Lean design in healthcare is considered the standard design and planning process, questioning and influencing each facet of the care delivery process. Medical providers, administrators, and designers alike are fully invested, creating early charters and goals for improving the healthcare delivery process and focusing on the seven flows of healthcare. Methods for implementing Lean design have evolved from early spaghetti diagrams drawn on facility floor plans to apps that measure footsteps and motion. Institutions and 

designers have developed a “kit-of-parts” for standard rooms and clinical configuration strategies to enable new facilities to be quickly designed with maximum efficiency. This enables the design team to quickly collect data and input from the steering committee and develop preliminary plans for the team to mock up, walk-though and provide feedback early in the planning process. 

This Lean process has changed the clinical delivery method and model, that for many years has put patients and caregivers in the same space. In the on-stage/on-stage model, doctors’ offices are separate from the patient rooms and staff work areas, requiring frequent treks back and forth from office to patient exams. Usually, one or two physicians work in a particular area with exam rooms forming around smaller core areas. In this model, patients and caregivers interact in and out of the patient rooms with a mix of doctors, nurses, medical assistants, patients, and family mingling in public corridors. This model results in continuous noise and motion as a result of the inherent interactions that occur outside of the exam room. 

A more current design strategy for multi-specialty clinics, born out of a series of Lean processes, has enhanced the care delivery process, and out-of-patient room workflow by separating the patient access from the caregiver areas in an on-stage/off-stage model. In this model, exam rooms have two doors, one from a dedicated patient corridor and the other from a care team work area. Additionally, this care teamwork area includes staff seats for nurses, medical assistants, doctors, and specialty support staff in one location. This Lean model has improved the care delivery process for the patients as well as the providers and has even resulted in quicker “throughput” of patients. 

Unintended Consequences and Potential Solutions 

Sometimes unintended consequences occur, even in the most thoughtfully designed facilities. A recent unintended consequence of the on-stage/off-stage model we have been implementing is the lack of ambient noise outside of the patient room. Separating patients from caregivers reduces informal interactions in the corridors, thus reducing background noise. This quiet environment is beneficial for staff, but can also be clearly audible as a patient walks down the corridor to their room and can hear conversations occurring in other patient rooms. This perceived lack of privacy has caused some patients to feel anxious about conversations with their caregivers. 

Sound mitigation measures that have been explored and implemented to reduce the unintended consequence include: 

Providing additional seals around the sliding doors to patient corridors door. While effective, this makes the sliding doors very difficult to open and close, especially for patients with limited strength and/or mobility. 

Installing insulated doors, which come with a significant price upgrade. 

Installing white noise systems that provide ongoing background noise. Although this strategy is effective, it is counter to the efforts to reduce background noise and create a quiet and healing environment. The most effective solution to date is staff training. Having the providers use quiet “inside” voices has reduced sound transmission and improved the quality of care. This behavior change can be readily implemented and is a simple way to make ensure the Lean design efforts can be fully recognized in a new clinical environment. 

The most effective solution to date is staff training. 

Through project takeaways, we, as a design firm, have learned to identify shortcomings and concerns early in the planning and design process. We work primarily to identify solutions to these issues, and if there is no clear, effective solution, we then engage our clients in conversations about how to address these concerns with a focus on striking a balance between the preferred care delivery process and the resulting consequences. As we practice architecture, we are constantly striving for improvement, just as you are constantly working for improvement in your field. The Lean Design Process has enabled us to work closely with our clients to seek better designs that enable improved processes, and at the same time, the Lean Design Process reminds us that there is always an opportunity for improvement. 

Innovation spurs on-demand, automated, and vertical solutions to meet consumer expectations

Like so many other logistics functions, warehousing has undergone a rapid evolution, driven most acutely by the growth of e-commerce and the unprecedented challenges of the COVID-19 pandemic. The digital shopping ecosystem has morphed to meet customers’ ever-growing demands; the new normal now includes single-click purchasing, same-day fulfillment, and direct orders via smart devices using Amazon’s Alexa or Google Assistant. Buying has never been easier, but to satisfy customer expectations, warehouse operations have had to quickly – and sometimes clunkily – shift to 24/7 schedules, automated systems, smaller and more frequent order batches, and more robust processes to handle increased returns. 

