An integral view of innovation in hospital building design: understanding the context of the research/practice gap

Despite the undeniable need for enhancements in hospital building design, there remain issues in the transition of and translation from research to innovation. While the literature highlights the Research/Practice gap as the prime obstacle, the interplay between research and other variables impacting design innovation remains unclear. This paper aims to understand the innovation system in hospital building design by considering the wider context of design. In seventy-seven highly cited papers, the Integral Design Framework was adopted to examine interactions between research and innovation. This was then used to map variables impacting two innovative moments in hospital building design. The analyses suggest innovation occurs at the intersections of different knowledge domains and point to an oversimplified picture of innovation. It is shown innovations have been generated in relation to new knowledge that is influenced by several critical variables: social shifts, political decisions, architectural design trends, and medical and technological advancements. Analyses utilizing the Integral Design Framework indicates that research informing hospital building design has lacked holistic perspective, thus hampering design innovation. This points to the necessity of re-formulating research questions holistically to drive innovation and the narrowing of the Research/Practice gap.