---
title: "Evidence-based design"
chunk: 4/5
source: "https://en.wikipedia.org/wiki/Evidence-based_design"
category: "reference"
tags: "science, encyclopedia"
date_saved: "2026-05-05T04:25:33.637659+00:00"
instance: "kb-cron"
---

Level 1
Informed design decisions based on available literature on environmental research, based on applicability, such as the use of a state of the art technology or strategy based on the physical setting of the project
Level 2
Design decisions based on predictive performance and measurable outcomes, rather than subjective decisions based on random choice
Level 3
Results reported publicly, with the objective of moving information on the methods and results moving information beyond the design team,
The peer review, makes the process more robust, as it could include varying perspectives from those who may or may not agree with the findings
Level 4
Publishing findings in peer-reviewed journals
Collaborating with academic and social scientists

=== Working model ===
A white paper (series 3/5) from the Center for Health Design presents a working model to help designers implement EBD decision-making. The primary goal is providing a healing environment; positive outcomes depend on three investments:

Designed infrastructure, including the built environment and technology
Re-engineered clinical and administrative practices to maximize infrastructure investment
Leadership to maximize human and infrastructure investments
All three investments depend on existing research.

=== Strategies ===
A white paper from the Center for Health Design identifies ten strategies to aid EBD decision-making:

Start with problems. Identify the problems the project is trying to solve and for which the facility design plays an important role (for example, adding or upgrading technology, expanding services to meet growing market demand, replacing aging infrastructure)
Use an integrated multidisciplinary approach with consistent senior involvement, ensuring that everyone with problem-solving tools is included. It is essential to stimulate synergy between different community to maximize efforts, outcomes and interchanges.
Maintain a patient- and family-centered approach; patient and family experiences are key to defining aims and assessing outcomes.
Focus on financial operations past the first-cost impact, exploring the cost-effectiveness of design options over time and considering multi-year investment returns.
Apply disciplined participation and criteria management. These processes use decision-making tools such as SWOT analysis, analytic hierarchy processes and decision trees which may also be used in design (particularly of technical aspects such as structure, fire safety or energy use).
Establish incentive-linked criteria to increase design-team motivation and involve end users with checklists, surveys and simulations.
Use strategic partnerships to create new products with hospital-staff expertise and influence.
Encourage simulation and testing, assuming the patient's perspective when making lighting and energy models and computer visualizations.
Use a lifecycle perspective (30–50 years) from planning to product, exploring the lifecycle return on investment of design strategies for safety and workforce outcomes.
Overcommunicate. Positive outcomes are connected with the involvement of clinical staff and community members with meetings, newsletters, webcams and other tools.

== Tools ==
Evidence-based design has been applied to efficacy measurements of a building's design, and is usually done at the post-construction stage as a part of a post-occupancy evaluation (POE). The POE assesses strengths and weaknesses of design decisions in relation to human behaviour in a built environment. Issues include acoustics, odor control, vibration, lighting and user-friendliness, and are binary-choice (acceptable or unacceptable). Other research techniques, such as observation, photography, checklists, interviews, surveys and focus groups, supplement traditional design-research methods.
Assessment tools have been developed by The Center for Health Design and the Picker Institute to help healthcare managers and designers gather information on consumer needs, assess their satisfaction and measure quality improvements:

The Patient Environmental Checklist assesses an existing facility's strong and weak points. Specific environmental features are evaluated by patients and their families on a 5-point scale, and the checklist quickly identifies areas needing improvement.
The Patient Survey gathers information on patients' experiences with the built environment. The questions range is wide, since patients' priorities may differ significantly from those of administrators or designers.
Focus Groups with consumers learn about specific needs and generate ideas for future solutions.

== References ==

Cama, R., "Patient room advances and controversies: Are you in the evidence-based healthcare design game?", Healthcare Design, March 2009.
Cochrane, A. L. (1972). Effectiveness and Efficiency: Random Reflections on Health Services. Nuffield Provincial Hospitals Trust. ISBN 978-0-900574-17-7.
Hall, C.R., "CHD rolls out evidence-based design accreditation and certification", Health Facilities Management, July 2009.
Kirk, Hamilton D., "Research Informed Design & Outcomes for Healthcare" in Evidence Based Hospital Design Forum, Washington, January 2009.
Stankos, M. and Scharz, B., "Evidence-Based Design in Healthcare: A Theoretical Dilemma", IDRP Interdisciplinary Design and Research e-Journal, Volume I, Issue I (Design and Health), January 2007.
Ulrich, R.S., "Effects of Healthcare Environmental Design on Medical Outcomes" in Design & Health – The therapeutic benefits of design, proceedings of the 2nd Annual International Congress on Design and Health. Karolinska Institute, Stockholm, June 2000.
Webster, L. and Steinke, C., "Evidence-based design: A new direction for health care". Design Quarterly, Winter 2009
Sadler, B.L., Dubose, J.R., Malone, E.B. and Zimring, C.M., "The business case for building better hospitals through evidence based design". White Paper Series 1/5, Evidence-Based Design Resources for Healthcare Executives Archived 2017-04-19 at the Wayback Machine, Center for Health Design, September 2008.
Ulrich, R.S., Zimring, C.M., Zhu, X., Dubose, J., Seo, H.B., Choi, Y.S., Quan, X. and Joseph, A., "A review of the research literature on evidence based healthcare design", White Paper Series 5/5, Evidence-Based Design Resources for Healthcare Executives Archived 2017-04-19 at the Wayback Machine, Center for Health Design, September 2008.