The Knowledge Repository is one of the most frequently visited tools on The Center’s website. This comprehensive and searchable database houses almost 4,000 citations that connect the built environment to outcomes in healthcare and related spaces; nearly 700 of those references have been translated by our research team into key point summaries. It’s supported through a partnership with American Institute of Architects Academy of Architecture for Health, the American Society for Healthcare Engineering, and the Facility Guidelines Institute.

An “additional resources” link on the Knowledge Repository landing page allows users to access two tools that industry professionals will also find helpful in their work: conceptual models and our Evidence-Based Design (EBD) Glossary. Both were created by our internal research team and a group of volunteers from The Center’s Research Coalition, including Eileen Malone, senior partner at Mercury Healthcare Consulting LLC, and Debajyoti Pati, executive director of the Center for Advanced Design Research & Evaluation.

The conceptual models visually represent the relationship between environmental variables and outcomes related to seven key topic areas: healthcare-associated infections, medical errors, patient falls, patient satisfaction, patient waiting, staff efficiency, and staff satisfaction. Each graphic model also includes a summary of key research findings for that topic.

The EBD Glossary is a nearly 70-page PDF that provides more detail on how the conceptual models were created. Additionally, we recognized that not having a set of commonly accepted standards can lead to difficulty translating research findings into design knowledge, inefficient communication between team members, and difficulty making informed predictions based on the research. To answer that challenge, the glossary establishes terms, definitions, metrics, and measurement tools that can be used as industry standards among interdisciplinary design teams.

The glossary also includes two tables. One cross references the seven topic areas identified with 50 different environmental variables, such as acoustic ceiling tiles or daylight, that were found to impact outcomes. The second table cross references 35 known outcomes, such as patient falls or hand hygiene compliance, to the seven topic areas and shows how outcomes could affect any given topic area.

Project teams can use the conceptual models in their work or with clients to show the relationship between the built environment and specific outcomes. For example, discover how to reduce distractions and interruptions by eliminating visual clutter or introducing a new unit configuration, leading to better outcomes in reduced surgical errors and medication

Healthcare design is as much science as it is art. Making the best decision to achieve the outcomes you are striving for means taking into account the many voices of those inhabiting the space, drawing on a vast well of creativity and knowledge of product performance and a solid understanding of what’s worked and what hasn’t for those who came before you. The Knowledge Repository and its multitude of research citations, glossaries, and conceptual models helps take the guesswork out of this last part.


Debra Levin is president and CEO of The Center for Health Design. She can be reached at