Whenever I give a talk about evidence-based design, I point out that the number of studies that link the design of the physical environment of healthcare to outcomes has grown from 80 credible studies in 1996 to more than 1,200 in 2009 -- which was the last time a full-blown literature review was done.
There's usually a physician in the audience who raises his hand and says, "Well. That's nothing. In evidence-based medicine, we have hundreds of thousands of studies."
That's true. But everything is relative. There are thousands more professionals doing credible research in the medical field than in the healthcare design field. And lots more funding from a variety of sources with deep pockets.
Evidence-based design is still an emerging science -- but a rapidly growing one. My guess is that the next literature review will find more than 2,000 studies that link the design of the physical environment of healthcare to outcomes.
What if we looked at quality vs. quantity? The EBD Glossary that was published in 2011 found 50 environmental variables that impacted 35 outcomes in these areas:
- Healthcare associated infections
- Medical errors
- Patient falls
- Patient satisfaction
- Patient waiting
- Staff efficiency
- Staff satisfaction
The first three on this list are in CMS's list of events targeted for reduction as part of its Partnership for Patients initiative. While most of what the 3,700 hospitals participating in the initiative are doing is process-oriented, they shouldn't ignore this piece (see my recent HCD blog post about this).
There's another category of research that I hope the next literature review includes -- operational savings as a result of building decisions. Things like maintenance, energy, staffing, etc.
Some of the critics of evidence-based design also point out that there hasn't been much research validating new design innovations recently. That's the other side of the argument about quantity vs. quality.
What do you think?
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