Five Minutes with Principal Rick Espe, FASLA, LEED AP

Karla Salmans, PLA, and Associate Landscape Architect with MKSK, sat down with Rick Espe, one of MKSK’s Principals in the Columbus, Ohio office to discuss his career, and specifically, his focus on complex healthcare campuses. Rick’s impressive healthcare portfolio includes The Ohio State University Wexner Medical Center (OSUWMC), Cincinnati Children’s Hospital Clinical Sciences Pavilion, Nationwide Children’s Hospital, and the recently opened OneFifteen. OneFifteen is a non-profit healthcare ecosystem dedicated to the recovery of people suffering from opioid addiction. Rick’s take on healthcare design stems from a holistic approach focused on all types of patient healing and the needs each condition may require.

Karla: With your career portfolio in mind, what is your perspective on place and how it impacts individuals?

Rick: It’s about how people react to the space. I’ve said this for years, you can have the most gloriously designed space in the world (scale, proportion, materiality, sun/shade), but if no one’s there, it’s not successful. You must think about how people are using that space and how the space can enhance experiences, cultural identities, and contextually sensitivities. In particular, healthcare is bound to greenspace. Numerous studies going back to the environmental psychologist Rodger Ulrich (1984) support how greenspace affects the outcomes of healthcare facilities – fewer drugs and quicker recovery times are all the result of simply viewing greenspace let alone being in nature. If you think back, healthcare started with traditional monastery gardens. Yet, as modern medicine progressed, we lost the value of greenspace associated with medical care. Now we find ourselves back to where we started, and we once again understand the importance of connecting with nature (biophilia) and what that means for the recovery of patients.

Karla: We’ve come full circle. It’s amazing actually.

Rick: It is. We think about that when we’re designing spaces at Children’s Hospital in Cincinnati, Nationwide [Children’s Hospital], OSU Medical Center, and the OneFifteen project. You know, the OneFifteen Project is all about that type of ecosystem. It’s all about the healing. It’s all about having a variety of spaces such as the introspective space where you can sit alone and think about where you’ve been to where you’re going or the social spaces for a few people or a larger gathering and how those spaces can help patients’ healing processes. One of the key pieces of OneFifteen is the Path of Recovery. It’s not a single directional path. It’s a continuum – never ending, but always changing with the seasons, the light, the animation. It draws its parallel to the individual dealing with addiction. Recovery is a process one that they live every day and every day there are new twists, turns challenges, and celebrations. Even when a patient is released from the program, they’re never out of recovery – the continuum is always present.

Karla: So what we’re finding now in healthcare landscapes, is that the manifestation of the healing process is now being transcribed into the landscape.

Rick: Yes. And luckily, with OneFifteen, we have a client who understands that. This project has been one of the most exciting things I’ve done in the last ten years, because it’s not only about the design of the space, it’s the social impacts that are so critical. During the first stages of the design process, the client Stephen Pomerenke, from Alexandria Real Estate, Jason East from Champlin Architecture, and MKSK were simply sitting around a coffee table sketching, designing, and feeding off each other’s ideas. Everyone quickly understood it’s not just about the buildings, but equally the spaces between buildings that become so important. Nature becomes a key piece to recovery.

Karla: With this design language you’re seeing at OneFifteen, are you working on any projects that are implementing the same ideals where the recovery is exemplified in the design?

Rick: It always comes into every campus we work on. The changes in healthcare can be interesting in how they evolve. Back in the day, when you had a baby, you stayed in the hospital for five days. Now, you’re released the next day. Many outpatient procedures are much the same, you’re scheduled in the morning, but leave that afternoon. If the stays are shorter, why are we building bigger and bigger hospitals? One of my healthcare clients explained, it’s because the patients who are in hospitals for an extended period of time are sicker than they’ve ever been. We need to think about that when designing. For example, at Wexner Medical Center, we developed the roof gardens for the 9th floor. That specific floor is for bone marrow transplants – very critical care patients. They can’t be subjected to potentially dangerous microbials. However, the doctor in charge of the transplant program is very progressive. He wanted the patients to get outside. He wanted them out in those garden spaces. Otherwise, they were going to remain hermetically sealed in the hospital until the day they’re released. Instead, the doctor wanted the patients to become somewhat acclimated to the outdoors during their stay.

Karla: And then, if needed, they can be treated while still in a safe, medically prepared facility.

Rick: : Exactly. And what was really interesting is how we designed one of the roof gardens. One of which is a food garden. It consists of raspberries, blackberries, carrots, and tomatoes, items OSUWMC James Cancer Hospital are researching for their cancer fighting properties. It’s that level of thought that landscape architects need to bring into our design work every step of the way.

Karla: With that said, do you have any anticipations of where healthcare design or design in general is heading?

Rick: Our healthcare spaces are changing, our higher education spaces are changing, our retail spaces are changing. It’s a different world now, interpersonal communications are changing, they are not as they once were. A while ago, Ruth Durack, a former mentor of mine, used to ask, “In this era of cyberspace, what is the role of public space?” It’s a fascinating question, because one could argue public space is more important now than it ever has been. You can have your groceries delivered, you can buy your shoes online, you have movies and television shows at your fingertips – you never really have to leave your house. But the public space is where we do gather, to interact, to talk with people and have a conversation – experience life. So, I could argue, it’s imperative we address our designs with the goal of engaging and encouraging people to step outside and interact, be human.