: I like your question though, K, because it brings up the question of how to curate the slides based upon the chart that you’re getting in. Dr. M: We struggle with that all the time.

KH: I guess I’m just wondering does anybody ever have a tray that SV: And so, maybe there’s a shape has samples from one patient with to them or color pattern or even all different parts of the body? something that’s diagrammatic within the slide sheet itself that Dr. M: Sometimes you have one helps the doctor understand what tray of a patient with samples from section of the body we’re looking different, but not a lot of parts of the at... body. So, for example, it’s not rare that you might get from the same Dr. M: That’s a great question, patient a portion of their pancreas, and I will tell you that we struggle stomach, and their spleen. And with that because it’s an imperfect then you might get some lymph system and it’s hard to predict. nodes and maybe some of their Because not all diseases are liver. That could happen. The good predictable based on site of origin. news is - stomach, pancreas, and So what we use now - we have liver are covered by the same non-physicians who do that. They sub-specialty. But spleen isn’t. decide who is the best person So as long as nothing too bad is to send it to. They mostly decide going on in the spleen, they’ll be on the organ, but not always. fine. But if they look at the spleen Sometimes they decide based on and say “Oh, crap”, then you’re the doctor who sent it to us. They going to have to expand the say, “That’s a piece of skin, but I conversation. So it does happen know he’s an eye doctor. I’ll send - it’s an exception and they’re it to the eye pathologist because I usually predictable exceptions. You bet that’s the right man.” And they won’t have sort of a broad range might get it wrong. of samples, except for autopsies where you have to sample SV: So it might be something that’s everything. But in terms of living on the skin that’s affecting the eye? patients, that’s unlikely. Now, it’s Is that why they would send it to Architecture 509 | Design Analytics for Ability in Architecture

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them?

asset and it won’t look so good. Actually people worry about that Dr. M: Yes. Or they might send me from a medical-legal perspective. a lung, because I’m a lung guy, but If a pathologist gets sued, they go in the lung is a non-lung problem find the slide on which you made like lymphoma. Or they may send your decision. People say, “If it’s a - this happens not infrequently digital asset and it was prepared they send a piece of lung to the from a glass slide what’s the frame lymphoma doctors imaging the of reference? How do you know answer is going to be lymphoma, there’s a one-to-one relationship but that’s not the answer. Then the between the digital asset and the lymphoma doctors bring it o my analog asset? How can you assure office saying, “We thought this was me that you saw what you were going to be lymphoma - it isn’t. supposed to see?” We’ll figure all Can you take care of it?” So it’s not that out. But it does change things. always easy for us to predict who should get a patient. So there’s SV: That’s definitely something rework and waste around that. that the computer will have to be taught as well. What is the metric Doug Sharpe: I have question for deciding whether or not this is about decomposition of slides. Is one set of conditions over another there a shelf life? set of conditions and how accurate is this slide? That’s going to be an Dr. M: That’s a great question. endless, ongoing conversation. We There is, and it’s variable. The have that in architecture and we’re shelf life of our slides is actually working with ideas - I can’t imagine surprisingly short with these cover what it would be for something slips. We have acetate cover slips that is real-time and reliant upon because of the volume that we put diagnosis. The fact that you have out, and those could last twenty a shelf-life to the forensic study is years, but it could be two years already changing the slide from depending on the environment what it’s been in the body. So even heat, how well it was adhered. But what the computer understands, it glass cover slips last a long time will not know to be true. - we have stuff from the turn of the century. And the stain can fade, Dr. M: Right - which is why lawyers but it doesn’t always - so there are will always have jobs. very old slides that are perfectly interpretable and there are year-old KH: I imagine the frozen slides have slides that I can’t look at anymore. a really short shelf life. So it’s not uniform. That’s another advantage of digital assets - it Dr. M: Actually, they’re preserved should look the same. Now you in much the same way, so they’re may go back to the origin for that preserved in the same way and 296


get covered with glass, so they stick around. They donâ&#x20AC;&#x2122;t stay frozen - you just freeze them long enough so they stay hard enough to cut, and then it thaws. Once you get it on glass it thaws. Then you preserve it the same way - you stain it, you put a cover slip on it, and it goes in the file. Itâ&#x20AC;&#x2122;ll look the same two years from now.

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002 Interview with Christine Rigney

Christine : We never had the right amount of offices located near the laboratories and close to surgery. Because they go down to the room of the outside of the ORs, with the frozen. Now they actually use the camera and can show the virtual images, but sometimes there’s nothing like looking the whole thing, the right margin. Being able to be close to mix is always good for everybody in any kinds of institution. We will miss that part once we build a new building cause our new building, I don’t know if you knew where it’s going to be located but, will be located far from the other department. And somebody has to stay near the ORs. And All the laboratory work, all the majority, all the grossing investments will be done in the new building. So, the book of the activities will be in the new building but the those criticals will stay

there. And, hopefully, cause we have pathologists over here and here (spread out), cause they have research/clinical appointments, we cover stuffs here. So there still be spokes we still need a lot right here. We lack a lot because we are so spread out. UD Team : Are you hoping all people in this parameters to the new building? that’s the goal? C : Yes. And we want to consider the future with technology and digital imaging, but we also want to consider in an action of all the players the ability of interact with the trainees, the residents, the fellows with all the pathologists. These are the other two (pointing two pathologists in the sign out room right next her office.) There’re GIs, they ... all things from the mouth through your stomach. The

