Over the past 10 years there have been several changes to how one solves the problem of designing a healthcare facility in the United States. Most notably, changes to the basic design approach are being influenced by Evidence Based Design (EBD) as well as the growing influence of professional and grassroots organizations that are dedicated to the improvement of healthcare facility. Specifically, architects and interior designers are taking into consideration white papers and peer reviewed studies about the built environment’s impact on patient outcomes prior to hitting the drawing board. They are also collaborating with owners and research teams on developing hypotheses for their own studies about the built environment.
Architects and planners have been utilizing EBD in concept for decades, however it has not been until recently that we have seen a shift in how we look at and implement EBD. Today design teams are starting to gather data or “evidence” to see how their design decisions impact areas such as staff injury rates, patient satisfaction scores and patient outcomes. By working with researchers, architects, planners and building owners will ultimately gather enough data to prove or debunk hypotheses related to the built environment. Similarly, some architectural firms are hiring clinical staff as design consultants and developing in house research teams to design better healthcare facilities. Ultimately a study’s results, whether a positive or negative, must be published and shared with the entire design community typically through a peer reviewed journal.
Additionally, there are organizations such as the Center for Health Design (CHD) and Planetree whose missions are to promote EBD and patient centered care via advocacy, education programs, publications and annual meetings. These organizations also offer certification programs for professionals and healthcare facilities such as CHD’s Evidence-based Design Accreditation and Certification (EDAC) as well as Planetree’s Visionary Design Network and Designated Facilities program. Although many objectives of these organizations parallel each other they are separately setting the new standards for healthcare facilities in the US and internationally through their member organizations.
Even though Roger Ulrich’s groundbreaking study of the affect of views to nature on patients took place nearly 30 years ago, the knowledge base for understanding how the built environment impacts patient outcomes is small, but continually growing. We are still a long way from understanding how powerful the built environment is and from being able to back up our theories with hard data. However, the design community is reaching the turning point where design professionals are not only understanding EBD, but also gathering the critical evidence needed to take this movement to the next level, a standard, best practice step for designing healthcare facilities. I see a time in the not so distant future where we are all not just discussing EBD as a concept, but are using it in everyday practice as a tool to create healing environments that are rooted in measureable, proven data.
Brandon R. Guzman is a Healthcare Interiors Specialist with the San Francisco office of SmithGroupJJR, a leading architecture, interiors, landscape, engineering and planning firm with offices across the United States. He has over 16 years of experience specializing in healthcare interiors.