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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

10 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

10 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

10 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

10 years ago

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

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What's my story? I'm a healthcare and senior living design knowledge expert who writes and speaks frequently about trends and issues affecting these two industries. I'm also a strategic marketing consultant and content creator, working with companies and organizations who want to improve the quality of healthcare and senior living through the design of the physical environment. You can reach me at .

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