Compounding those issues are pandemic-related stressors like supply chain hiccups, staffing shortages, and increased costs to maintain worker safety and hygiene. The story of the last few years has been one of the unforeseen consequences. But logistics is a resilient industry, and in the face of these complexities, four trends have emerged that suggest warehouse owners are embracing creativity and innovation to drive greater efficiencies. 

On-Demand Warehousing for Greater Storage Capacity

In the past, the standard warehouse was designed to store large quantities of product, so orders could consistently be shipped to keep retailers’ shelves stocked. There was a predictable product flow, and this operational model allowed the typical warehouse to store anywhere from six to nine months’ worth of product. Fast forward to present day, however, and it’s clear that predictability is a relic of a bygone era. 

Amazon’s e-commerce approach (e.g., faster shipping, vast product assortments, individual orders, etc.) disrupted the shopping paradigm, and pandemic panic buying only exacerbated the problems wrought by the shift. On-demand shopping has led to large fluctuations in space requirements. As such, the amount of product that retailers need to store changes far too often for warehouses to keep any single product in stock long-term. Warehouses need far more flexibility to meet their clients’ storage demands. Thus, warehouse owners and product suppliers are rethinking the current storage capacity model to navigate this new reality. 

For example, the Port Authority of New York and New Jersey built out a database of all unused racking and storage positions. Then, the organization rented out these positions as cheaper short- term options, based on individual suppliers’ needs. The combination of a comprehensive database and shorter rental terms enabled suppliers to make better use of existing storage space and keep up with consumer demand. 

Warehouse Automation to Combat Labor Shortcomings

Suppliers haven’t been exempted from the countrywide labor shortage. As customers have placed more orders – and done so more frequently – there haven’t been enough workers to load and unload product shipments. The scarcity of qualified help has forced each supplier’s hand when it comes to automation. 

Automated processes and autonomous robots can ensure warehouse tasks get handled regardless of who’s on staff. Even better, automation reduces labor costs, freeing up capital for other expenditures. Forbes recently reported warehouse automation spending would continue increasing over the next three years. Among the top categories, conveyor/sorting automation could jump 65%, shuttle system automation could rise 56%, ASRS stacking crane investment could go up 49%, and AGV (point-to-point) automation could grow by 48%. 

Already, increased automation has dramatically improved throughput and storage densities while simultaneously minimizing labor spending and productivity losses.

Suppliers embracing automation will also see advancements in overall shipping performance and accuracy. 

We’re living through what many consider the Fourth Industrial Revolution, driven by the implementation of 5G communication infrastructure and IoT (Internet of Things) technology. 

IoT tech gives each individual product its own communication node, allowing the transmission of data from every package. That data flows directly into larger online networks that track a wide range of statistics. With so much data at suppliers’ disposal, there’s greater transparency in inventory control systems. 

More specifically, in the IoT model, robots are programmed to recognize when a product has entered a warehouse facility, when it has been stocked on a shelf, when it has been pulled from a shelf, and when it has been shipped out to the consumer. There’s unparalleled insight into product movement at every stage of the process. That means warehouses can consistently operate at ideal capacities since empty positions will automatically be identified and filled. 

Warehouse Design That Prioritizes Vertical Space

Of course, operating a warehouse isn’t only about what happens once it’s open for business – many considerations go into design and construction on the front end. 

Along with many other changes, the industrial warehousing industry has witnessed a rapid increase in the cost of commercial land. Cheaper plots allowed for expansive facilities, but record-high prices have forced warehouse owners to maximize the square footage they can afford. Instead of going wider, they’re building higher. 

In Europe, this is already the norm. Land has been in short supply for decades; fully automated High Bay Rack Supported Frozen and Chilled Storage was introduced as a solution. Using this method, storage facilities can top out at 110 feet tall, with 80,000 pallet positions. Furthermore, this racking style enables a smaller building footprint since the facilities use vertical space, not horizontal. Narrower, vertically-oriented warehouses require less land, and lower costs as a result. It’s a cutting-edge concept that’s perhaps the best representation of American warehousing’s brave new world. 

