Evidenced Based Design: Impacting Health Care Today

Evidence Based Design

The core goals of the healthcare facility designer are to improve healthcare delivery through built space while maintaining cost effectiveness for the client . To achieve these goals, many architects who specialize in healthcare are mindful of current trends.  A key, new resource for today’s designer is “evidence based design” (EBD) introduced by the Center for Healthcare Design. Evidence Based Design (EBD) is defined as the process of basing decisions about built environment on credible research to achieve the best possible outcomes.(1)   This scientific approach aims to advance best practices and empowers healthcare leaders with quality research to improve health outcomes, patient experience of care, and provider/staff satisfaction.

The Center for Healthcare Design recommends eight key steps for an evidence based process, i.e.,  (i) define the goals for the project, (ii) review literature to find research relevant to the goals (iii) interpret the research evidence, (iv) translate relevant evidence to create design guidelines, (v) create a testable hypotheses that can be measured or quantified by empirical research, (vi) collect data and employ for program, (vii) monitor the implementation of design during construction, and (viii) measure the post occupancy and performance results. (2)

The key step process looks linear, but it can be fluid and integrated into any stage of building design process.  Although complex, EBD is achievable if everyone is committed to giving stakeholders healthier and safer healing environments.  A terrific example of EBD described in Health Facilities Management magazine was the 126 inpatient room addition to the Cleveland Clinic Foundation Avon Hospital (3). The scale of the project, openness to innovation, and the times the room need to be replicated presented an opportunity to implement the EBD approach. The team established onset of the project focused on the inpatient room configuration.  After establishing goals the team reviewed the scientific literature on single occupancy inpatient rooms and developed a hypothesis driving design of mock-up room layout options together with a self-reported questionnaire. The post occupancy evaluations provided an empirical result that can be measured and proven effective.

It is easy to see that open communication and teamwork among stakeholders, architects, staff, contractors, and construction managers create an environment for collaboration. While most small or midsized architecture firms cannot cover the overhead cost for an EBD approach, this should not limit or stop a firm implementing it. Now that many EBD literature reviews have been made available, adapting the EBD approach in healthcare design can be efficiently achieved.


(1) https://www.healthdesign.org/about-us

(2) EDAC Introduction to EBD, exploring healthcare and design

(3) How to employ EBD Strategies www.hfmmagazine.com

(4) Building Type basics for healthcare facilities


By Myrna Villanueva, Architectural Designer, JL Architects