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									  Book Review

Efficient Healthcare:
Overcoming Broken Paradigms
Reviewed by Nicholas Watkins, PhD

Efficient Healthcare: Overcoming Broken Par-                    health care crisis that is viewed always from the
adigms (2009), David Chambers. Houston, TX:                     perspective of the built environment” (p. 6).
Rice University Building Institute. 104 pages.
ISBN 978-0-9842221-0-0                                          The first section, entitled “A Call for Change:
                                                                (Incrementalists Need Not Apply),” is brief and
Manifestos, statements, and proclamations have                  powerful. The purpose of this section is to iden-
been issued imploring a wider recognition of                    tify the real task at hand, to pull us from our di-
the impact of healthcare design on the quality                  versions and urge us to consider solutions that
of healthcare delivery (ASHE, 2008; Hendrich,                   are proportionate to the monumental task ahead
Chow, & Goshert, 2009). Each document has                       of us. Chambers’s inspirations follow from forces
advanced an argument on how research does or                    that converge on what could be a pivotal moment
does not help us understand that impact. David                  in the history of the United States and, perhaps,
Chambers’s manifesto, Efficient Healthcare: Over-               of global healthcare. First, Chambers is a survivor
coming Broken Paradigms, contributes an archi-                  of a recent heart attack. During his experience, he
tect’s voice to the discourse. Published in 2009 by             had firsthand exposure to—and proof of—a bro-
the Rice University Building Institute, the mani-               ken healthcare system. Second, Chambers refer-
festo is introduced as “…the first in a series on the           ences the mind-numbing statistic that a mount-
                                                                ing bulk of the U.S. gross domestic product is
                                                                dedicated to a healthcare system whose gluttony
Author’s Note: The author would like to thank the project       is disproportionate to the value it struggles to de-
managers, healthcare planners, and clients he collaborates
with on research and design-related projects.                   liver. In short, the road ahead is rocky and will
Author Affiliation: Nicholas Watkins, PhD, is Director of Re-   not be easily traversed by light-duty vehicles that
search & Innovation for HOK. His professional work focuses on
                                                                offer only incremental solutions. Chambers di-
the interactions between humans and the built environments
that reflect excellence in design and contribute to physical    rects our attention to talented architects as our
and psychological well-being.                                   overlooked saviors.

124      WWW.HERDJOURNAL.COM iSSN: 1937-5867
                       HERD VolumE 3, NumbER 3, pp 124-129 CopyRigHt ©2010 VENDomE gRoup, llC   Book Review

The author cogently argues that the first cost of                ingly impossible geography of operations and
a capital project is a small slice of a healthcare               plan the journey toward an actionable solution.
organization’s total dir
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