Navigate this brave new world with the help of the VCBO Industrial Team. We’re competitively positioned to assist you in redefining your Warehouse Portfolio as either End Users or Developers. Our professionals ensure your success by utilizing decades of combined experience in the heavy industrial worlds of Logistics, Processing, and Manufacturing, along with comprehensive research of the latest trends. We know that a warehouse is no longer just a warehouse – it’s more important than ever to take full advantage of warehouse design innovations to maximize your profitability and that of your tenants. 

The Brave New World of Modern American Warehousing

Since the beginning of the 2020 pandemic, and perhaps for the first time in the 21st century, the global community has been asking the same question: How do we get back to work? In May 2020, 83% of United States office workers were either partially or exclusively working from home, (Saad, Wigert, 2021). With increased numbers of Americans receiving vaccinations, that number is falling. But with the new work-from-home model came a new age of enlightenment. Workers realized they could do their jobs in the comfort and personalization of their own homes. So how do we, as an industry, help to accommodate all abilities in the workplace and ensure that our corporate clients are attracting and retaining the workforce they need? The answer is to design for neurodiversity.

According to Harvard Health Publishing, “Neurodiversity describes the idea that people experience and interact with the world around them in many different ways; there is no one ‘right’ way of thinking, learning, and behaving, and differences are not viewed as deficits.” A few conditions that fall within this category are autism, dyslexia, ADHD, and Asperger’s Syndrome. Based on a collection of studies, between 15-30% of the human population is neurodivergent – that is well over two billion people globally. 

“Neurodiversity describes the idea that people experience and interact with the world around them in many different ways; there is no one ‘right’ way of thinking, learning, and behaving, and differences are not viewed as deficits.”

Pre-pandemic, the typical office trend was moving toward an open-office layout. This was a vast improvement to the previous style of maze-like rows of grey cubicles so often seen in the late-1900s, but it is far from a perfect system. While physical and metaphorical walls were being demolished to allow better communication between ranks, the new trend created a rise in workplace distractions and a lack of privacy. And for those with sound sensitivity or trouble focusing on a task, the constant distraction can be unbearable. 


So how do we create a universal design for both the socially inclined and those who need privacy? The answer is to incorporate several different options that are open to everyone. For example, the current rise in awareness of biophilic design has led to workstations being located along the exterior walls of office space to allow employees exposure to daylight. Those with light sensitivity may find the direct sunlight painful, so keeping a few individual working pods centralized in the office away from the sunlight with easily operated lighting controls can be a way of ensuring that everyone’s comfort levels are met. 

In an effort to save cost and create an industrial aesthetic, many companies are opting for polished or sealed concrete floors over carpet and LVT options. While concrete most certainly cuts costs and allows for employees to skateboard, scooter, and bike their way across large office spaces, the increased volume of hard surfaces creates much higher levels of sound transference. Individuals with sensitivity to sound or an inability to focus with constant noise would have an almost impossible time working under these conditions. 

If having concrete floors is on your client’s must-have list, consider adding ceiling and wall acoustic solutions to absorb some of the noise. Another solution is to section off a piece of the open office space that remains carpeted with partial walls as an area for those people who need a quieter space to work. Even smaller solutions like including soft-seating lounge areas throughout the space can contribute to noise control tactics. 


If your space isn’t quite as large, but you still need universal design solutions, take a look at your office’s quiet rooms. Ideally, they should be located near an exterior wall with access to daylighting, but if the only space you have is in the dark back corner, there are plenty of improvements that can be made there, too. 

Diffused, color-changing LED strip lights or fixtures can help regulate mood through color therapy. 

Weighted blankets and pillows help soothe those prone to panic attacks or high-stress levels. 

Rocking or gliding chairs in place of stationary lounge furniture are helpful for those who require movement either to calm down or ease the need to fidget. 

