I know we've all heard about EB research, etc. Saw this article, and want to know what you think: Process: Is evidence-based design the best model for healthcare practices?
In late August 2008, shortly after the American Institute of Architects (AIA) named the winners of its first health design awards, The Wall Street Journal ran a story on design improvements in patient-treatment areas in its Informed Patient column. Although the article addressed the heightened focus on patients as a positive development, linking many of the design innovations to what author Laura Landro referred to as "the nascent field of 'evidence-based design,'" she noted, "Evidence-based design is not without controversy." The critique turned on the use of evidence-based design as a "marketing tool" often deployed without sufficient research to support design decisions.
While it is true that evidence-based design is an emergent model for design practices, there is a long and well-documented history of studies that confirm the influence of the physical environment on human activity and behavior, and of the physiological effects on patients. As a growing body of research continues to demonstrate that the quality of space in healthcare buildings affects the outcome of medical care, architectural and interior design has become an important part of the healing process. Further, healthcare design professionals are increasingly challenged to provide environmental design solutions that not only contribute to therapy, but also create safe environments that are supportive of patients and staff.
Still there are healthcare planners and designers that make critical design decisions based upon intuition—designs assumed to be better, instead of decisions based upon rigorous research with results that prove the superiority of the decision. A completed design may or may not result in a healing environment. A healing environment, however, can be identified by evidence from measurement and results.
So, what is evidence-based design? D. Kirk Hamilton, founding partner of WHR Architects, associate professor of architecture and fellow of the Center for Health Systems & Design at Texas A&M University, and pioneer in the field, defines evidence-based design as "the deliberate attempt to base design decisions on the best available research evidence. Evidence-based designers make critical decisions, together with an informed client, on the basis of the best available information from credible research and the evaluation of completed projects."
Not that the approach is new—the practice of gathering evidence to demonstrate success or failure in building systems design has been the most reliable methodology for solving complex design problems since man first put up a wall. What has evolved is the professionals' ability to research the most effective solution and then to measure the results. With a rigorous research process that includes relevant literature search, documentation and measurements from system failure analysis, post-occupancy evaluations, benchmarking best practice sites, as well as other shared findings, design professionals are simply better prepared to make design decisions.
It's no wonder that healthcare designers have been among the first to adopt the evidenced-based design model. In healthcare facilities design decisions are tested by life and death situations everyday. Beyond the obvious call for accountability on the part of owners and the public-at-large, professional knowledge carries a moral obligation to represent the best interest of society with an accepted standard of practice.
When designing an emergency room, a nurses' station or a patient room, the architect or interior designer has the obligation and the opportunity to address critical issues of safety and healing that effect everything from the mitigation of stress to the provision of comfort, from operations to technology, from the placement of sinks to the availability of views. The good news is that these choices need not be subjective. Today's practitioners have access to an incredible and expanding store of research to help them develop rational hypotheses. With healthcare's focus on tracking results—be it turnaround times in the ER, the number of patient falls, or prescription errors—developing measurements of post-occupancy effectiveness is a logical extension of the design effort.
While the benefits of evidence-based design for patients and staff are increasingly recognized, the model also provides design staff with a framework for decision-making that promotes thoughtful and innovative design. Young architects and interior designers flourish in a robust practice model that offers a clear methodology and the ability to see the results of their initiative in measurable improvements to the health and safety of patients.
Evidenced-based design is being embraced by leading hospitals internationally because the stakes are so high (financial investment, patient/staff safety, quality of care, customer satisfaction, staff recruitment/retention, clinical operations, etc.). Savvy hospital executives know that design is a very important component for a successful healthcare business enterprise. Many realize there is value added for well thought out design solutions, which are based upon credible sources of information. For these reasons, design professionals should expect hospital preference for firms who truly practice evidence-based design.
Does your facility rely on this? How does it affect your practice? Does it help? Hinder? Are you even asked?
In late August 2008, shortly after the American Institute of Architects (AIA) named the winners of its first health design awards, The Wall Street Journal ran a story on design improvements in patient-treatment areas in its Informed Patient column. Although the article addressed the heightened focus on patients as a positive development, linking many of the design innovations to what author Laura Landro referred to as "the nascent field of 'evidence-based design,'" she noted, "Evidence-based design is not without controversy." The critique turned on the use of evidence-based design as a "marketing tool" often deployed without sufficient research to support design decisions.
While it is true that evidence-based design is an emergent model for design practices, there is a long and well-documented history of studies that confirm the influence of the physical environment on human activity and behavior, and of the physiological effects on patients. As a growing body of research continues to demonstrate that the quality of space in healthcare buildings affects the outcome of medical care, architectural and interior design has become an important part of the healing process. Further, healthcare design professionals are increasingly challenged to provide environmental design solutions that not only contribute to therapy, but also create safe environments that are supportive of patients and staff.
Still there are healthcare planners and designers that make critical design decisions based upon intuition—designs assumed to be better, instead of decisions based upon rigorous research with results that prove the superiority of the decision. A completed design may or may not result in a healing environment. A healing environment, however, can be identified by evidence from measurement and results.
So, what is evidence-based design? D. Kirk Hamilton, founding partner of WHR Architects, associate professor of architecture and fellow of the Center for Health Systems & Design at Texas A&M University, and pioneer in the field, defines evidence-based design as "the deliberate attempt to base design decisions on the best available research evidence. Evidence-based designers make critical decisions, together with an informed client, on the basis of the best available information from credible research and the evaluation of completed projects."
Not that the approach is new—the practice of gathering evidence to demonstrate success or failure in building systems design has been the most reliable methodology for solving complex design problems since man first put up a wall. What has evolved is the professionals' ability to research the most effective solution and then to measure the results. With a rigorous research process that includes relevant literature search, documentation and measurements from system failure analysis, post-occupancy evaluations, benchmarking best practice sites, as well as other shared findings, design professionals are simply better prepared to make design decisions.
It's no wonder that healthcare designers have been among the first to adopt the evidenced-based design model. In healthcare facilities design decisions are tested by life and death situations everyday. Beyond the obvious call for accountability on the part of owners and the public-at-large, professional knowledge carries a moral obligation to represent the best interest of society with an accepted standard of practice.
When designing an emergency room, a nurses' station or a patient room, the architect or interior designer has the obligation and the opportunity to address critical issues of safety and healing that effect everything from the mitigation of stress to the provision of comfort, from operations to technology, from the placement of sinks to the availability of views. The good news is that these choices need not be subjective. Today's practitioners have access to an incredible and expanding store of research to help them develop rational hypotheses. With healthcare's focus on tracking results—be it turnaround times in the ER, the number of patient falls, or prescription errors—developing measurements of post-occupancy effectiveness is a logical extension of the design effort.
While the benefits of evidence-based design for patients and staff are increasingly recognized, the model also provides design staff with a framework for decision-making that promotes thoughtful and innovative design. Young architects and interior designers flourish in a robust practice model that offers a clear methodology and the ability to see the results of their initiative in measurable improvements to the health and safety of patients.
Evidenced-based design is being embraced by leading hospitals internationally because the stakes are so high (financial investment, patient/staff safety, quality of care, customer satisfaction, staff recruitment/retention, clinical operations, etc.). Savvy hospital executives know that design is a very important component for a successful healthcare business enterprise. Many realize there is value added for well thought out design solutions, which are based upon credible sources of information. For these reasons, design professionals should expect hospital preference for firms who truly practice evidence-based design.
Does your facility rely on this? How does it affect your practice? Does it help? Hinder? Are you even asked?