I’m a big fan of the unknown. Adventures are part of what makes life interesting for me. Getting into the car on a vacation and just driving to see where you end up, being open to whatever it is that you’ll find, often culminates in unexpected moments that you could never plan, even if you tried. Not that this devil-may-care attitude should take the place of doing your homework and finding out if there is anything that shouldn’t be missed. It would be disappointing to come back from a trip to Rome and find out that you missed experiencing the beauty of the Sistine Chapel while you were driving in the country to find the perfect gelato. The key for me is knowing when to be prepared and when to let things unfold.

The work we all do is somewhat the same. There are times when you have to do your homework and times when you just have to trust the process and the people around you and0 let things unfold. This ties into a very important and interesting conversation happening in our field right now concerning what is, and what is not, evidence-based design, as well as how these concepts are being used to make multimillion-, even billion-dollar decisions that we will live with for decades to come.

We are in a very exciting time, a time when a new industry is being birthed. We are creating a foundation based on art and science that will be the building blocks for the next generation of healthcare facilities. Everyone is looking for the same results: safer, better healthcare facilities that provide the highest quality of care and are also fiscally responsible. That process is not always easy or straightforward, and dialogue is a welcome and valuable tool.

Evidence-based design should never be used as a marketing tool without the substance and knowledge to back it up. Doing so reduces the process to its lowest common denominator. Anyone responsible for designing healthcare facilities or making decisions about the selection of these designs needs to arm themselves with knowledge. Though there is a copious amount of well-researched information already available, it is still nowhere near all that we need to know to ensure that every significant decision we make has science behind it.

But, there are scores of people working toward that end. Many architecture and design firms are building research components into their design projects so that they can measure results based on the hypotheses they and their clients set forth with at the start of the projects. Many firms are even bringing full-time researchers on staff. More and more, RFP’s are calling for the use of evidence-based design. Many universities and professional associations are involved in research projects or creating tools to help their members navigate this new territory. More and more, universities are creating masters-level educational programs for healthcare design professionals. We have industry conferences, webinars, magazines, and multiple books on evidence-based design being published just this year, as well as Health Environments Research and Design (HERD), a peer-reviewed journal copublished by The Center and Vendome Group.

Here at The Center, we have pulled together a group of definitions from throughout the industry and worked with a small team of industry experts to put forth a definition of evidence-based design for our work. It states that:

“Evidence-based design is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes.”

We are also making many of our publications and resources available to the industry, free of charge, so that having access to information is no longer a barrier. Through our work with the Global Health and Safety Initiative we have created RIPPLE, an open-source, searchable database to help you begin to sort through all of the design recommendations and related research out there. The beta version is available to you at http://www.ripple.healthdesign.org. Though it is in its infancy, you can use it to gather information for decisions, as well as add to its vitality by adding information and joining in on conversations that will soon be available.

Through a grant from the Robert Wood Johnson Foundation, we are working with Georgia Tech University to publish white papers on a variety of topics geared towards hospital leaders—but valuable to all. Topics range from the impact of the environment on nursing and patient care, to the business case for using evidence-based design, and include a road map of practical guidance for hospital leaders. These papers will be available in the next few weeks on a variety of websites including The Center’s. In the coming months, downloadable webcasts, with select authors of these white papers, will be available.

Recently we copublished, with the National Association of Children’s Hospitals and Related Institutions (NACHRI), a comprehensive literature review of the latest research on designing children’s healthcare environments. In the next month, through a grant from the California Healthcare Foundation, we will make available a compilation of research and best practices for ambulatory care clinics. We have also just published a report that links environmental design factors to patient falls and the effects of environmental design on reducing nursing and medical errors in acute care settings.

There is no question that much more research is needed before all significant design decisions have evidence behind them to back their claims of safer and more efficient healthcare. But there already is a great deal of data to digest before making a decision on the future and efficacy of evidence-based design.

Part of what I love about my nearly two-decade career at The Center is that it has always been an adventure. No two days are ever the same, and both challenges and opportunities keep coming. I wouldn’t want it any other way. I hope as you go on your journey that The Center can help you with the tools and resources you need so that you are prepared when you need to be. Then, you can just go with the moment.

I invite you to visit The Center’s blog and post your thoughts on the definition of evidence-based design or add to the ongoing discussion of the value of evidence-based design decisions. The URL to join the conversation is http://www.healthdesign.org/blog. I hope to see you there. HD

The Center for Health Design is located in Concord, California.


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