Those of us who believe that the design of the physical environment affects healthcare safety and quality are a small, but important group.

But when it comes to getting our voices heard with the foundations and government agencies that fund research, we are like the Whos down in Whoville.

(The Whos, you may recall, are the small, but important group of beings called the "Whos" in Dr. Suess' classic story about the elephant Horton who fails -- at first -- to hear them.)

With all the emphasis on patient safety and quality nowadays, you'd think that those who are concerned about those issues would at least consider supporting healthcare design research to help advance the field. But many do not see the connection.

About 10 years ago, the Robert Wood Johnson Foundation was interested in healthcare design, and funded several million dollars of projects through various universities and nonprofit organizations -- including seed money for The Center for Health Design's (CHD) EDAC certification program.

But then, it turned it's attention to working directly with hospitals and health systems to improve quality. At one point, those of us at CHD thought they'd include the physical environment in that discussion, but they never did.

The California Health Care Foundation (CHCF) has also supported several healthcare design projects, including the development of a very useful Clinic Design website.  But it too, has cut back funding in this area in the past year.

Recently, the Kresge Foundation put some money toward healthcare design research, helping to continue some of the clinic design work started by the CHCF. It has also funded research projects on green design.

And, the tiny, but influential Hulda B. and Maurice L. Rothschild Foundation, has also been a long-time supporter of small healthcare design research projects -- funding educational videos, task forces, and more recently a literature review of studies that link the design of the physical environment to residents in long-term care facilities. (Read my recent blog post on the Foundation's president, Rob Mayer.)

Fun fact:  Of the top 10 biggest foundations in the U.S. by total giving, seven of them are funded by drug companies.

On the government side, the Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention, both subsets of the U.S. Department of Health and Human Services have funded small projects for CHD and Kaiser Permanente on safety and the built environment.  But until the budget mess gets straightened out, it's unlikely that more healthcare design projects will be funded.

In my experience, it's mostly been individuals who have made the personal connections at these foundations and agencies to get them interested in healthcare design.  And within our group of Whos, we must know people at some of these foundations.

Maybe if more of us tried to get our voices heard, they'd listen.

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