At the recent Healthcare Design '08 conference, one of the attendees asked me, What does it mean that HERD is peer reviewed? I gave him my usual answer: peer review is the process of sending a submitted manuscript stripped of author identifiers to a panel of three reviewers expert in the focus area of the manuscript. After careful review, they offer their opinions to the editors about the accuracy of the content, the appropriateness of the research design and methods if the article is a research paper, or the quality of the content and writing if the article is an opinion or theory paper. The author does not know who the reviewers are, and the reviewers do not know who the author is. After explaining the process, I was aware that I still had not answered the what? question to his satisfaction, and I realized that while peer review is a common term among academics, it may not be for practitioners in design, nursing, medicine, or other fields related to healthcare design. So what is a peer-reviewed journal, and why does it matter?A peer-reviewed (or refereed) journal is a scholarly publication that requires that each article submitted be critically appraised by an independent panel of subject experts who are peers of the author (in the same discipline). Articles not approved by a majority of these experts are not accepted for publication in the journal. If the review panel recommends revisions, the editors review and consider their recommendations. If the editor agrees with the reviewers' comments and recommendations, they are forwarded to the author (absent identifying information about the reviewers) with a request to make any needed changes before the manuscript can be accepted for publication. This process is the same for all scholarly journals (Cline Library; University of Illinois, 2004).Not all articles in a peer-reviewed journal are subject to the peer review process. In HERD, such things as letters to the editors, book reviews, and editorial columns are not peer reviewed, although both coeditors and the managing editor review and edit this content. Any article (other than the columns) written by one of the coeditors is assigned to the other editor for management and is subjected to the same rigorous review required of all submitted manuscripts.Peer review is the undisputed cornerstone of scientific writing; its purpose is to ensure that the published content-both information and data-is of the highest quality. Most reputable scientific journals in all disciplines send papers out to a refereed panel to judge the manuscript on its originality, the importance of its conclusions to the field of study, and the validity of its claims (Greenhalgh, 2001; Wager, Godlee, & Jefferson, 2002). Peer review is also required of journals that aspire to be indexed in databases such as PubMED, Web of Science, Academic Search Premier, OVID, Science Citation Information Expanded, Social Sciences Citation Index, Arts and Humanities Citation Index, and a host of other databases that facilitate the search for articles on specific topics. Using an electronic database to locate evidence-based articles is critical for practitioners who want to translate what is published into design decisions or academics who want to use the information in their own research or writing. HERD is working toward being indexed, and strict criteria must be met regarding the peer review process, timeliness, content, the international diversity of the Editorial Advisory Board, and citation analysis. The latter influences the factor, which is derived from the number of times that HERD is cited in other publications and the references cited by HERD's contributing authors. All of these elements are considered when the journal is being assessed for worthiness to be assigned an impact factor and listed in the scientific databases (Thomson Reuters, 2008).Answering the Question, What?Much has been published in popular magazines, newspaper articles, and industry journals about healthcare design. …