---
title: "Evidence-based design"
chunk: 3/5
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"
---

== Evidence-based design for healthcare facilities ==
There is a growing awareness among healthcare professionals and medical planners for the need to create patient-centered environments that can help patients and family cope with the stress that accompanies illness. There is also growing supporting research and evidence through various studies that have shown both the influence of well-designed environments on positive patient health outcomes, and poor design on negative effects including longer hospital stays.
Using biophilic design concepts in interior environments is increasingly argued to have positive impacts on health and well-being through improving direct and indirect experiences of nature. Numerous studies have demonstrated improved patient health outcomes through environmental measures; exposing patients to nature has been shown to produce substantial alleviation of pain, and limited research also suggests that patients experience less pain when exposed to higher levels of daylight in their hospital rooms. Patients have an increased need for sleep during illness, but suffer from poor sleep when hospitalised. Approaches such as single-bed rooms and reduced noise have been shown to improve patient sleep. Natural daylight in patient rooms help to maintain circadian rhythms and improve sleep.
According to Heerwagen, an environmental psychologist, medical models of health integrate behavioral, social, psychological, and mental processes. Contact with nature and daylight has been found to enhance emotional functioning; drawing on research from studies (EBD) on well-being outcomes and building features. Positive feelings such as calmness increase, while anxiety, anger, or other negative emotions diminish with views of nature. In contrast there is also convincing evidence that stress could be worsened and ineffective in fostering restoration in built environments that lack nature.
Few studies have shown the restorative effects of gardens for stressed patients, families and staff. Behavioural observation and interview methods in post occupancy studies of hospital gardens have shown a faster recovery from stress by nearly all garden users. Limited evidence suggest increased benefits when these gardens contain foliage, flowers, water, pleasant nature sounds, such as birds and water.

== Related approaches ==

=== Performance-based building design ===
EBD is closely related to performance-based building design (PBBD) practices. As an approach to design, PBBD tries to create clear statistical relationships between design decisions and satisfaction levels demonstrated by the building systems. Like EBD, PBBD uses research evidence to predict performance related to design decisions.
The decision-making process is non-linear, since the building environment is a complex system. Choices cannot be based on cause-and-effect predictions; instead, they depend on variable components and mutual relationships. Technical systems, such as heating, ventilation and air-conditioning, have interrelated design choices and related performance requirements (such as energy use, comfort and use cycles) are variable components.

=== Evidence-based medicine ===
Evidence-based medicine (EBM) is a systematic process of evaluating scientific research which is used as the basis for clinical treatment choices. Sackett, Rosenberg, Gray, Haynes and Richardson argue that "evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". It is used in the healthcare industry to convince decision-makers to invest the time and money to build better buildings, realizing strategic business advantages as a result. As medicine has become increasingly evidence-based, healthcare design uses EBD to link hospitals' physical environments with healthcare outcomes.

=== Research-informed design ===
Research-informed design (RID) is a less-developed concept that is commonly misunderstood and used synonymously with EBD, although they are different. It can be defined as the process of applying credible research in integration with the project team to inform the environmental design to achieve the project goals. Credible research here, includes qualitative, quantitative, and mixed methods approaches with the highest standards of rigor suitable for their methodology.
The literature for "research-informed" practices comes from education, and not from the healthcare disciplines. The process involves application of the outcomes from literature review and empirical investigation to inform design during the design phase, given the constraints; and to share the process and the lessons learnt just like in EDB.

== Research and accreditation ==
As EBD is supported by research, many healthcare organizations are adopting its principles with the guidance of evidence-based designers. The Center for Health Design developed the Pebble Project, a joint research effort by CHD and selected healthcare providers on the effect of building environments on patients and staff. Health Environment Research & Design journal and the Health Care Advisory Board are additional sources of information and database on EBD.
The Evidence Based Design Accreditation and Certification (EDAC) program was introduced in 2009 by The Center for Health Design to provide internationally recognized certification and promote the use of EBD in healthcare building projects, making EBD an accepted and credible approach to improving healthcare outcomes. EDAC identifies those experienced in EBD and teaches about the research process: identifying, hypothesizing, implementing, gathering and reporting data associated with a healthcare project.

== Process ==
There are four components to evidence-based design:

Gather qualitative and quantitative intelligence
Map strategic, cultural and research goals
Hypothesize outcomes, innovate, and implement translational design
Measure and share outcomes

=== Meta-analysis template for literature review ===
In his book Evidence-based Policy: A Realistic Perspective, Ray Pawson suggests a meta-analysis template which may be applied to EBD. With this protocol, the field will be able to provide designers with a source for evidence-based design.
A systematic review process should follow five steps:

Formulating the review question
Identifying and collecting evidence
Evaluating the quality of the evidence
Extracting, processing and systematizing data
Disseminating findings

=== Conceptual model ===
According to Hamilton, architects have a responsibility in translation of research in the field, and its application in informing designs. He further illustrates a conceptual model architects could use, that identifies four levels of addressing research and methods base on varying levels of commitment: 