Book Review: Evidence-Based Healthcare Design

Abstract

Evidence-Based Healthcare Design by Rosalyn Cama. Hoboken, New Jersey: John Wiley & Sons, Inc., 2009, 256 pages, $75.00. ISBN 978-0- 470-14942-3Informing design decisions through the use of evidence rather than relying on intuitive ideas or preferences represents a change in the healthcare design process. The integration of research does not change the structure of the design process; it elevates the level of inquiry and the assessment of information used to improve healthcare environments and the quality of healthcare. According to a news release from the American College of Healthcare Executives (January 5, 2009), the top concerns confronting hospitals are financial challenges, patient safety, and quality of care. Hospitals are living laboratories, full of qualitative and quantitative evidence to justify or call into question the physical environment, the work processes that define the quality of care, and outcomes for the occupants-patients, families, and staff.The concept of evidence-based design is not new; for more than 25 years, a growing group of researchers and practitioners has studied the relationships between humans and the highly stressful hospital setting. The acceptance of evidence to inform practice and design has been slow, though momentum has been building over the past few years. We are now on the edge; healthcare architecture and design are preparing to make that leap. We expect much from integrating the science of inquiry into our beloved design process, and much will be expected of us. Design is not just about aesthetics, comfort, and productivity. Design can contribute to the quality of care, experience, and health outcomes in hospitals and other healthcare facilities.Using evidence to inform design requires new skills and new specialties for consultants; measuring outcomes to provide new for the next generation of healthcare architects requires rigor, integrity, and critical thinking. Evidence- Based Healthcare Design promotes a cross-disciplinary methodology that uses intelligence, relevant best evidence from research and practice, to inform the design process. The completed projects discussed in the text, such as Dublin Methodist Hospital, Weill Cornell Medical Center, and Riley Hospital for Children, attest to the commitment and investment of these healthcare organizations and design teams and to the success of evidence-based design. Are we at the tipping point? If so, there is still much work to be done.Rosalyn Cama is a professional interior designer who has focused her career on designing places that improve the quality of the human experience. Her dedication to healthcare design is confirmed by her leadership on The Center for Health Design board of directors and her award-winning designs. The description of evidence-based design from Cama's practitioner perspective offers a compelling approach to integrating informed design decision making into the design process. Using examples of work products and checklists that illustrate the steps and procedures of the decision- making process, this text facilitates sharing the gained by measuring outcomes. The book is organized into three parts. Part 1 is an introductory chapter that discusses the timeliness and importance of the book by exploring the shift toward evidence-based design in healthcare, the process of conducting an evidence-based design project, and the levels of evidence-based practice. Part 2 details the author's recommended process, four steps that may be loosely defined as: (1) gathering data; (2) predesign planning; (3) best practice and/or innovation in design; and (4) measuring outcomes and sharing results. Part 3 addresses the use of evidence-based design in practice and the need for environmental design research; it also offers a glimpse of the future of evidence-based design. The book as a whole draws on a knowledge bank of experts whose essays illustrate the process. For the novice, there are key words, terms, and idea boxes that help develop vocabulary and provide conceptual and practical ways to engage in evidence-based design practice. …