Sound-isolating these rooms through acoustic wall and ceiling solutions can also make them a refuge for those who need more control over their sensory environment. 

Let the VCBO Interiors Team partner with you to create the best possible solutions for your office environment. With decades of combined experience in Interior Design and a range of certifications including WELL, LEED, NCIDQ, and SCCID, our professionals are uniquely equipped to help you attract and retain the next-generation workforce. 


Madeleine Helgren, NCIDQ, SCCID, IIDA  
Interior Designer, VCBO SLC

We want a high school designed for the future. We want a high school that questions which skills individuals will need for the future economy, and we want the high school to provide an ideal environment for equipping students with those skills. We want our high school to be focused on learning, not just in the classrooms, but throughout the entire building. We want our high school to foster creativity, collaboration, critical thinking, and communication. We also want this high school to be sustainable- a zero-energy campus if possible. We want to involve students, teachers, administrators, and the community in the design process. Emphatically, we do not want to rebuild the same high school that we did ten years ago. We do, however, want this high school to be cost-effective, both in the short-term upfront costs, but also in the long-term maintenance and operational costs. 


“We want to involve students, teachers, administrators, and the community in the design process” 

This was the direction and challenge given to VCBO Architecture by Davis School District (DSD) when we were first selected to design Farmington High School (FHS). Davis School District is home to approximately 70,000 students, and FHS will be their tenth high school. At the project’s onset, DSD assembled a steering committee comprised of a cross-section of District personnel to aid in providing direction and decision-making during the design process. The Steering Committee’s input was a key element in tailoring the school design to this particular District’s needs. Fourteen months went by from the initial visioning meeting to the time the project went to bid. During the first 10 months, our architectural team had 37 design-related meetings with Davis School District.

Figure 01: Steering Committee touring Marysville Getchell in Bellevue, WA.

The design and decisions came from the guidance of all stakeholders. The group toured numerous innovative high schools across
 the U.S. to benchmark the qualities of the best new facilities while keeping the unique needs of Davis School District in mind. The focus of the new design was to positively impact the learning environment for the student and teacher, providing the greatest amount of flexibility for the future. As architects, we listened closely to the owners’ criteria and converted their ideas into architectural solutions. 

One of the most productive meetings came from a workshop with the Steering Committee and a Faculty Committee consisting of a group of 29 teachers. They provided valuable feedback on their vision for their teaching space. Three key elements emerged from that discussion. First, teachers wanted size-appropriate classrooms, not only for the number of students in the specific class period, but also to accommodate the learning activities planned. Second, they desired building ownership, meaning they want their own space. Third, they understood they did not need their classroom during their prep period. 


Figure 02: The Steering Committee with the Faculty Committee

Instead of starting to design the spaces after this meeting, we decided to take a step back and question every space in the new high school. Why were classrooms typically 900 sq. ft.? Why did every classroom need to be the same size? Why did we need 90 classrooms? VCBO made the decision to study how the current DSD high schools were being used. We requested schedules and enrollment data from all of the District’s high schools, resulting in very useful representative information from four of the nine high schools. After spending several weeks inputting data, we were able to analyze what was happening period by period, school by school. 

The data revealed a glaringly obvious fact. The uniformity architects have historically designed into schools does not align with how currently operate. Imagine if every family, regardless of size, was given a five-seat sedan to drive in any circumstance. A family of five can fit, but not comfortably. A family of two has more room than they need. 

A family of eight, well, they get to sit on each other’s laps, make two trips, or not go anywhere at all. The solution that we are often presented with is, “make it bigger.” If we give everyone a suburban, they can all fit, but costs increase, waste levels rise and that family of two is in a cavernous vehicle.

Figure 03: DSD High School Class Size Average Pie Chart 

The “one size fits all” approach does not work in any aspect of life, so why should it work in a high school? DSD utilizes an A-B block schedule with four classes taught per day. The data showed that on average in the DSD high schools, there were 60 classes being taught per period per day. Of those classes, 17% had less than 25 students, 68% had 25- 35 students and 15% had more than 35 students. This information on class sizes enabled us to focus on size-appropriate spaces for teachers. We decided to make three different size classrooms based on this data; A focused classroom of 650 sq. ft., an enlarged classroom of 950 sq. ft., and an extra-large classroom of 1400 sq. ft.

