Most of the ones I can think of refer to terms to describe types of people/professions — policemen are police officers; postman is a mail carrier; old people are seniors. But some refer to things or conditions — a man hole is a utility cover; handicapped is physically challenged. You get the picture.

So, remember the term “old people’s homes?” That’s what we used to call nursing homes. Then nursing homes became long-term care facilities and then senior living facilities — assisted living, continuing care retirement centers — came along.

Some think that long-term care and senior living are not the right terms to describe the industry. The Guidelines for the Design and Construction of Health Care Facilities now calls it “residential care” and includes adult day care in the mix.

The Veteran’s Administration used to offer our nation’s rehabbing and aging veterans care in VA Nursing Home facilities, but it’s recently changed the name of the program to “Community Living Centers.”

All of these are a lot better than old people’s homes, but I still think there needs to be some consensus on what to call what. Personally, I like the term, “residential care” to describe the industry, but I’m not sure if most nursing homes are really community living centers.

Maybe they are. At least we’re moving toward a more politically correct society when it comes to caring for our seniors and disabled — I mean physically challenged — individuals.

As reported in Health Facilities Management, some in the industry are alarmed by a bill introduced by Senator Al Franken last October to protect staff from injuries related to manual patient lifting — not because of its intent, but because the timeline for its implementation might not allow enough time to make changes to the built environment to install the lifts.

What’s more, the Revisions Committee of the Guidelines for Design and Construction of Health Care Facilities worked with experts to develop patient handling and movement assessment standards — and published a very comprehensive white paper on the subject, with can be downloaded free from the Facility Guidelines Institute’s (FGI) website.

There is great potential for innovation in this area — especially in equipment and technology used to support patient handling and movement. Kudos to FGI and the Guidelines Committee for helping to push the industry forward at the pace it needs to go.

He recently shared his perspective on the growing interest in evidence-based design (EBD) and the challenges that come with applying it in New Zealand.

There remains a great deal of interest with respect to evidence-based design in New Zealand from both from individual hospitals and the Government. The “National Infrastructure Plan” is a guidance document produced by our government to address challenges to our infrastructure including healthcare facilities and its plan to meet them.

Either way it is agreed that an evidence-based approach is the logical path.

“Kasian has an established reputation for working collaboratively and productively with its clients to create leading-edge healthcare facilities,” says Milton Gardner, principal and head of Kasian’s healthcare sector. “Our focus with each project is to create inviting spaces that provide a healthy, supportive and healing environment for patients and staff. We are proud to be at the forefront of healthcare planning and pleased to demonstrate our commitment to evidence-based design by becoming an EDAC Advocate Firm.”

“We are excited that this innovative Canadian firm with its extensive international portfolio of work is engaging in the EDAC program. We look forward to learning from Kasian’s experience and spreading knowledge of the evidence-based design process globally,” said Debra Levin, president and chief executive officer at The Center for Health Design.

The Center for Health Design launched the EDAC exam in April 2009 after publishing a set of study guides to augment exam preparation. A second edition of study guides will be available in August 2010. EDAC’s mission is to develop a community of accredited industry individuals through education and assessment of an evidence-based design process. To date, more than 425 individuals among eight countries across the globe are now accredited. For more information about the EDAC program, visit www.healthdesign.org/edac.

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The Center for Health Design (CHD), formed in 1993, is a nonprofit research and advocacy organization of forward-thinking healthcare, elder care, design and construction professionals and product manufacturers who are leading the quest to improve the quality of healthcare facilities and create new environments for healthy aging. Its voluntary board of directors guides the work of paid staff that manages and directs the organization’s research, education, and advocacy efforts. For more information, visit www.healthdesign.org.

Kasian Architecture Interior Design & Planning is a keen advocate of evidence-based design. The firm creates sustainable, award-winning spaces that promote and support health and well-being. Kasian’s landmark projects include the 44 acre South Health Campus in Alberta, the largest greenfield social infrastructure project under construction in North America; Alberta Children’s Hospital, the first free-standing pediatric facility to be built in Canada in more than 20 years; and the innovative Surrey Outpatient Care and Surgery Center, which provides the first dedicated facility for outpatient surgeries, diagnostic procedures, specialized clinics and community programs in British Columbia. To learn more about Kasian, please visit www.kasian.com

CONCORD, CA (August 5, 2010)—Intravenous pump alarms and conversations between nurses are essential to hospital patient care, but they are also highly likely to keep patients from getting a good night’s sleep, according to a newly released, landmark study from The Center for Health Design (CHD).

