Pebble Partner opening the doors of a new facility presents an eagerly anticipated opportunity to see evidence-based design strategies at work and to measure the results of their implementation. The opening of Dublin Methodist Hospital last month after many years of visionary planning, design, and construction has been anticipated by both the healthcare design and research community alike. To date, no other hospital has been constructed that implements so comprehensively what is known about the connection between design of the built environment and the outcomes it can affect.

The project team and hospital leadership share a common belief that evidence-based design can improve the emotional and physical well-being of users as much as it can improve operational efficiency, the quality of clinical care, and productivity. This belief will now be put to the test. Throughout the project, the design team—a partnership between Columbus, Ohio-based architecture firm Karlsberger and Rosalyn Cama, FASID, president of CAMA, Incorporated, and board chair of The Center for Health Design—applied out-of-the-box thinking and took measured risks based on evidence. Firmly committed to evidence-based design, they applied research in a sensitive and thoughtful manner that considered elements of healing environments and every user’s individual experience.

Dublin Methodist is constructed on a Greenfield site. In lieu of actual user groups, the team worked with advisory groups composed of leaders in their respective areas of expertise from within the OhioHealth system. These areas included:

  • Surgery

  • Maternity

  • Medical-Surgical

  • Emergency

  • Imaging

  • Materials Management

  • Special Care Nursery

  • Pharmacy

  • Rehab Services

Applied evidence

Research and data was incorporated into the project’s development and helped create the key guiding principles for the design of the new facility. Throughout the project, the team applied current best practices based on evidence. Large single-patient rooms with ample family space to reduce infection, reduce noise, increase privacy, and support family presence in the caregiving process have been built. In an effort to reduce noise, sound-absorbing ceiling tiles and flooring are integrated within the nursing unit. The unit layout has been thoughtfully designed to influence work effectiveness in terms of minimizing walking distances to maximize patient care time, decentralized nursing stations to improve patient visibility and time efficiency, and to reduce falls. The nurse “perches” are a unique concept—standing-height workstations that provide staff with a quick go-to location to review records, talk, or just lean on to rest.

The location, quantity, and design of the handwashing sinks were designed to improve compliance and reduce infections. Patient rooms have a stripe design built into the floor and up the wall leading to the sink to draw the eye to it—a subliminal cue for staff to wash their hands. Natural daylight and sunlight can be found within the facility to reduce depression, length of stay and the amount of pain medication administered.

Other key design concepts integrated within the project and found through research include: standardization of patient rooms, acuity-adaptable rooms, areas for family presence and participation, areas for staff support and retreat, separation between public and service, patient and visitor orientation and wayfinding capabilities, connection to nature and view, and many sustainable strategies.


Dublin Methodist integrated several sustainable strategies. The overall site was designed to achieve LEED certification and followed a community concept in terms of scale, massing and campus development, while still leaving flexibility for future growth. Entrances and parking at the facility are visitor-oriented, providing ease of access for patients, visitors, and staff. The unique “pulled apart” design of the building maximizes daylight and views and serves to create connectivity between the outside and inside of the building. Even among areas of the hospital that are traditionally without windows, such as the pharmacy, have large wraparound windows to give staff views to the outside.

From an exterior perspective, the site was designed to treat runoff through bio-swales and in sediment retention ponds before leaving the site into the watershed. The exterior brick for the facility was produced within a 500-mile local radius to reduce fuel consumption in shipping to the building site. Natural-

finish recycled aluminum exterior metal windows and trim were specified and a green roof, which reduces water runoff and assists in insulating the building from excess heat load in summer and heat loss in winter, was used. The majority of plant materials on site were selected for drought resistance to reduce/eliminate irrigation.

From the interior, paint was specified to be low VOC (volatile organic compounds), the carpet selected was specified to be recyclable, floors are exposed stained concrete (water-based low VOC), and the handrails are bamboo—a rapidly renewable resource. A large glass atrium is designed with exterior louvers to deflect sunlight in summer months, which reduces heating loads. The glass is clear to admit natural daylight and was treated with a low-emissivity (Low-E) coating to reduce heat and cold transfer for energy efficiency.

Next steps

Now that Dublin Methodist is open and running, the next step in its Pebble Project will be to collect and analyze the data from these innovations. HD

For more information on Dublin Methodist Hospital, please visit To learn more about The Pebble Project, visit The Center for Health Design’s Web site at For more information about becoming a Pebble Partner, contact Mark Goodman at The Center for Health Design, 1850 Gateway Boulevard, Suite 1083, Concord, CA 94520, or 925.521.9404 x120.

The Center for Health Design is a nonprofit research and advocacy organization of forward-thinking healthcare, elder care, design, and construction professionals and product manufacturers who are leading the quest to improve the quality of healthcare facilities and create new environments for healthy aging. To comment on this article, visit http://www.healthcaredesign


The Pebble Project creates a ripple effect in the healthcare community by providing researched and documented examples of healthcare facilities where design has made a difference in the quality of care and financial performance of the institution. Launched in 2000, the Pebble Project is a joint research effort between The Center for Health Design and selected healthcare providers that has grown from one provider to more than 45. For a complete prospectus and application, contact Mark Goodman at


Dublin Methodist Hospital is the newest addition to the not-for-profit, faith-based OhioHealth system, headquartered in Columbus, Ohio. It serves a 46-county region with 14 hospitals, 14 ambulatory sites, home care, hospice, and employer health services and is Central Ohio’s largest health system. The new 94-bed hospital includes 34 maternity/nursery beds and 60 identical, acuity-adaptable medical/surgical/ICU beds, as well as 32 emergency department beds, four surgical and two endoscopic suites, a full complement of imaging technology (including two CT scanners and one MRI scanner), 25,000 square feet of shelled space, and a central energy plant, for a total of 325,000 square feet. Dublin Methodist became part of the Pebble Project in 2004.