Developing a Spirit of Inquiry

Abstract

Perhaps many readers recall Heard It the Grapevine, first sung in 1967 by Gladys Knight & the Pips and then by Marvin Gaye in 1968, whose version made it to Rolling Stone's The 500 Greatest Hits of All Times. Recently this song came to mind when I was thinking about how we come to know certain facts or truths in healthcare design. We are all in search of knowledge, truth, facts, things we can hang our hat to make good design decisions, because much is at stake. Decisions in healthcare design are multimillion- and sometimes billion-dollar decisions, presenting once-in-a-lifetime opportunities with high stakes, and we need to get it right. How hospitals are designed and built today will affect the delivery of healthcare, patient outcomes, and the bottom line for many decades to come. So where do we start? We start by asking the right questions. How do we know what we know? Why are we designing it this way? What is the for what we do? Would designing it this way be better than designing it that way? And who says so? What constitutes best practice?Just a few short years ago, what was written in a book, what was shown on television, what our leaders told us, we just knew to be the truth. Now we have websites to check out the accuracy of what we hear, see, and read (e.g., www.snopes.com), because so many urban myths seem too real to be untrue. So it is in healthcare design; merely reading an article with pretty before-occupancy pictures, hearing a great lecture about all that went well in a project, seeing the project the eyes of the designer and owner, or hearing about it through the grapevine is no longer enough evidence to use as a foundation for future decision making. We must develop a spirit of inquiry and be driven to ask questions; search out the best evidence; and weigh all the from the literature, experts, and clients (patients, providers, and organizations) for its relevance to a project's goals and in the context of clients' resources.The expert in evidence-based healthcare design is now defined as one who knows how to approach a project with the 4 A's of the evidence-based design process: (1) Ask the right questions; (2) Acquire sources of evidence; (3) Appraise all findings; and (4) Apply the findings to practice. The real experts in evidencebased design promote a spirit of inquiry, question all sources of information, and develop and test hypotheses of their own in their projects to add to the body of knowledge and the new science emerging in the healthcare design field. We can no longer dance to the tune of Heard It the Grapevine; now we are challenged to sing the new song of inquiry.In the next few issues of HERD, we will be sharing articles that offer insight into developing researchable questions and searching sources for about environmental influences on staff efficiency, human behavior, healing, and organizational performance. …