The Center for Health Design Blog

EDAC and The Item Writing Workshop

As you know, CHD is developing an exam to assess individuals’ abilty to employ evidence-based design in their projects. On August 13 and 14, volunteers convened at our office to begin the process of writing examination questions. We were all surprised to learn about all the mechanics that are involved.

Our group was fearlessly led by psychometrician Robert Shaw of Applied Measurement Professionals (AMP). According to Rob, each test item should only measure one ability. By doing this, you have the best chance of measuring a candidate’s knowledge of one situation.

For half the day, Rob explained to us the process of item writing. For example, we learned that when writing the “wrong” answers, called distractors, these have to be neutral and must not cue the candidate to any one choice.

By the end of day one, I think all of us had a pretty good understanding of the item writing process. However, actually developing our own items was quite a different challenge. After Rob let us each select our assignments, everyone started writing. For most, the first item we each wrote took over an hour. I started to wonder if we were going to complete the required 300 items by the end of day two!

Well, we didn’t. We finished about 70 items. However, considering how difficult the task is, I am still extremely impressed with this number. Not only did the group write all these items, but they also started to review a few of them. This turned out to be a huge process in itself.

Because the group needs to unanimously support the terminology used to express an item as well as the available multiple choice answers, reviewing one item could take up to 30 minutes. (And this is only because Rob made us stop discussing the item.) There is no doubt that our wonderful group of EDAC volunteers is dedicated to meticulously approving the right content.

In the next few weeks, volunteers will continue to write examination items. Our goal is to produce at least 300 items by Labor Day. In September, AMP and CHD volunteers will re-convene to edit and approve many of these items. Concurrently, we are working on creating study materials to ensure that we are educating candidates to appropriately prepare them for the exam. If anything, learning the item writing process has renewed my appreciation for all of the tests I’ve taken throughout the years.

July CHD CHER Update

The CHD Coalition for Health Environments Research (CHER) has been busy these past few months. Here’s an update:

Presentations
CHD CHER Committee Members Jane Rohde, AIA, IIDA, NCARB (President, JSR Associates, Inc.) and Roger Leib, AIA, ACHA (President, Leib & Leib) presented “CHER: Exploring the Evidence” at NeoCon on June 12th in Chicago, IL. Jane and Roger gave an overview of some of the CHD CHER reports, including the most recent, ” Limiting the Spread of Infection in the Health Care Environment“.

The objective of this study was to investigate the ability of upholstery, wall finishes, and floor finishes to harbor microorganisms before and after cleaning, and to evaluate the possible microbe transmission by healthcare providers. The principal investigators (Mary G. Lankford, Susan Collins, Larry Youngberg, Denise Rooney of Northwestern Memorial Hospital and John Warren and Gary Noskin of The Feinberg School of Medicine of Northwestern University) of this study suggest that manufacturers test their products with typical hospital cleaning methods.

They recommend starting this evaluation process through the Centers for Disease Control and Prevention’s Division of Healthcare Quality Promotion (DHQP). You can view a full report on “Guidelines for Environmental Infection Control in Healthcare Facilities” on the CDC website. We encourage manufacturers to collaborate with the design and research community to re-evaluate their products.

Coming Soon
The latest CHD CHER report to be produced is coming soon! Look for “The Effect of Environmental Design on Reducing Nursing & Medication Errors in Acute Care Settings” to be posted on CHD’s website. The investigators of this study (Habib Chaudhury of Simon Fraser University and Atiya Mahmood of Oregon State University) examined the issue of errors in medical-surgical units through a literature review, a nursing survey, focus groups and site visits.

To read more about other upcoming reports and activities for CHD’s CHER Members, visit our website.

A Room with a View

This evening I was looking out my office window at Mount Diablo. From time to time, it’s important to remind myself why I became interested in the work of The Center. This is important because I never want to take things for granted - especially a view of Mount Diablo.

In 2001, I worked at a children’s psychiatric treatment facility in Washington State. The living area consisted of three lounges and 16 single bed rooms. Each lounge was furnished with heavy furniture, upholstered in a coarse material. The weight of the furniture was meant to discourage the patients from lifting and throwing chairs. The lounge carpet was also coarse and difficult to sit on for long periods of time. Each lounge was built with only one window, about 15 feet hight. The color of the entire facility was beige. Needless to say, there were few positive distractions for the staff or the patients.

One afternoon, I was assigned to take a patient to Children’s Hospital in Seattle, Washington. At the psychiatric treatment center, this patient’s (a 16 - year old girl, diagnosed with schizophrenia) demeanor was consistently subdued. However, upon entering Children’s her face brightened immediately. She happily talked about her previous experiences at Children’s and excitedly spoke about her appointment that day.

As soon as we entered Children’s, it was apparent that this hospital was extraordinarily different from the treatment facility she was used to. We were both struck by the bright murals and inclusion of nature. The patient’s face reflected the same positive environment that I noticed. That moment was a dramatic demonstration of the constrasting influences the built environment can have.

I often wonder what it would have been like to work at a treatment facility where the environment reflected the hope that we had for the patients’ future. Remembering this experience reminds me how lucky I am to be part of an organization that supports this hope (and one that gives me a room with a view!!)