“Evidence-based design meets evidence-based medicine: The sound sleep study” is the first study to identify decibel (dB) levels at which 14 typical hospital sounds are too loud for undisturbed sleep. The study’s results and recommendations are expected to drive innovation in design, construction, materials, equipment and care protocols to improve acoustics in healthcare environments, positively impacting medical outcomes and increasing safety.

The sound-sleep study was conducted by two Harvard researchers in Massachusetts General Hospital’s sleep laboratory. While participants slept, researchers played recordings of 14 different noises typically heard in a medical-surgical unit. Arousal information confirmed that at levels commonly experienced by patients, the selected hospital sounds significantly disrupted sleep.

For example, at the lowest sound level tested, 40 dB, intravenous alarm and phone signals aroused 88-94% of subjects; human voices aroused 70-75% of subjects; the sounds of an automatic towel dispenser, ice dispenser, door closing and toilet flushing aroused 35-73% of subjects.

Improving the acoustic environment

National surveys of hospital patients have shown that room noise levels received ratings that were worse than other quality of care indicators. Similarly, disrupted and/or limited sleep has been demonstrated to have adverse impacts on several important health measures and outcomes including blood pressure, weight gain, heart disease, pain, stress levels, and inflammation.

Getting a good night’s sleep contributes to higher patient satisfaction and aids in recovery, resulting in improved medical outcomes, shorter hospital stays and reduced costs.

The new sound-sleep study contributes to the growing effort of improving environments of care and related health outcomes. It contributes scientific evidence validating the provision of minimum acoustic standards recently established in the 2010 edition of the “Guidelines for Design and Construction of Health Care Facilities.’’

Sponsored by CHD through its Research Coalition, Facilities Guidelines Institute, and Academy of Architecture for Health Foundation, the study’s principal investigators included Jo M. Solet, PhD, Orfeu M. Buxton, PhD and Jeffrey M. Ellenbogen, MD, all from Harvard Medical School, Division of Sleep Medicine.

“The new sleep-sound study provides valuable knowledge to the growing field of evidence-based design,” says Debra Levin, president and chief executive officer, CHD. “The report is a valuable tool for designers who are working to improve the quality of healthcare environments. We look forward to seeing the findings of this study utilized in the field.”

“This is one the most exciting studies looking at the impact of hospital sounds on patient well-being,” adds Paul Barach, co-chair of CHD’s Research Coalition. “This is an important and new frontier that promises to enrich our understanding of how external factors, including the sounds and vibrations in healthcare facilities, can improve the quality of care that healthcare delivers.”

“Evidence-based design meets evidence-based medicine: The sound sleep study” is available by free download from CHD’s online store: store.healthdesign.org, under White Papers & Reports.

“Guidelines for Design and Construction of Health Care Facilities” is available from Facility Guidelines Institute: www.fgiguidelines.org/2010guidelines.html

About The Center for Health Design
The Center for Health Design (CHD) formed in 1993, is a nonprofit research, education and advocacy organization of forward-thinking healthcare, elder care, design and construction professionals and product manufacturers who are leading the quest to improve the quality of healthcare facilities and create new environments for healthy aging. The CHD Research Coalition promotes the dissemination of research that contributes to therapeutic, safe, efficient and effective healthcare settings. The group also strives to support projects that fill critical gaps in the field of evidence-based design (EBD) while growing the network of researchers engaged in EBD by rewarding funds to select EBD research projects. For more information, visit www.healthdesign.org

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We have been having a very interesting time in China. I have met with architects and Ministry of Health officials in Beijing and Nanjing and am heading to Shanghai. The people I met have great interest in evidence-based design and evidence-based best practice examples.

We did get a few days to walk in the rice paddies in the countryside; it’s lovely and calm, with a uniquely Chinese combination of water buffalos plowing the fields and Internet access.

Ray Pentecost, the current president of the American Institute of Architects Academy of Architecture for Health (AIA/AAH) also gave a presentation. He spoke about a “national knowledge strategy” that the AIA is looking to adopt. Basically what this means is that the AIA is acknowledging that architecture is a knowledge-driven business and that any building type is going to be knowledge-driven.

For educators, the key question is whether they are training people about architecture or to be architects?

Pentecost explained that for the AIA/AAH, this means that architecture has to be central in the discussion about personal health and that it is looking to shift its focus from healthcare design to creating healthy buildings. Which is interesting, because that’s exactly the bigger long-term vision of The Center for Health Design.

