10 Questions With... Mohammed Ayoub and Brooke Horan of HDR


HDR is a leading healthcare-design firm, ranking #8 among our Healthcare Giants (and #25 among our top 100 Giants ). The Middle East has become a hotbed of new hospital construction, and HDR is handling some 15 million square feet of it. Two of the firm’s major players in this work are design principal and associate vice president Mohammed Ayoub and senior interior designer and associate Brooke Horan , who together are designing 14 projects in the Gulf region—including King Faisal and King Saud Medical Cities, both in Saudi Arabia, and Cleveland Clinic Abu Dhabi .


C:\fakepath\hdr Portrait Interior Design: How has HDR been able to win so many hospital commissions in this region?


Mohammed Ayoub: Because we’ve been successful in adapting our healthcare design and planning, for which we’ve been leading the industry in the U.S. for over a dozen years, to suit various rich cultures around the world. We don’t come to international clients with the notion, “This is what we do in the U.S., so that’s what you should do here.” We think globally, rather than domestic vs. international.


ID: What are some differences in hospital design in the Middle East?


MA: Spiritualism is very much intertwined within the science of medicine in the Middle East. Community and family are also crucial to the overall healing process there. Designwise, that translates to us creating spaces that allow large families to be part of the facility yet ensure they don’t get in the way of delivering healthcare.


Brooke Horan: We design generous spaces for family to gather in public areas as well as in the patient rooms. We provide different amenities, too, such as tea rooms, since it’s customary for families to prepare tea and coffee for visitors. Locating patient-room toilets inboard—sometimes controversial stateside, where they’re usually outboard—creates a buffer between the room and corridor, which is our response to patients’ and families’ need for privacy, as well as the overall modesty of the culture. Gender separation is also a factor, so we integrate screened, private areas into the circulation and waiting spaces.


ID : How does being a woman affect how you work there?


BH: In the UAE, foreign women dress as they see fit. But in the Kingdom of Saudi Arabia, I’m required to wear an abaya, a shoulder-to-foot loose gownlike covering, and a shayla head scarf in public. When I travel to the region (approximately three times a year), I’ll put on both before deplaning, even though technically I don’t need to wear them in the airport or hotels. But I prefer to not draw attention and be respectful. I’ve also been in client meetings where they’ve suggested that I can remove the shayla, but I’m happy to keep it on. I think small subtleties such as this go a long way toward building understanding and trust with the client.


ID : Can you go around unaccompanied by a man?


BH : Not really. I’ve flown in to Riyadh on my own, but company policy requires one of my HDR colleagues to collect me at the airport. Generally speaking, we travel together. But there are all-female malls in Saudi, so women do travel unescorted if need be. Regardless of gender, their mores are that one always takes food or drink when it’s offered, but it’s never to be taken with your left hand, and to not point shoe soles at anyone, which can easily inadvertently happen when you’re crossing your legs.


ID : How does religion factor into planning?


BH : Careful attention is paid in space-planning in regard to the direction of the Holy City of Makkah. Patterns and motifs of the local vernacular, such as Islamic-patterned screen elements, are integrated into the interior architecture, as way-finding elements to denote points of entry and places of respite. And it’s not simply applying these patterns; there is an understanding and recognition that these geometries are sacred.


ID : Explain the iconography that appears on the facade and entrance canopies at King Faisal Medical City.


MA : We started with traditional Islamic geometries, particularly the eight-pointed star, and we deconstructed them to their first principles, exploring their inherent meanings and relationships to each other. Then we rotated these geometries in numbers important in Islam: five (daily prayers) and seven (layers of heaven).


ID : Why was it important that Cleveland Clinic Abu Dhabi be so sustainably designed?


MA : It was important because of the size of the hospital and the amount of energy it could have consumed. It seemed fitting that one of the foremost healthcare innovators led the development of alternative ways to reduce energy consumption. The double-skin glass wall surrounding its central patient tower will reduce mechanical cooling costs by 30 percent.


ID : Is sustainability important to all your Middle East clients?


MA : Yes. These projects are mostly located in harsh climates, and the leaders of these countries are very much aware that the availability of fossil fuels is finite.


ID : Any new materials you’re using for these projects?


BH : The seamlessness of solid-surfacing is ideal for healthcare, so we’ve been working a lot with Futrus on designing headwalls and casework for our patient rooms.


MA : Stone behind glass is a favorite of mine—you get the look of stone, but with the cleanability of glass. Plus, both are natural and durable and age gracefully.


ID : What is the future of healthcare design?


MA : We have an aging population that is growing. People for the most part are healthier and living longer. Hospitals will evolve to address and redefine wellness and longevity. I see more integrated clinics involving not just medical services, but social and retail services as well.


BH : I believe healthcare on the whole will be revolutionized in terms of where and how it’s delivered. Innovations like Theranos, which can run 30 diagnostic tests from a single drop of blood and will be rolled out in select Walgreens across the U.S., could replace the hospital phlebotomy and significantly reduce visits to clinical labs and doctors’ offices. This will in turn have a long-term effect on patient engagement and empowerment and ultimately on how we plan and program healthcare facilities.

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