Redefining “Evidence-Based Design”
The beauty of words, terms and phrases in any language lies in understanding that their meanings can evolve over time as dictated by cultural and societal changes. There are many definitions of “evidence-based design” currently in circulation in the healthcare design community that focus on the use of evidence and creating hypotheses in the service of patient, family, staff outcomes.
As an organization, we feel that it is time to reconcile those different interpretations, and articulate a CHD endorsed definition that captures where our industry is today. The new definition was recently drafted in a collaborative effort by a group of 15 industry experts, including CHD Board members and staff, and can be read below. We welcome your comments.
Evidence-Based Design is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes. (Source: The Center for Health Design)
July 31st, 2008 at 9:51 pm
Evidence-Based Design demands credible research to inform its practice.
The above CHD definition seems too ambiguous in using the term “best possible outcomes.” “Best possible outcomes” as a standard is hardly used in clinical or regulatory standards. Rather, standards are far more specific. It seems to me that the objective of defining EBD is to do so in a way that separates what it is from what it is not.
August 1st, 2008 at 12:08 pm
In response to Ms. Mazer’s comments, we purposely kept the “best possible outcomes” ambiguous because we see evidence-based design as a process that can, and is, being used in all types of building projects — not just healthcare.
August 4th, 2008 at 12:46 pm
Please define “credible research”. Is CHD suggesting the rigor of true scientific research or some standard below what is widely accepted as the “scientific method”?
Per Susan Mazer’s comment and Sara Marberry’s reply; I do not think you can excuse not defining “best possible outcomes” by simply stating CHD avoided it because EBD can be used across the entire realm of architecture. Everyone agrees the built environment is a significant factor in the health and well being of society but, it is not the only factor. The struggle most of us have in developing true scientific research (EBD) in the field of architecture is that it is difficult to isolate the effects of the built environment on health and well being. We have much work to do as a profession as we head down this path and providing loose definitions that are left to interpretation. “Credible Research” and “best possible outcomes” are both ambiguous, and until we can better define what they mean I think we still have much serious work ahead in defining EBD.
August 5th, 2008 at 10:30 am
In response to Ed Huckaby and Susan Mazer’s comments - as Sara mentioned we created a more general definition for evidence based design because it is extremely relevant to other types of settings as well - schools, long terms care, housing, etc - where the best possible outcomes might be different - for example - increased social engagement and activity participation among assisted living residents. It is our intent to create a supporting definition to this one that specifically addresses healthcare issues and outcomes.
I completely agree with Mr. Huckaby’s comment regarding the need for careful definition of terms in this growing field of evidence based design. The Center’s research council has identified EBD taxonomy as a key area of focus for developing a stronger foundation for all our work. We will be doing some serious work on taxonomy in the near future. Meanwhile, we have done some work around defining terms especially around research through EDAC (Evidence Based Assessment and Certification Program)and this will be available through the EDAC study guides (to be published soon).
August 7th, 2008 at 3:19 pm
Some interesting thoughts on the subject of EBD from SmithGroup’s Jens Mammen over at the HEALTHCARE DESIGN Web site. Sorry for the long URL!
http://www.healthcaredesignmagazine.com/ME2/dirmod.asp?sid=&nm=&type=Blog&mod=BlogTopics&mid=67D6564029914AD3B204AD35D8F5F780&tier=7&id=FF556EBDA5EB4C8DBC4763493E0B98C2