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GI pathologist, we figured that it’s OK to move up here cause some of them are researchers that were way over up here, and some of them are surgical pathologist, so they cover breast and surgical pathology. So, it will take a lot of those problems in that way but researchers probably. Or, they can take a picture with real time and send it to the sign out rooms. We don’t really want limitations, and we also don’t want necessarily want, so when you outgrowing of space, you don’t want the walls are permanent. UD : Right, you want the flexibility? C : Yes. And you want to know the space, if the equipment is big now, but in the future it may become a lot smaller, which we did not consider at all with the current space. We need to work with immunology labs all the time they can’t do anything without us. I can’t see what they’re doing. So, those are the basic things that we really want to consider. UD : I was wondering if you can go over again with the highlighters all the spaces you pointed out. (refer the diagram) C : Surgical lab, frozen lab...

Most of the stuff in this Taubman center, even if there’s pathology department, but it’s usually blood draw. They are separated from the main lab. I think the focus is mainly on laying out our part. UD : it is quite spread here. C : it is crazy. But these are the people (main lab) who are going to mainly moving. UD : I was wondering if there’s any places where you deal with other departments? There’s any collaboration area? Do you do a lot of collaborating with other departments? C : We do. I mean it’s supposed to be what we are going to be where up. We work a lot with surgery and other examples. We might be working with Cancer Center on some things like we do multi disciplinary conferences. I think they do them all at the Cancer center, but I’m not sure. But that’s where the radiologist and the surgical anthologists and pathologist, group of folk get together and discuss the cases. UD : you see yourself go certain places than not?

UD : We walked down here and C : I’m going all the places all the saw a pathology of blood pressure, time. I feel like our pathologist is that you guys? going back and forth. That’s where material are transported most from. C : that’s the clinical lab. it’s a It’s distributed from here. It’s kind of blood drawing station. They will big deal. That’s going everywhere. probably stay there cause it’s clinic. And the current storage for our 300


slides, is in this building right now down to the basement down to the public center? UD : Not good? C : Horrible, probably. Archive file, we do have to pull them a lot for these conferences, and it may be .. it’s quite often. That storage would be great, if it is located near the lab and the pathologist as well. Because I think they walk miles a day. And when they need the stuffs, not all the time, but in the circumstances that I just describe like the diagnoses scenario, they need it and if they can have it right then, that would be awesome. UD : In daily thing, where most people here park in this area?

C : It will be nice if we can host, if that’s an option. it would be nice. Those space are often small and they are often booked. So, if we wanted to have as we have every other month we have APQA meeting, it’s hard to move to gianormous theater. One example, one thing we hope it never happen but it happens, some kind of quality or risk management, we will have not only other department are coming but also a lot of people to see where this would happen. And we often give tours to guest outside of our institutions to come see our lab, like you guys. If there’s a place open, we wouldn’t have squished you to Dr. Myer’s office. It is cozy. Labs are staying but all the offices are moving. Inside of the whole square, all of them are moving.

C : I park depending on where my 8 o’clock meeting is. And most of the people, they will at the cancer center parking. And then there’s another parking lot, right here and here. A lot of people park at the yellow park, it’s super cheap. It sometimes cracks me with up the handicapped parking. Why is it on the 7th floor that is not attached to anything? You know what I mean? I know it has to be, but it’s not helpful. UD : Is there any other areas that we should think like your network spaces? Is there better way to collaborate with you guys? If it’s going to be over here (new location), it seems like remote. Architecture 509 | Design Analytics for Ability in Architecture

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Appendix References American Association of Retired Persons. (1992). Mature America in the 1990s: A special report from Modern Maturity magazine and the Roper Organization. New York, NY: The Roper Organization, 21. Jones, M. and Sanford, J. (1996). People with mobility impairments in the United States today and in 2010. Assistive Technology, 8.1, 43-53. LaMendola, B. (1998, April 12). Age-old question: How long can we live? The Denver Post, 1F. McNeil, J.M. (1997). Americans with disabilities: 1994-95. US Bureau of the Census Current Population Reports, P70-61. Washington, DC: US Government Printing Office. Shapiro, J.P. (1994). No pity: People with disabilities forging a new civil rights movement. New York, NY: Times Books (Random House). Welch, P. and Palames, C. (1995). A brief history of disability rights legislation in the United States. In Welch, P. (Ed.), Strategies for teaching universal design. Boston, MA: Adaptive Environments Center. i Cary B. Phillips, Norman I. Badler, “Jack: A Toolkit for Manipulating Articulated Figures” Department of Computer & Information Science Technical Reports (CIS) University of Pennsylvania Year 1988 ii Bubb, Heiner: “Computer Aided Tools of Ergonomics and System Design. - In: Human Factors and Ergonomics in Manufacturing” (Summer 2002) (2002) 3, p. 249 – 265 iii Molly Follette Story, James L. Mueller, Ronald L. Mace, North Carolina State University Center for Universal Design, “THE UNIVERSAL DESIGN FILE Designing for People of All Ages and Abilities” (1998) 3, p 31-84

