Doreen Lorenzo: Talk about when you first became interested in architecture and some of the experiences that led you to this career path.
Joan Saba: My father’s an architect, so I’ve been embroiled in the field since I was old enough to press the “on” button on his Xerox machine. He taught me that architecture can bring renewal and empowerment. This was cemented in my mind growing up and attending school in Pittsburgh in the ’80s–at the height of when businesses were closing and the city did not have a lot of hope. Yet soon after, there was a revitalization of industry, culture, education, research, and, yes, architecture. And the city just rose out of the embers. It was an exciting time, and it was inspirational to me in terms of seeing a Rust Belt city emerging into a new and beautiful future.
Tell me about your firm, NBBJ.
At NBBJ we’re focused on performance in two ways. First, the performance of the environment that we create—not just buildings, but also the community surrounding them. Second, the performance and the experience of people in those spaces.
We get that by building a culture of leadership. We like to say, “leading from any chair”: Whether from an intern here for the summer or a partner who’s been here for 30 years, we seek out the most creative, most innovative ideas. Some of my colleagues cringe at the analogy, but instead of thinking of ourselves as hierarchical, I think of us as flat and lumpy. We want our people to try new things, and if they fail, we want them to fail fast, and move on to something better.
We also don’t have disciplinary silos. We have people who specialize in hospitals, technology, corporate offices, commercial buildings, and courthouses. But our ideas and approaches cut across all those areas of expertise and go through our firm like lightning. We learn from each other, teach each other new things, and often find the intersections between two separate areas of practice—like hospital and workplace design—are where we generate our most exciting ideas.
How does this work in terms of health care?
A hospital has to deliver high-precision and high-technology care every day of the year. No building or system is more complicated than a hospital. In addition, hospitals are where life’s most precious joys and most difficult moments converge.
So we can never just recreate what’s been done in the past. The stakes are too high. Technology, innovation, creativity, and research are always changing in health care. So we have to constantly be challenging ourselves. Hospitals like Massachusetts General understand that they have to evolve and innovate. When we designed a major new addition for them several years back, we met with all their top people and went through a period of intense observation, walking in their shoes to understand what they needed to continue to perform at a high level. As a result, we did a lot of rapid prototyping, mock-ups, field testing, and working with industry partners. It was a full-on application of all the best minds together to come up with something profound.
Design thinking is a process. It’s important for the client to understand what design thinking is and how it’s going to benefit their business, their performance, their patients, their clinicians, their recruiting, and their community.
Can you give us a specific example?
We must adhere to building codes, for good reason—primarily safety—but the codes are often three steps behind innovation. At the MGH project I referenced, we had this idea to bring natural light deep within the building so that patients, especially intensive care patients, could experience the positive health effects. But this required us to place rooms along an interior atrium, and the code required all rooms to have an exterior exposure. So we had to show how our approach met or even improved the intent of the code in order to implement the design. It was difficult to accomplish, since we had to work with the building code authorities. But we were able to demonstrate with metrics, research, and modeling how the light would improve the patient experience throughout the day, through all seasons, and in the end that’s what allowed us to convince the authorities to make the necessary changes.
What do you think is the future of health care design?
The evolution of technology and clinical research—the fields of genomics and immunotherapy, for example—is moving fast. Then there’s the proliferation of industry partners in biotechnology. Those partnerships are changing the way that care is delivered and are going to have profound effects on the way we design buildings and the way we design care.
There’s also the rapid evolution and proliferation of IT systems: the way information is being transmitted and the way patients can access it. Interestingly, we’re seeing our Chinese health care clients a little ahead in terms of bringing personal technology into health care and empowering patients to manage their health care.
Finally, there’s what’s happening in materials science and biomaterials to deal with all the different viruses and germs that pose such a challenge to us today.
How is it being a woman working in this field?
When you’re in a room of 12 high-powered industry and health care leaders who, in my experience at least, have tended to be mostly men, you’re not going to win them over simply with your ideas. You have to understand what they value and how to explain your idea in a way that resonates with them. This is a hallmark of leadership, and one that I find many women are especially excellent in executing.
At the same time, a lot of young women ask me for advice about other aspects of working in the field, and I tell them that they have to find their own voice. You can’t try to mimic somebody else.
This leads to an important point: the need for mentorship. I was lucky enough that my first project out of school was for a big health center, and my mentor on the project was a woman in her late fifties. She was amazing. She took me to construction trailers and board meetings. I followed her everywhere. It was the best education: watching somebody like that finesse those environments, and it taught me how to find my voice. I learned to bring people along, expose them to a lot of issues, and give them enough line so they can be a little daring.
Has your view of design evolved over time in architecture?
Absolutely. Rather than focusing on just aesthetics, design has evolved into being more about the thinking and the process, the feel and the experience of a building. This began in earnest around 15 years ago, but now it has even filtered into some of the architectural juries I’ve served on. Yes, there is this built object at the end of the design process, but now we’re realizing that the way it performs and the experiences we have within it are the true soul of architecture.