ROSALYN CAMA, FASID, is the president and principal designer of the evidence-based planning and interior design firm CAMA Incorporated in New Haven, Connecticut. CAMA Inc. was founded in 1983 and has completed many award-winning projects nationwide, including Yale-New Haven Hospital, New Haven, Connecticut; and American Cancer Center Headquarters and Hope Lodge in New York City. A frequent writer and speaker on the topic of evidence-based healthcare design, Ms.Cama was the 1998 national president of The American Society of Interior Designers and currently serves as chair of the board for The Center for Health Design. Permissions Request permission to reuse content from this site
Evidence Based Healthcare Design Rosalyn Cama.pdf
2. Biophilic Design: The Theory, Science and Practice of Bringing Buildings to Life by Stephen R. Kellert, Judith Heerwagen, Martin Mador (432 pages, John Wiley & Sons, 2013). While not specifically about healthcare, I think this is the "bible" of biophilic design, which is so important to health and well-being in any setting. Find out more or buy this book>>>
6. Hospitable Design for Healthcare and Senior Living Communities by Albert Bush-Brown and Dianne Davis (263 pages, Van Nostrand Reinhold, 1992). Unlike it's title might imply, this book isn't about designing healthcare facilities to look and feel like hotels. Its central thesis is that patients/residents' physical, mental, and emotional well-being are improved by hospitable design and services -- a pioneering concept at the time. Find out more or buy this book>>>
7. Hospital and Healthcare Facility Design, 3rd Edition by Richard L. Miller, Earl S. Swensson, and J. Todd Robinson. An updated version of a book that has introduced three generations of students and professionals to state-of-the-art healthcare facility planning and design. Find out more or buy this book>>>
9. Innovations in Healthcare Design: Selected Presentations from the First Five Symposia on Healthcare Design edited by Sara O. Marberry (306 pages, John Wiley & Sons, 1995). My first healthcare design book is a collection of edited presentations by the early pioneers and rising stars that gave birth to the healthcare design industry in the late 1980s. Find out more or buy this book>>>
10. Medical and Dental Space Planning: A Comprehensive Guide to Design, Equipment, and Clinical Proceedings, 4th Edition by Jain Malkin (663 pages, John Wiley & Sons, 2014). This most recent edition of Jain's definitive reference on medical and dental office design explores transformative changes in technology, healthcare policy, and patient care management. Includes more than 600 illustrations and drawings. Find out more or buy this book>>>
12. Nurses as Leaders in Healthcare Design: A Resource for Nurses and Interprofessional Partners, edited by Jaynelle Stichler and Kathy Okland (234 pages, Herman Miller Healthcare and the Nursing Institute for Healthcare Design, 2015). Written by nurses involved across the globe, this one-of-a-kind book offers a unique and essential perspective on the planning and design of healthcare facilities. Email Herman Miller to request a copy if any are still available.
13. Rigor and Research in Healthcare Design by D. Kirk Hamilton (235 pages, Herman Miller Healthcare, 2013). No one better to explain the evidence-based design process than Kirk. This book is a compendium of the best of his evidence-based design writings from the HERD Journal and Healthcare Design magazine. Email Herman Miller to request a copy if any are still available.
14. Sustainable Healthcare Architecture, 2nd Edition by Robin Guenther and Gail Vittori (480 pages, John Wiley & Sons, 2013). Another instant classic and the most authoritative book on sustainable healthcare facility design. Second edition is even better than the first, with 55 new project case studies. Find out more or buy this book>>>
Evidence-based design (EBD) is the process of constructing a building or physical environment based on scientific research to achieve the best possible outcomes.[1][2] Evidence-based design is especially important in evidence-based medicine, where research has shown that environment design can affect patient outcomes. It is also used in architecture, interior design, landscape architecture, facilities management, education, and urban planning. Evidence-based design is part of the larger movement towards evidence-based practices.
