The Decaf Hospital, a model for addressing the interconnected challenges of cost, equity, access and quality of care in the context of climate change, developed by a team at SmithGroup, has been named the winner of Healthcare Design magazine’s 2024 Breaking Through conceptual design competition.  

The Breaking Through competition encourages design innovation by asking teams to develop their most imaginative and inspiring concepts to solve the challenges anticipated in the future delivery of care, without the typical restrictive constraints of budget, schedule, codes, etc. 

The members of the SmithGroup team for The Decaf Hospital concept are Neil Abrams, Nuti Dave, Farimah Raisali, Cassidy Roberts, Nate Savage, and Siqi Zhu, supported by visualization and graphics specialists Vince Jaramillo, Virginia Rice, Brian Donovan, and Abby Teibel, and advisors Wayne Barger, Erin McNamara, Y Pham, and Karthik Ramadurai. 

At the October 2024 HCD Conference + Expo in Indianapolis, four finalist teams presented their concepts in a keynote session. Audience members chose SmithGroup’s team as the winner, awarding them a $10,000 grand prize. 

This year marks HCD’s fourth installment of the competition. In its previous installments, SmithGroup has been recognized as a second-round participant in the inaugural 2018 competition and the firm’s Fare2Care concept was awarded second place in 2020. In the 2022 program, SmithGroup’s MediDesis concept was recognized as a semifinalist. 

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Part design concept, part manifesto for change, the Decaf Hospital is designed to address the profound public health crisis posed by climate change.  An innovative concept that not only heals people but also heals the planet, it operates as a fully self-sustaining, closed-loop system where water, energy, food, and waste are managed more sustainably. The hospital can be adapted to virtually any location in the world and is capable of generating its own energy, treating its own water, and converting all waste into energy and building resources.

This innovative approach creates a healing sanctuary that supports both its community and the environment.

The Decaf Hospital concept is inspired by the decaffeination process, which uses supercritical CO2 to extract unwanted compounds from coffee. A carbon sink acts much the same way: a system that absorbs more CO2 than it emits. 

By producing more renewable energy than it consumes, the Decaf Hospital shifts the narrative, ensuring that healthcare contributes positively to the planet.

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At the heart of our mission lies a profound truth: the health of our patients and the health of our planet are inextricably linked. We, the architects of change, stand united in our vision for a new era of healthcare—one that breathes life not only into our patients but into the very planet we inhabit. The Decaf Hospital is our pledge, our blueprint for a future where hospitals are havens of ecological healing. 

Our manifesto is simple: to heal is to protect. Every action we take, from the materials we use to the energy we consume, must reflect a commitment to this dual purpose. We envision hospitals as ecosystems, self-sustaining and regenerative, mirroring the natural world’s balance and resilience.   

Although we had some fun with this concept—no rules, no codes, no barriers—this is not a distant dream. The technology, the knowledge, the passion are all here, now. What remains is the will to act.   

This is our pledge, our manifesto for change. It is a declaration that we will no longer be passive observers of the climate emergency. We will be active participants in designing a world where the act of healing extends beyond the walls of our hospitals and into the heart of our shared home, Earth. 

We are all the architects of our future.