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New booklet distributed at last week's Healthcare Design conference.

A few weeks ago, I asked a bunch of smart people in the healthcare design industry if the conversation around evidence-based design has quieted. I wrote a post about their responses and also shared the post with my LinkedIn groups, asking them to add their voice to the discussion.

As you might expect, folks in the Evidence-Based Design Accreditation and Certificate Program-EDAC group were quick to respond.

"Evidence-based design is viewed as a fringe design topic, from what I have gathered." wrote Keith W. Starnes, AIA, LEED AP, Associate & Senior Project Architect, Birchfield Penuel & Associates, LLC. "Clients and user-groups associate it more with healthcare delivery than anything else."

Dayle Krahn, Vice President, Property Maintenance & Development at Baptist Housing Ministries, had a slightly different take. "I am finding a great deal of pushback from care team members regarding EBD," he wrote. "'That's not the way we do it.' They want proof that it will work in their residence with their residents."

"I think evidence-based design today is where sustainable design was 10-15 years ago," wrote Stefnee Trzpuc, CID, EDAC, LEED A.P., Design Research and Knowledge Management Specialist at BWBR. "We have to keep pushing education, research, and discussion to get it to the point where it'll be more accepted as an integrated mode of practice, much like a lot of the industry views sustainability today."

Jennifer Heppner, Associate at DIALOG, brought up a key point. "One of the challenges with EBD not having more rapid traction in the healthcare sector is that the process for many healthcare projects is already a such a lengthy one, that to add more to the process from project conception, can be challenging," she wrote, suggesting that EDAC should "borrow concepts" from LEED and establish different levels of certification.

Not Just Healthcare

"I feel EBD needs more exposure beyond healthcare environment," wrote Morana Medved, Job Captain at Hawley Peterson Snyder Architecture/Interiors/Planning. "My area is not healthcare and I got the EDAC credential hoping to apply it more to commercial interiors where too many decisions get made based on someone's personal impression rather than actual evidence."

Sherry Carroll, Sr. Project Manager, LEED AP, EDAC, Associate IIDA at Reel Grobman & Associates, agrees. "About 90% of my current projects are commercial interiors for high tech organizations in Silicon Valley," she wrote. "Exposure to evidence-based design could really make an impact on environments for people, health, productivity and overall profitability of these companies."

Perhaps one day, the EDAC program will expand into other areas.  It's still a babe in the healthcare woods, though.

For evidence-based design to gain traction, we need to keep having these discussions -- and continue to educate and help professionals put it into practice. Many still believe that it a prescriptive action (if you do "x," "y" will happen), rather than going through a process.

It is true, though, as was pointed out in the EBD and Lean discussion held this past week at the Healthcare Design conference, that producing new research from an evidence-based design process takes 5-7 years -- or more. "It's not getting us the data that we need quickly," said Ron Smith, AIA, ACHA, AHE, EDAC, President and CEO, design at the intersection, LLC, referring to it as a "macro research cycle."

What are your concerns about evidence-based design?

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Terri Zborowsky

9 years ago

The use of research in helping to inform design decisions must become our standard. To do this, not all research has to go through a long process. We can integrate research as quality improvement whenever working to improve our client's process and therefore, the built environment. We must think about the interactions of people, place and process and in doing so, continue to measure the impact that "place" has on "people" and "process."

Sara Marberry

9 years ago

Thanks, Terri, for your comment. No question that good research takes time.

Bill Coble

9 years ago

Great post and insightful comments. Markets embrace solutions that can deliver against their challenges. In the case of EBD solving for cost containment, influencing behavior change and establihsing a method of addressing both known and perceived issues. EBD and EDAC in 6 years has produced a community that is willing to dialogue and share. I couldn't agree more that the cycle on developing research could be accelerated and looking at data in new ways is critical. As the educational partner for the Center, we are sensitive to how we can address the concerns cited and maintain the momentum achieved.

Sara Marberry

9 years ago

I agree that EDAC has produced a community that is willing to dialogue and share. I just want to see more of it going on!

Dr. Susan E. Mazer, PhD

9 years ago

Sara, most interesting and not surprising. Further, the entire family of "evidence-based" practices is challenged into the moment. The research takes years; acceptance of new concepts take generations; and, in the moment, practitioners go back to what they know and have little time to visit the Cochran Collaborative to see what the data says. Research outcomes can be out of date as soon as they are published, given the timelines.

From our experience, multi-disciplinary methodologies, seeking knowledge beyond the borders of ones own professional training and interest. Without this, EBD will not move forward. Architects and designers must learn what matters to nurses, patients, administrators -- and where the data is. EBD is a start, but getting past the starting gate with new knowledge is like skiing uphill.

Sara Marberry

9 years ago

Thanks, Susan, for your comments. I believe EBD is trying to take a multi-disciplinary approach. The EDAC study guides put forth many ideas for doing this. It's just that it's not always translating into practice.

Ron Smith

9 years ago

Terri - you're on the right track with your comments. But even more than considering the 'impact' of place on people and process, we need to take design to the next level and treat "People", "Process", and "Place" as elements of one Whole System. When we do this, then continuous improvement methodologies like Lean and HRO become natural platforms for research on a "Micro" cycle that includes the physical environment. Such research will be informed by what we know from the "Macro" cycle of EBD.

Sara Marberry

9 years ago

Ron, I like where you are going with this.

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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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