EBD is Not ‘Medical Feng Shui’
Yesterday, Maureen Larkin posted an article for HealthLeaders Media Quality Leaders e-newsletter on Emory Hospital’s new ICU titled “Medical Feng Shui.” She opened her article with these words: “We’ve all seen the designers on the home improvement networks talking about the design and flow of a home and how it can effect a person’s energy. Turns out that feng shui is a valid concept in healthcare, too. We just call it evidence-based design.”
Now perhaps Ms. Larkin thought she had come up with a compelling lead to her article, but I respectfully have to disagree with her interpretation. Comparing evidence-based design (EBD) to feng shui is like comparing apples to oranges. They may both look at how the design of the built environment affects behavior, but EBD is based on solid, scientific evidence — more than 1,500 studies and growing every day — that document the built environment’s impact on outcomes. Feng shui has no such scientific rigor behind it.
I’m not saying that there isn’t something to the ancient Chinese art of placement, but feng shui isn’t even in the same league as evidence-based design. According to researchers Roger Ulrich, Ph.D., and Craig Zimring, Ph.D., the 1,500 studies show clear links between the built environment and patient outcomes, including safety issues like infections, medical errors, falls and injuries, confidentiality and privacy, and also other outcomes such as stress, sleep, spatial orientation, pain, depression, social support, communication, length of stay, and satisfaction.
They also link building design to staff outcomes, such as stress, safety, effectiveness and efficiency, and satisfaction. In addition, there are clear financial implications to many of these outcomes, which can affect operational performance.
Ulrich and Zimring’s latest review of the evidence-based design literature (a project funded by the Robert Wood Johnson Foundation in association with the Georgia Institute of Technology and The Center for Health Design) is being published in the Spring 2008 issue of the HERD journal, which is coming out this week.