Welcome to a Special Issue

Abstract

As the United States enters one of the largest healthcare construction programs in its history-with construction projected to exceed $70 billion a year by 2011 (Jones, 2007)-many healthcare organizations are using evidence-based design (EBD) to help guide their capital facility investment. EBD relies on a deep and broad knowledge of the relevant evidence from research and best practice. However, as Zimring, Augenbroe, Malone, & Sadler (2008) say in their paper in this issue:At the core of EBD is a fundamental shift in the way healthcare organizations think about, deliver, and manage buildings. Rather than simply being regarded as cost centers, in EBD buildings are seen as strategic tools where strategic investments can yield important benefits. Yet to achieve these benefits, buildings must be planned, designed, and operated in a new way?. [A]n EBD approach is a structured process that establishes broad agreement on the principles underlying a design, articulates goals that must be satisfied to achieve those principles, and sets measurable, expected outcomes. (pp. 7-8)This special issue focuses on four sets of key questions that illuminate the practice and science of EBD:* How does a chief executive officer actually implement EBD? All projects have ambitious goals; how can this practice actually be infused into the thousands of decisions made in a multiyear healthcare project?* What is the overall business case for EBD and how does one build a business case for individual projects?* How can physical design development be linked to development of the culture of an organization?* What is the evidence base for EBD? Where is rigorous evidence about the impact of the built environment on key healthcare outcomes to be found?These articles are based on research conducted by a diverse group of thought leaders with funding from the Robert Wood Johnson Foundation. The purpose of this grant is to provide materials and tools that will help high-level hospital decision makers effectively implement EBD in their projects. As this project, conducted jointly by Georgia Tech, The Center for Health Design, and the research partners writing in this issue, is completed, it will yield white papers, webinars, a Health- Care Design Community Portal, and other tools.This issue of HERD includes four papers:1. Implementing Healthcare Excellence: The Vital Role of the CEO in Evidence-Based Design. This paper uses lessons learned from hospital leaders and the experience of the authors to create practical guidance for CEOs who want to use EBD as a tool to transform their organizations. In addition to keys to success, the paper also discusses barriers to innovation and strategies for overcoming these barriers. This paper provides a model for EBD that CEOs can use to create a facility that increases quality, safety, patientand- family centeredness, and revenue and that reduces cost. …