Using an EBD Approach for Healthcare Design

Abstract

Those of us who work in the world of evidence-based design (EBD) are often under the illusion that everyone believes as strongly about using an evidence-based approach in healthcare design as we do. Apparently this is not the case-for some, EBD is still merely a marketing strategy rather than a solid approach to use in the design of healthcare facilities. This became clear to me at the 2013 Healthcare Design conference in Orlando. While riding the bus from the conference site back to my hotel one evening, I overheard three gentlemen with me on the bus discussing a session about EBD that they had attended. Without introducing myself as the co-editor of HERD, I joined their conversation and asked them if they an evidence-based approach in their They all answered with an enthusiastic yes. I asked how they found the evidence to guide their design projects. After a few moments of silence, one stated that he simply asked the client what they wanted in the and another answered that he used experience from past projects to guide his work. Next, I asked what journals they read to guide them in their project decisions. One answered that he occasionally read Healthcare Design. Since none of them mentioned HERD, I asked them, Do you ever read HERD? I was saddened to discover that one of my fellow passengers had never heard of HERD. The other two gentlemen explained that they had seen HERD but felt that it was too technical for them to use for their everyday practice.Of course this wasn't what I wanted to hear, being completely enthusiastic about HERD and EBD. Remember, all three gentlemen had said they EBD, but they didn't read any journals. This conversation validated my suspicion that some people will tell you that they use an evidence-based approach to healthcare design, when in fact they may do little to search for credible evidence to guide their project decisions. The conversation also caused me to reflect on factors that architects and designers at the grassroots level may consider to be barriers to using an evidence-based approach in their design. Therefore the aims of this editorial are to discuss frequently cited barriers to EBD and demystify the EBD process, making it easier for design practitioners (my buddies on the bus) to actually use evidence in their practice.Barriers to EBDThere are several aspects to an evidence-based approach in design that some may perceive as barriers. Some may believe that EBD is too costly, that they must add extra steps in the design process to accomplish EBD, yet there are few design firms who add extra charges for an EBD approach. Perhaps the notion that EBD adds costs to a project stems from the misconception that EBD implies a pure research methodology, when in fact EBD is the use of and application of existing evidence (research findings, observations, expert opinions, past experiences) to guide decision making in the design process. Working with the pure definition of EBD, no additional costs should be incurred in the process. On the other hand, if a formal research study is being conducted for a project, it is possible that additional costs may be incurred with the hiring of a research consultant (if necessary), the data collection process, the data analysis, and the dissemination of the research findings at national conferences or in professional journals.Another commonly cited barrier was mentioned by my fellow bus passengers, who indicated that research articles were too technical or too intimidating to read. Unfamiliarity with the research process, statistical analysis, and research terms can certainly be a barrier to those who have not had the opportunity, experience, or education in the research process. HERD has attempted to minimize this barrier by adding the Implications for Practice section to every article and will soon be adding a new feature, the Executive Summary section, which can be quickly perused by any reader for a quick synopsis of the purpose and findings of the article. …