Written by: Catherine Binuya, Ed.D.

Presentation Overview Crews-Joshua

Joshua Crews, AIA, EDAC, serves as Studio Director at Nelson Worldwide. As an expert in project management in architecture, he leverages his expertise in research and Evidence-Based Design (EBD) to collaborate with leading research institutions to develop wellness designs used in the healthcare industry. He presented on the application of functional scenarios and how the design principles of Flexibility and Efficiency influence the outcome of Evidence-Based Design models.


  • Evidence-Based Design (EBD) considers the principles of design flexibility and design efficiency to evaluate scales of flexibility
  • Eight (8) Steps of EBD: Define, Resource, Interpret, Create, Measure, Monitor, Collect, and Hypothesize
  • EBD Flexibility employs Functional Scenarios that seek to provide design solutions for the space between the Start State and the End State by answering the “What if…”
    • The processes bridge the gaps from “what is known” versus “what we think we know” versus “what we don’t know”
      • E.g., The Paimio Sanatorium, designed by Alvar Aalto in 1932, was originally a facility to treat tuberculosis (TB) which was then a public health pandemic. The overall design incorporated what was thought to cure TB, i.e., access to fresh air and sunlight, as evidenced in the construction of the building, outdoor seating area chairs, and ventilation systems. Due to the Paimio Sanatorium’s EBD design flexibility, this was one of the few TB sanatoriums that survived demolition after vaccinations were widely available in the 1950s. The former sanatorium stands today, with a recent remodel in 2014 to convert the building into a pediatric hospital to serve the community. https://www.architectural-review.com/buildings/revisit-aaltos-paimio-sanatorium-continues-to-radiate-a-profound-sense-of-human-empathy
  • Three (3) types of Flexibility:
    • Adaptability- no construction, multiple use of a single space
    • Transformability– moveable, able to relocate, responsive/surge capacity
    • Convertibility– construction involved, time considerations
  • Five (5) Drivers of Change: Demographics, Patient Mix, Volume, Disaster, Technology *The Unknowns are always a factor in the change process

Next Event

Join us at the next PMI Atlanta Architectural, Engineering, & Construction (AEC) Forum on October 11, 2022

Keynote Presentation: "How to Prevent Risky Business in Supply Chain Facilities" by Stephen (Steve) T. Hopper, PE, Founder & Principal at Inviscid Consulting

Register at www.pmiatlanta.org/events/event-calendar 

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