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I had a conversation the other day with a vice president of facilities for a large U.S. healthcare system and somehow we got to talking about evidence-based design.

"It originally was a marketing ploy," he said. "I kept asking, 'Where's the data?'"

In the early days of evidence-based design, there were some healthcare architects and designers that did exploit the term in the name of marketing. They didn't understand that it is a process, not a prescription.

I doubt that the facilities VP understood that either. His beef was with the lack of evidence, which, in the late 1990s when the term "evidence-based design" was coined, was only about 80 credible studies.

But, we've come a long way.  We still need to collect more evidence that links the design of the healthcare environment to outcomes, but we've defined evidence-based design and established 8 steps. Not everyone is doing all 8 steps, but some firms are coming close. (Download the 2013-2014 EDAC Advocate Brochure from this page to see some examples.)

Questions healthcare organizations should ask design firms to gauge their evidence-based design expertise and design firms should be prepared to answer are:

  1. How many people in your firm are EDAC-certified?
  2. What are the eight steps of the evidence-based design process?
  3. Do you have examples of projects in which you've used all or some of the eight evidence-based design steps?
  4. If it's not possible to do all 8 steps, which are most important?
  5. How does evidence-based design and Lean process improvement work together?

What would you add to this list?

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Phyllis Goetz

9 years ago

Sara, I would ask if any of their projects are published in a peer reviewed journal? I would also ask how they blend the idea of EbD (metrics) with a patient centered approach?

Sara Marberry

9 years ago

Good questions, Phyllis! Although -- not many "projects" get published in peer-reviewed journals. I assume you meant published research studies based on projects...

Dale Anderson

9 years ago

Sara/Phyllis: The challenge Sara notes is very similar to the early days of sustainable design practices - a lot of marketing positioning and little actual implementation. After years of evidence being made available as proof, it finally took off. I think this is still the case with EBD - there are enough skeptics that still don't believe/understand the benefits of research-based design since they can't get their hands on it. As the published data grows, the process will become more accepted and practiced - it won't be seen as simply a "trend" as many consider it today.

Sara Marberry

9 years ago

Thanks, Dale, for your comment. The comparison to the early days of green design is right on target!

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Sara Marberry, EDAC, is a healthcare design knowledge expert, thought catalyst, and strategic marketing and business development consultant. The author/editor of three books, Sara writes and speaks frequently about industry trends and evidence-based design. She can be reached at sara@saramarberry.com.

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