Abstract
Health care settings represent a unique built environment because their primary function is maintaining and restoring health. In health care settings, patients, staff, visitors, and even community members may all be affected by design. Design features of health care institutions such as improved indoor air quality and natural daylighting may promote health. Some features offer direct benefits to patients, and some operate indirectly, for example, by reducing medical errors. Health care facilities are much more resource intensive than other commercial facility types, using more than twice as much energy per square foot, in part because they operate continuously. There is now a growing focus on the environmental performance of health care institutions, as a subset of green building initiatives more generally. Evidence-based design (EBD) uses systematic, empirical evidence on risks and benefits to guide design decisions. Applicable to many types of buildings, EBD has been especially well defined and applied in health care facilities. EBD can incorporate many kinds of outcomes, including health, environmental performance, cost, and aesthetic preference, although it has been most extensively applied to health impacts. Ideally, the design of health care facilities optimizes both health and environmental performance, while reducing cost.
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