The Joint Commission on Accreditation of Healthcare Organizations (the Joint Commission) has long recognized that design is an essential component of creating an environment for safety and quality. The rise of the field of health design significantly advances our understanding of the relationship between design and safety and now has the potential to inform decisions about approaches to design that are clinically and financially effective and that promote safety and quality. Health design should include identifying and incorporating the best available evidence for quality and safety. Evidence should also be used to help organizations prioritize and make decisions that will help reduce or eliminate the risk of harm to patients, employees, and visitors. This paper discusses the Joint Commission's support for the use of evidence-based design and describes tools and strategies that can be used to enhance design safety for professional staff, patients, and their families while complying with Joint Commission standards and National Patient Safety Goals (NPSGs). The multistep process of incorporating evidence-based design requires intensive teambased activities in addition to using Joint Commission standards and the NPSGs as a supporting framework.The Joint Commission on Evidence-Based DesignHealthcare organizations, particularly those that have developed a culture that focuses on improving safety, have achieved success using evidence-based design as a major component of the health design process. Evidence-based design has proven results, and its strategies for improving healthcare facilities are consistent with the Joint Commission framework, including Joint Commission standards and NPSGs. Using evidence-based design as part of the overall health design process has resulted in facilities with improved clinical, economic, organizational, and cultural performance and has improved the experiences of patients, families, and professional staff. The growing evidence for health-based design is compelling enough that it is incumbent upon healthcare organizations to consider such evidence as they address the physical design of facilities. It is critical that healthcare leaders research and gain knowledge of the design evidence base, applicable accreditation standards, new technology, related industry practices and standards, and the need for organizational education about designing for patient safety. In addition to evidence-based design and the review of all available evidence, during the planning and design phases the health design process should also include methods for re-engineering current processes to achieve measurable improvements to quality and safety. Such re-engineering will prevent replication of ineffective processes in the new design.Organizational AssessmentEvidence-based design requires an organizational culture that promotes evidence-based care and patient safety. Such organizations are constantly learning from self-examination and from others, leading to an identification of their own strengths as well as any shortcomings that need improvement.The first assessment activity focuses on whether an organization is ready to use evidence-based design successfully. This is best achieved by the participation of organizational leaders, physicians, nurses, other clinicians, facility staff, safety and security professionals, materials managers, and infection control practitioners. Beginning at the board level, an organization should assess its culture's openness to structural and organizational change. Preparing an organization for anticipated changes is critical to the success of any new construction or renovation projects that use evidence-based design.Health design is a large and growing field, but it is still in a stage where it is important to review information carefully and critically. The organization that approaches evidence believing that clear and simple solutions will emerge from a quick review of research reports is at risk of making ill-advised design decisions. …