A Deeper Sense of Flexibility – Research by HKS Architects, CADRE, Steelcase Health

Images courtesy of HKS

Flexibility has been, and continues to be, a buzz word theme with staying power in workplace design. We talk constantly of its benefits, what it looks like, and the role it must play in the open office.

But, while we continue to design spaces that look and feel and hopefully are flexible, do we really know what lies beneath the surface of this sweeping term?

HKS, in partnership with the Center for Advanced Design Research and Evaluation (CADRE) and Steelcase Health, recently published a report on understanding flexibility at a deeper level, through the lens of modern healthcare facilities. Our healthcare landscape continues to evolve and grow more complex, and flexibility is perhaps more critical in that field than any other; because of this, a healthcare lens is a perfect starting place for developing our understanding of flexibility in workplace design.

“FleXX: A Study of Flexibility in Outpatient Settings” includes 10 Key Takeaways, reprinted below for your reading pleasure. We highly recommend reading through the full report on your commute in to work or simply as a break from your regularly scheduled work day.

In their opening letter to readers, Upali Nanda, Executive Director of CADRE, and Michelle Ossmann, Director of Health Environments at Steelcase Health, expressed their organizations’ interest in a deeper understanding of flexibility in interior design.

“In 2017, the CADRE team partnered with HKS & Steelcase Health, to dive deeper into this issue. Early on it was evident that while a severely over-used word, the definitions around flexibility were wide and varied. It was also evident that to truly push the boundary on designing for flexibility we may need to look at examples outside of health care. Finally, we realized that an ambiguous definition also hampered stakeholders’ decision making: owners often make a blanket request for ‘flexibility’, but some levels of flexibility require a strategic investment and a clear ROI. In other words, we were missing an actionable framework for flexibility.”

“Researchers at HKS and Steelcase got together to start chipping away at this question for CADRE. They did workshops and charettes, in-depth interviews with stakeholders, reviewed both peer-reviewed and gray literature, looked for health care and non-health care exemplars, and did a nationwide poll of what stakeholders (health care administrators, facility managers and nursing administrators) thought about flexibility, and what would they invest in. We asked hard questions about “over-investment” in flexibility, and how sometimes flexibility designed, is not flexibility deployed.”

“The result is this report – FleXX. It proposes a simple and actionable framework to address flexibility. It also calls out the need to consider flexibility in operations and strategy prior to flexibility in space, and the need for space flexibility to support operational and strategic goals. Finally, it shares some implementation-ready design solutions – ranging from the FFE to shell/core and master planning that can be deployed immediately.”

“The collaboration between an architectural firm and a furniture solutions vendor allowed us to look at flexibility from a micro to a macro scale. We believe that this report only scratches the surface of this area of study, that will remain relevant at least for our lifetime.”

Children’s Hospital of Richmond Pavilion. Image Courtesy of HKS, Inc.

The Takeaways

  1. Buildings must “be” flexible “to” adapt. “Stakeholders (administrators, nurse managers and facility managers) believe facilities must be flexible in order for organizations to adapt and change. In other words, flexibility is the affordance of the built environment that allows organizations to change and adapt in response to external drivers that we cannot predict. The uncertainty is the X factor that we must be prepared for and is part of the FleXX approach.”
    Within a framework of flexibility, HKS identified four primary attributes.
  2. V-M-C-S are the core tenets of FleXX. “Flexibility for the built environment has different sets of considerations including: user/owner perspective, built elements that are affected, soft/hard, level of ease, duration of time to complete change, and when/how much investment should take place. These considerations also occur over various layers: social, stuff, space, services, skin, structure, site, and surroundings. Four core attributes for flexible outpatient environments are: Versatility (user/owner can do different things in a space without making any changes), Modifiability (user/owner can change a space without needing support from facilities/contractors), Convertibility (space can be changed but will need minor renovation and involve facilities), Scalability (space can physically grow or shrink but will need minor/major renovation and involve facilities).
  3. Versatility & Modifiability are key FleXX attributes (baked into a design solution). “Of the four flexibility attributes – versatility and modifiability were rated the most important. Specifically having stakeholders consider multi-use spaces and standardized, universal rooms that allow users to adapt for a different function as successful examples of versatility. On the other hand, furniture/equipment etc. that is not modifiable and spaces that do not easily adapt to a secondary purpose are some of the biggest dissatisfiers. However, stakeholders did not think this level of flexibility should be at a premium cost (especially if we think in lifecycle costs).”
  4. Flexibility should not cost more, but a premium cost for long-term scalability is acceptable. “More than 70% of stakeholders hold that flexibility does not always have to cost more- it is a part of good design. However, the qualitative responses to this question suggest that they consider lifecycle cost, and not just first cost in making this determination. For example, stakeholders in this sample were willing to pay close to 20% in premium costs for convertibility and long-term scalability, with an eye to improving their bottom line and keeping their patients and employees satisfied. Stakeholders consider the amount of space as a top consideration for flexibility and want to invest in scalable spaces. Most examples of flexibility from stakeholders are at the infill level, and not in terms of transformation to the shell and core that form the base building. This suggests a need for further study (and education) about the long-term potential for building scalability at the structural level.”
    HKS’ proposed FleXX Framework
  5. More space, more control, more choice. “The top three selected considerations for flexibility were amount of space, variations in sensory environment (and control over them), and ability to use the same space for different purposes/choices. Variations in sensory environment did not emerge as a key concern in our literature review, suggesting a need for future research. Balancing with more versatile, multi-purpose spaces with individual control over sensory environments can also be an interesting design challenge.”
  6. Flexible “stuff” should be considered separately. “Facilities and their related “stuff” (e.g. furniture, fixtures, equipment) may change at a different rate and need to sync to support one another. Therefore, it is important that flexible stuff is addressed and taken into account during space planning.”
  7. Experience with modularity anchors on furniture. “Modular workstation and cabinet solutions were more often found in the survey respondents’ facilities than demountable walls, prefab exterior panels, or prefab rooms. The survey results also indicated that rooms were more likely modified or converted from offices to something else (typically exam rooms) than any other change. This might contribute to survey respondents’ more frequent experience of modifying/ converting offices to another function than from any other type of spatial change.”
    What drives the need for flexibility?
  8. Demountable Walls: Need for a systems approach. “Movable/demountable walls are seen as a big need, but are contextual to the entire building system. Survey participants indicated that demountable walls were less likely used in their current facilities because they were too difficult to change. A key challenge is when demountable walls are not aligned with infrastructure affordances (MEP, lighting, etc.).”
  9. FleXX ROI yet to be determined and needs FleXX. planning “It is not clear yet to stakeholders how ROI can be measured, and over what time. 1-5 years seems to be a comfort zone, and the metric is a combination of Organizational Growth, Improvement in Bottomline, Ease of Change, Increase in Patient Satisfaction, and Improvement in Employee satisfaction.”
  10. FleXX beyond buildings. “Flexibility is not just spatially defined. Stakeholders have a different lens for thinking about flexibility including time, roles and resources. These are all needs for flexibility that designers can create in the built environment. The most prevalent forms of operational flexibility in this sample appear to be role flex (cross-trained staff, floating staff, shared staff etc.), time flex (innovative and flex hours of operation, and staff shifts) and resource flex (multi-purpose spaces, equipment & modular furniture). Adaptable organizations use building flexibility as a tool to accomplish organizational flexibility.”
    Top considerations for flexibility