Figure 04: Farmington High School Extra-Large Classroom 

Another aspect the study indicated was that on average, 20-25%
 of the classrooms were not being used for teaching students at any given time. The classrooms were being used by teachers for their prep period, or for student groups that did not need that large space. Through increasing the utilization of the classrooms, we realized we could make the design more efficient while providing student-centered collaboration spaces and flexible learning spaces for project-based learning throughout the school. This would require that teachers no longer “own” a classroom space exclusively. However, we believe it is important for teachers to have some type of ownership in the building, so that they are treated as the professionals they are. The design idea was to provide every teacher with their own personal office accessible and visible from the main circulation spine of the school. This provided supervision and moved the teacher out of a classroom and into an office for their prep period. 

We call the architectural solution for this a “learning suite”, comprised of a group of different-sized classrooms surrounding a flexible learning space and connected to the main circulation of the school through two entry points. 

The teachers using these classrooms will be given adjacent offices to minimize travel distance between class periods. One benefit of the learning suite is to provide each group of teachers with close proximity for working together on project-based learning assignments. Students can break out into different size groups, rearrange spaces for presentations and have group lectures, all while being supervised. Further, the learning suite provides increased security by allowing the access doors to be shut and locked, with each individual learning suite capable of evacuation independent of the remainder of the building. By pulling classrooms away from direct exterior glass, energy efficiency is achieved by reducing the mechanical loads on the classrooms. Full glass into the collaboration areas provides ample views and daylighting to the learning spaces, minus the glare factor. 

Figure 06: Farmington High School Main Entry 

In conclusion, the design of Farmington High School was a solution that stemmed from analyzing the specific in which Davis School District was utilizing its high schools. It also captured the vision of the Steering Committee for the future of education for their District. Because VCBO Architecture designs schools for districts all over the United States, we understand that each district is unique with independent goals and ideas for education. The one consistent truth that endures is that no one has a crystal ball to see 20 (or 40 or 80!) years into the future to know what education will look like. The decisions we make in designing schools have an impact for decades to come, and because of this, flexibility and adaptability are key for the longevity and sustainability of the school. Ultimately, at VCBO Architecture, we pride ourselves on listening to the client and providing architectural solutions for schools that focus on the learning experience for the students and teachers using these spaces day in and day out while staying flexible for future modifications. Through successful outcomes- such as FHS- we know we can improve the educational experience. By studying data and understanding how each specific school and district uses their schools now, we are better equipped to address how they aspire to use them in the future.

Alex Booth, AIA, LEED AP BD+C  
Principal, VCBO SLC

Designing a High School for Future Learning 

A foundational principle at VCBO is a commitment to environmental sustainability.

We have always worked to provide the most energy-efficient projects possible, within the project budget and performance expectations set forth by the owner. With this approach, we have designed and constructed several LEED-certified schools, as well as numerous high-performing schools across the State. 

In 2010, Davis School District hired VCBO Architecture to design a new prototype elementary school for the District. At this time, we had been pushing our energy-efficient design forward with each project completed together, which led the VCBO and Davis School District Team to set our most ambitious target yet: to design and build a net-zero energy building. 

Through a thoughtful, innovative, and integrated design process, paired with the full support of the School District leadership, the team was successful. Odyssey Elementary School became the most sustainable and first net-zero energy school in Utah. Due to the success of this project, Davis School District has committed to achieving net-zero energy in all subsequent prototype elementary schools, as demonstrated by Kay’s Creek and Canyon Creek Elementary Schools. 

There have been several definitions of net-zero throughout the years, but the current standard for a net-zero building is a building that generates as much energy as it uses, on-site, over the course of a year. For each of the Davis School District elementary schools, a large photovoltaic array on the roof of each building generates as much energy in kilowatts throughout the year as the school uses over the course of the same year. 

"A net-zero building is a building that generates as much energy as it uses, on-site, over the course of a year." 