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iv Molly Follette Story, James L. Mueller, Ronald L. Mace, North Carolina State University Center for Universal Design, “THE UNIVERSAL DESIGN FILE Designing for People of All Ages and Abilities” (1998) 3, p 31-84 v Paolo Baerlocher, Ronan Boulic, “An inverse kinematics architecture enforcing an arbitrary number of strict priority levels” Published online: 22 June 2004@ Springer-Verlag 2004 vi Massachusetts Institute of Technology, Center for Policy Alternatives, “Analyzing the Benefits of Health, Safety, and Environmental Regulations”, Environmental Protection Agency 2009 vii North Carolina Board of Architecture, “The Rules - North Carolina Rules, Title 21, Chapter 2”, 21 NCAC 02 .0203 GENERAL OBLIGATIONS OF PRACTICE viii Fergus W. Campbell, Lamberto Maffei, “Contrast and Spatial Frequency”, Nov. 1974, Recent Progress in Perception, W.H. Freeman and Company Publishers 1976, pp.30-36 ix Gloria Hale, “The Source Book for the Disabled”, Paddington Press 1979 pp68-133 x Matthew W. Brault, “Review of Changes to the Measurement of Disability in the 2008 American Community Survey”, U.S. Census Bureau, September 22, 2009 xi Bela Julesz, “Experiments in the Visual Perception of Texture”, Nov. 1974, Recent Progress in Perception, W.H. Freeman and Company Publishers 1976, pp.37-46

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xii Jorg-Peter Ewert, “The Neural Basis of Visually Guided Behavior”, March. 1974, Recent Progress in Perception, W.H. Freeman and Company Publishers 1976, pp.96-104 xiii Irvin Rock, “The Perception of Disoriented Figures”, January. 1974, Recent Progress in Perception, W.H. Freeman and Company Publishers 1976, pp.96-104 xiv Marcelo Pinto Guimaraes, “An Assessment of Understanding Universal Design through Online Visual Resources and Role-Playing Simulation Exercises”, NC State University 2005

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Contributors l Respondents Jeffrey L. Myers, M.D. joined the faculty of the Department of Pathology at the University of Michigan in January 2006 as the A. James French Professor of Diagnostic Pathology and Director, Division of Anatomic Pathology. In 2011 he was also appointed Director of MLabs. He serves as an Associate Director of the University of Michigan Medical Innovation Center. Dr. Myers has served as an invited speaker nationally and internationally on over 300 occasions and has over 200 publications in peer-reviewed scientific journals, abstracts, and book chapters. He is the recipient of numerous honors and awards including the Mayo Distinguished Clinician Award, the F.K. Mostofi Distinguished Service and Presidentâ&#x20AC;&#x2122;s Awards from the United States and Canadian Academy of Pathology, and the Outstanding Clinician Award from the University of Michigan Medical School. He is a member of a number of professional societies including the United States and Canadian Academy of Pathology, College of American Pathologists, American Society of Clinical Pathology, Arthur Purdy Stout Society, the American Thoracic Society, and the Michigan Society of Pathologists. Christine Rigney is the Assistant Administrator of Operations Div of Anatomic Pathology at University of Michigan. Christine joined the Pathology Department in 2000 as a histotechnologist, was appointed Senior Clinical Technologist in 2002, and has served as Supervisor of Surgical Pathology since 2008.

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Contributors l Editors Editor in Chief U. Sean Vance is an Assistant Professor of Architecture at the University of Michigan. His current research focuses on the influence of design standards and policies that enable people with disabilities the use of products and built environments, as well as how a universal design approach can be utilized to redefine access for a larger spectrum of physical difference. Previously, he served as North Carolina State’s Center for Universal Design director, where under his leadership, the center expanded its focus on housing and product design to include urban environments and public spaces. Vance is an advisor and liaison with the University of Michigan Medical Innovation Center, assisting Fellows with spatial considerations for prototypes in development. He is the principal of Sean Vance Architecture and serves as a member of the National Council of Architectural Registration Boards. Vance received his B.Arch. from the University of Tuskegee and an M.Arch. from North Carolina State University. Copy Editor Claire H. Kang is an M.Arch candidate at the University of Michigan. While previously working with the Adaptive Technology Resource Center at the University of Toronto, she began to understand the extended notion of “dis/ability” as a gap between an individual’s needs and the existing infrastructure. As a student of architecture, she believes that design should be an instrument for overcoming the flaws in systems and that it needs to prescribe ways of folding into architecture the needs and desires of the generations yet to come. Her studio work has reflected her interest in urban infrastructural renewal and architectural interventions on the post-industrial urban fabric. She received her B.A. in architecture from the University of Toronto.

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Equilibrium WIN 2012  

Equilibrium is an annual publication which includes student work from the Universal Design seminar at theTaubman College of Architectureand...

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