Evidence-based design (EBD) was popularized by the seminal study by Ulrich (1984) that showed the impact of a window view on patient recovery.[3] Studies have since examined the relationships between design of the physical environment of hospitals with outcomes in health, the results of which show how the physical environment can lower the incidence of nosocomial infections, medical errors, patient falls, and staff injuries;[4][5] and reduce stress of facility users, improve safety and productivity, reduce resource waste, and enhance sustainability.[6]
Evidence in EBD may include a wide range of sources of knowledge, from systematic literature reviews to practice guidelines and expert opinions.[7] Evidence-based design was first defined as "the deliberate attempt to base design decisions on the best available research evidence" and that "an evidence-based designer, together with an informed client, makes decisions based on the best available information from research and project evaluations".[8] The Center for Heath Design (CHD), a non-profit organization that supports healthcare and design professionals to improve the understanding and application of design that influence the performance of healthcare, patient satisfaction, staff productivity and safety, base their model on the importance of working in partnership with the client and interdisciplinary team to foster understanding of the client, preferences and resources.[1]
The roots of evidence-based design could go back to 1860 when Florence Nightingale identified fresh air as "the very first canon of nursing," and emphasized the importance of quiet, proper lighting, warmth and clean water. Nightingale applied statistics to nursing, notably with "Diagram of the causes of mortality in the army in the East".[9] This statistical study led to advances in sanitation, although the germ theory of disease was not yet fully accepted. The evidence-based design movement began much later in the 1970s with Archie Cochranes's book Effectiveness and Efficiency: Random Reflections on Health Services.[10] to collect, codify, and disseminate "evidence" gathered in randomised controlled trials relative to the built environment. A 1984 study by Roger Ulrich[11] found that surgical patients with a view of nature suffered fewer complications, used less pain medication and were discharged sooner than those who looked out on a brick wall; and laid the foundation for what has now become a discipline known as evidence-based design. Studies exist about the psychological effects of lighting, carpeting and noise on critical-care patients, and evidence links physical environment with improvement of patients and staff safety, wellness and satisfaction.[3] Architectural researchers have studied the impact of hospital layout on staff effectiveness,[12][13] and social scientists studied guidance and wayfinding.[14] Architectural researchers have conducted post-occupancy evaluations (POE) to provide advice on improving building design and quality.[15][16] While the EBD process is particularly suited to healthcare, it may be also used in other fields for positive health outcomes and provision of healing environments.
There is a growing awareness among healthcare professionals and medical planners for the need to create patient-centered environments that can help patients and family cope with the stress that accompanies illness.[17] There is also growing supporting research and evidence through various studies that have shown both the influence of well-designed environments on positive patient health outcomes, and poor design on negative effects including longer hospital stays.[17]
EBD is closely related to performance-based building design (PBBD) practices. As an approach to design, PBBD tries to create clear statistical relationships between design decisions and satisfaction levels demonstrated by the building systems. Like EBD, PBBD uses research evidence to predict performance related to design decisions.
The decision-making process is non-linear, since the building environment is a complex system. Choices cannot be based on cause-and-effect predictions; instead, they depend on variable components and mutual relationships. Technical systems, such as heating, ventilation and air-conditioning, have interrelated design choices and related performance requirements (such as energy use, comfort and use cycles) are variable components.
Evidence-based medicine (EBM) is a systematic process of evaluating scientific research which is used as the basis for clinical treatment choices.[27] Sackett, Rosenberg, Gray, Haynes and Richardson argue that "evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients".[28] It is used in the healthcare industry to convince decision-makers to invest the time and money to build better buildings, realizing strategic business advantages as a result. As medicine has become increasingly evidence-based, healthcare design uses EBD to link hospitals' physical environments with healthcare outcomes.
Research-informed design (RID) is a less-developed concept that is commonly misunderstood and used synonymously with EBD, although they are different. It can be defined as the process of applying credible research in integration with the project team to inform the environmental design to achieve the project goals. Credible research here, includes qualitative, quantitative, and mixed methods approaches with the highest standards of rigor suitable for their methodology.It is important to understand that the literature for "research-informed" practices comes from education and not from the healthcare disciplines.[29] The process involves application of the outcomes from literature review and empirical investigation to inform design during the design phase, given the constraints; and to share the process and the lessons learnt just like in EDB. 2ff7e9595c
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