Mind the gap: A translational approach to research and medicine

“Mind the gap!” In London, most of us hear this phrase all the time. It immediately peaks your attention, makes you alert and aware of the “liminal position” you are in—you are in a literal gap, upon a threshold from one place to another. One moment, you are riding the Victoria line on London’s Tube; the next moment, you are moving to the platform, navigating over “the gap” and into a separate, more active public place. At that moment, you are, translational.

Translational research and medicine also demands that we mind the gap, in the sense it strives to navigate another liminal position, the threshold between curing and caring—or translational health. This field of research and medicine continues to become an increasing aspect of how we design facilities for health wellness and discovery; and here, too, our clients are “minding the gap” as they integrate healthcare and research.

What is translational research and medicine?
It’s been said that translational research means different things to different people. That is true, but in partnership with our clients, we design facilities to focus on removing the gaps of communication and barriers between scientists and clinicians. For many, this field refers to the “bench-to-bedside” enterprise of harnessing knowledge from basic sciences and transferring it to produce new devices, treatments, and drugs—rapidly generating innovations for patients. It is the interface between science and clinical medicine; and the conclusion of this process is the creation of new treatments that can change the lives of patients and be brought to market to help us all. This is how we heal people in the 21st Century.

These translational facilities are characterised by three essential ingredients, all necessary in minding the gap.

1. Translating Healing and Discovery
   Promoting collaboration so creativity may flourish is our key design principle, which allows the two different and traditional isolated disciplines—caring and curing—to converge and intertwine, so the insights of each are mutually informing and drive success. The resulting power of innovation through heightened collaboration cannot be overemphasised. At the University of British Columbia’s Djavad Mowafaghian Centre for Brain Health, an agile theme-based research environment promotes these interactions in new ways—utilizing a “neural network” to planning in order to design impromptu idea exchange into the facility while connecting laboratory work with clinical activity. Researchers dedicated to conquering diseases and clinicians focused on patient needs can bridge the gap between them through this collaborative neural network in a facility with enough literal and virtual transparency to discover where the two parts converge in support of a new whole.
2. Inspiring Patients and Care
   Removing gaps and barriers for the patient and their families also is a key consideration. There is a new generation of renaissance medical professionals who are working on a new breed of medicine, blending the science of curing with the art of caring while inspiring and motivating patients. Architecture that caters to and supports patients in traditional ways—good wayfinding, non-institutional feel, a calming environment—must work harder to both create a sense of sanctuary and inspire patients to participate in ongoing research, obtaining the therapeutic benefits of participation. Additional liminal space or gaps to be minded include mapped public spaces to allow unplanned synergies between patients, physicians, and researchers.
3. Campus Cohesion
   The highly synergistic and collaborative environment of these facilities brings people together to enhance curing and increase research efficacy by minding those gaps. However, the institutes should expand their sphere of influence to strengthen wider interaction to adjacent clinical and research buildings in widening the translational effect. This third horizon of liminal space, between and connecting medical and research buildings, is conceived as part of the design enterprise to further integrate translational health while enhancing campus cohesion.