Why Does Designing a Net-Zero School Matter? 

A net-zero school shows the District’s commitment to healthy air and a more sustainable future. From a school district perspective, operating a net-zero school reduces the potential volatility in energy costs. At the end of the day, this puts more money into the classroom. 

This money can be spent within the school for other resources and programs, and to better serve students and teachers. 

A net-zero building can also be used as a teaching tool, on many levels. On a broader level, students attending a net-zero school have a personal frame of reference for climate
 solutions. Rather than learning about theoretical strategies to address pollution and energy issues, they can see the benefits of tangible practices implemented at their own school and learn by the example set by administrators that energy solutions are a priority. On a more specific, educational level, students can track energy use, compare it to energy generation, and see what happens to the power use and generation as the sun shines, snows, and temperatures fluctuate. This engagement and data review can be as basic or technical as the teachers would like it to be. 

The first step in achieving net-zero is to drive down energy use through smart design. A few ways to do this include: 

Determining the right orientation for the building: making sure there is not too much solar heat gain in the summer months, and enough solar access in the winter. 

Designing an air-tight and thermally sound building envelope. 

Selecting an efficient mechanical system and making sure it is not over-sized or over- 
designed for the building. You can even consider letting the temperatures shift up a bit in 
the summer and down a bit in the winter to save energy. 

Using high-quality, LED lighting, and not over-lighting the building. 

Integrating effective controls to make sure your building management team can control 
the start-up and set points of the mechanical and lighting systems and manage energy use throughout the day, season and year. 

Engaging the building users to help reduce energy consumption is imperative in achieving net-zero success. The more informed the building users are of the ways in which they can be more energy conscious in the classroom, the better. 

The second step is to determine how renewable your energy system can be. Solar panels, wind turbines, and geothermal energy are a few examples to consider. 

Additional considerations for your next potential net-zero project include: 

In order to maintain a renewable energy system on-site, you have to balance the building size and energy use with the available area for renewable energy systems. Schools are often optimally sized for solar panels, with relatively large roof areas and lower heights, typically one to two stories, providing an optimal spot for photovoltaic panels on the roof. Smaller sites can consider alternative locations for renewable energy, such as covered parking, or even off-site renewable energy systems. 

The amount of renewable energy required for the building is typically estimated through the use of an energy model. This model creates an assessment of how much energy is being used to heat and cool the building and power all of the electronics and equipment, based on the orientation and building envelope design. This model estimates hours of operation and start-up and operational energy use profiles and makes assumptions based on typical user behaviors. 

As designers, we have a great deal of influence on the building envelope and how it impacts heating, cooling, and lighting. Although we know the number of occupants, we do not have much control over the hours of operation and how occupants use the building. It is vital for the owner to be an integral member of the team and convey the vision of net-zero to all occupants. 

While this energy model gets very close to the actual energy profile of the building, the best opportunity to right-size the renewable energy system is to track actual energy use for one year and size the system based on actual data. 

Electrical Costs, Fees, and Demand Charge Impacts

Even with a renewable energy system, if it is tied back to the electrical grid, you will need to continue to pay fees to the power provider, and these fees will increase as they realize the impact of solar panels on their grid. Additionally, demand charges may still apply, as net-zero is assessed on an annual basis. There will likely be times, in the winter specifically, when more energy is used to heat the schools at peak times when the sun may not be out and the system is not generating electricity. Managing these peak demands will help reduce operating costs and reduce the size of the photovoltaic (PV) array upfront. 

Early Investments Enable Net Zero Success

A wide range of investments is needed to ensure a successful net-zero project. Starting from the beginning of the process, these investments include: 

Engaging an energy modeler early in the process 

Investing in a high-performing building envelope 

Commissioning your building: making sure your energy-impacting systems work 
properly from the beginning 

Planning for and installing an effective building management system to control your 
energy use 

Each of these early investments will result in ongoing cost savings and ensure that net zero is achievable.

If you are ready to design a net-zero building, give us a call and we’ll guide you through the process and help you achieve your goals! 

Spaces for people to thrive.

ETC.