Founded in 1915 and in practice in Florida for more than 50 years, LEO A DALY, is an architecture, planning, engineering, interior design, and program management firm with a world-wide presence in a variety of industries. Consistently ranked among the top design firms, this organization has earned national prominence for pioneering the use of an interdisciplinary “whole project” team approach that ensures creative efficiency, coordination, and client satisfaction, notably in health care. In 2020, amidst the uncertainties of the Covid-19 pandemic, that ‘forward thinking’ legacy continues to serve their clients well.

Joshua Theodore, VP, Global Health Practice Leader and Eduardo Egea, Vice President, Miami Healthcare Leader, are both graduates of Clemson University’s College of Architecture, with Eduardo completing his Master of Architecture and Health, the most established program in the U.S. The curriculum concentrates on relationships between architectural settings and their impact on human health and well-being. They talked about the firm’s philosophy, shared passionately by 800 skilled employees which allows them to exceed health care client expectations for innovative, cost effective efficiencies, broad application flexibility, and code compliant sustainability to create an improved patient journey.
Evidence-based Design
According to Egea, all LEO A DALY team experts take personal and professional pride in their experience with evidence-based research, Lean tactics and Six Sigma concepts to create intentional design that encourages a collaborative approach with clients, enhancing interaction and eliciting feedback on the whole patient care experience.
“We go to the source, like checking in as a patient, shadowing providers, analyzing Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and integrating patient thoughts into the team design process. This hands-on experience enables us to map the flow of the health delivery experience and incorporate empathetic sensibilities into the design to create a patient-focused environment that will streamline operations—from food delivery to surgery,” he explained.
They use HCAHPS scores to identify dissatisfiers and then re-imagine things in their control such as lighting, noise, air flow, color, designated space, and staff flow. They shadow nurses, administrators, and other service providers to identify and understand the barriers to care delivery and work to eliminate them through design of a nursing unit, patient room, corridor, or supply cabinet with a holistic overview of workflow.
The design teams create 3-D models of scenarios and, with a full lineup of clinical and support players, navigate through a virtual experience to map trajectories, eliminate waste, and test spatial and operational hypotheses to create the optimal design – both functionally and aesthetically.
According to Theodore, it doesn’t end there. “Each design must also be flexible to adapt to tomorrow’s needs. We constantly search for innovative, affordable, sustainable, and efficient materials and adaptable schemes to design a facility from top to bottom. It must offer clinicians and staff the most efficient and responsive space resulting in the highest patient satisfaction today; along with the essential inherent structure to transform into another purpose tomorrow,” he said. “Exceptional health care doesn’t happen by chance, it must be intentionally designed,” he said.
He explained that orchestrating an environment is important, and that is accomplished through design. “Starting from the smallest feature like accessible outlets we incorporate evidence-based design elements into the big picture, to accelerate our clients forward on their mission; and, as healthcare changes, they’re also able to adjust without starting over,” Theodore said.
Designing for a Pandemic
With all its horrendous consequences Covid-19 also gave them pause to strategize and pique their innovative energies to solve issues. The pandemic highlighted the stressors which put up barriers to a healthy environment, even in an infectious disease epidemic. The team sought to create built-in design options in preparation for the next disaster.
“Looking to the future, we recognize how vital it is to design a workplace that takes care of both staff and patient needs during highly stressful health delivery periods. For example, we design courtyards and balconies near surgical, trauma and intensive care units to provide staff with an opportunity to escape to catch a moment of nature’s healing powers amidst anxiety-charged responsibilities,” Egea noted.
Also, they track and modify design features to retrofit the things they can control such as: air flow, biocontainment, windows, lighting, temperature controls, water and sink access. Predicting and accommodating staff, patient and family needs can soothe nerves in emotionally ridden units including birthing suites, hospice and palliative care settings.
The firm had extensive experience dealing with the Ebola biocontainment issues in recent years and transferred that knowledge to the current pandemic. During the pandemic, hospitals were quickly at capacity census for quarantined infectious patients and had to extend beyond hospital-defined Intensive care units to manage the surge. As technology becomes more portable, ambulatory care settings can be designed to expand and transform into facilities to handle patient surges during disasters. The team also creates designs to quickly transform dormitories or hotels to accommodate less acute patients and first responders.
Theodore explained, “In addition to evidence-based research orchestrating design to improve staff functionality, we think outside the box and create robust patient personas, considering generational, cultural, religious, and lifestyle influences in addition to geographic and disease specific trends and include technology like iPhone and online appointmenting to adapt configurations that will foster medical compliance and healing.”
Large ambulatory waiting rooms may be a thing of the past utilizing such technology, but it is built into a concierge-type service, noting the value of personal greeters for patients not adept at current technology.
Hurricane and Disaster Preparedness
Most hospitals deal with flu season annually, and as COVID-19 rages, hospitals are now more mindful of the need to plan for pandemic events. Additionally, Florida’s institutions weather the annual hurricane season. In yet another nod to the future, Egea points to the firm’s readiness to incorporate drones into hospital design and operations to potentially deliver medications, blood, food, or material supplies.
“Drones are going to be part of our day-to-day tools in the near future,” Egea said. A native of Puerto Rico with family still there, he is acutely aware of the implications that weather disasters, including hurricanes and tornadoes, have on transportation, food supplies and recovery efforts. After hurricane Maria, relief efforts to deliver life-saving supplies were hampered due to washed out roads. Seeking a solution, the Miami studio designed a drone powered micro-hospital concept. It is intended to help hospitals not only receive and deliver vital medications and transport supplies necessary in the aftermath of weather disasters but even help hospitals in rural areas during normal times. Hospitals could be reinvented with drone ports and a smaller footprint with the benefit of a decentralized supply chain. The plan would use technology to directly deliver food and supplies instead of having large costly warehouses or on-site space to stock medications and equipment. The introduction of drone assisted delivery also opens doors to new partnerships with technology, pharma companies, food distributors and a host of business opportunities.
Egea said “We envision benefits of treating more patients, with better care, for less money, and with better reliability by introducing health care services with minimal infrastructure in smaller communities where traditional hospital economics would not be feasible. The healthcare industry is trending toward more ambulatory care settings and a micro-hospital could be easily assembled and introduced into any community with the support of a drone powered supply chain.”
Over centuries, hospitals have evolved from dark, poorly ventilated, unsanitary buildings in which patients did not expect to survive into today’s impressive facilities with life-saving technology and a patient-focused healing ambiance. This evolution is due in large part to infusion of innovative and intentional design of buildings and operations.
LEO A DALY does not design in a vacuum and shares ideas gained from their global presence. No matter where their home office is, top shelf specialists are dedicated by expertise and geography to a project. A full-service team response is SOP and clients rely on hands-on customer service.
Thanks to a committed corporate mindset with a no-holds approach on innovation, flexibility or resourcefulness, the LEO A DALY team exudes a confidence built on a foundation of experiential knowledge and innovative thinking that prepares them to invent and implement design to meet the inevitably changing health care world.