It’s why we didn’t call ourselves The Center for HealthCARE Design. We always thought that design could improve peole’s health and well-being in any building type — we just focused on healthcare first because it was the area of expertise of our founders.

Pentecost posed the question to the educators about what that would mean for design education. A rich discussion followed, in which several professors in the room said that the approach to education has to be interdisciplinary — involving not just the schools of architecture, but also the schools of interior design, engineering, construction, landscape architecture, and public health.

Pentecost urged this group to write a white paper outlining the challenges and opportunities of such an approach. It will be interesting to see what comes of this dialog and thinking.

Laguna Honda Hospital & Rehabilitation Center, San Francisco, designed by Anshen+Allen Architects and Stantec Architecture (LEED Silver).

Jersey Shore University Medical Center, Neptune, NJ, designed by WHR Architects (LEED Gold).

Arlington Free Clinic, VA, designed by Perkins+Will (LEED Gold)

I proud to say that two of these organizations — Laguna Honda and Jersey Shore — are members of The Center for Health Design’s Pebble Project research initiative.

It’s good to see that more healthcare organizations are realizing that health outcomes and sustainability are compatible. And that many evidence-based design strategies support designing a facility to meet LEED criteria — including reducing toxins and energy use through materials, air-handling systems, water processing systems, and lighting.

But, the LEED for Healthcare rating system hasn’t been without it’s critics. Gary Cohen, President of Health Care Without Harm(HCWH), wrote a commentary in Modern Healthcare last month criticizing the U.S. Green Buildings Council for removing all language about persistent bioaccumulative toxic (PBT) chemicals (including dioxin and halogenated materials) from LEED for Healthcare credits.

“Without these material credits, LEED for Healthcare falls short of providing guidance and credits to the healthcare sector for reducing toxic materials in healthcare buildings,” he wrote, stating that there remains “fundamental” differences between LEED for Healthcare and the Green Guide for Healthcare that was developed under HCWH’s guidance.

Whatever the shortfalls of LEED, healthcare is moving in the right direction toward a more sustainable future.

“Visions in Architecture is dedicated to improving the lives of others through culture and the built environment. We believe that we can make a positive impact on those who are vulnerable through the design of buildings that protect and uplift its occupants,” says Doug Elting, managing principal at VIA. “EDAC provides an avenue to spread the message about what works and what does not work. We can only make progress by learning from the successful and unsuccessful attempts of others. In order to have value and impact, our design concepts must be properly researched and documented and the results openly shared. It is our intent to have all members of our design staff become accredited.”

VIA recognizes that there are opportunities for a healthcare design firm that is both creative and agile, and therefore believes that there can be no greater calling than to improve the lives of others through the design of healthcare facilities that are safe, effective, and uplifting. Since 2005, VIA has strived to create environments that replace fear and stress with peace and anticipation.

“VIA has been a loyal supporter of CHD for many years, and its staff brings valuable knowledge and interdisciplinary experience that will help further evidence-based design, so we’re excited to welcome it into this growing program,” says Debra Levin, president and chief executive officer of The Center for Health Design.

The Center for Health Design launched the EDAC exam in April 2009 after publishing a set of study guides to augment exam preparation. A second edition of study guides will be available in August 2010. EDAC’s mission is to develop a community of accredited industry individuals through education and assessment of an evidence-based design process. To date, more than 425 individuals in eight countries across the globe are now accredited. For more information about the EDAC program, visit www.healthdesign.org/edac.

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About The Center for Health Design
The Center for Health Design (CHD), formed in 1993, is a nonprofit research and advocacy organization of forward-thinking healthcare, elder care, design and construction professionals and product manufacturers who are leading the quest to improve the quality of healthcare facilities and create new environments for healthy aging. Its voluntary board of directors guides the work of paid staff that manages and directs the organization’s research, education, outreach and advocacy efforts. For more information, visit www.healthdesign.org

About Visions in Architecture
Visions in Architecture believes that there are opportunities for a healthcare design firm that is both creative and agile. VIA believes that there can be no greater calling than to improve the lives of others through the design of healthcare facilities that are safe, effective and uplifting. We strive to create environments that replace fear and stress with peace and anticipation. We leverage the best technology available into a holistic process that pays dividends in savings and value to our clients. For more information visit www.visionsinarchitecture.com

“For years Peters and Associates has provided clients with facilities that meet the needs of their residents. We continually research new methods of care and their effects on the built environment. When we learned about EDAC, we easily saw the need share our experiences with the health design community, and also learn new aspects of delivering the best building possible for the resident,” says Don Peters, president of Peters and Associates.

Recent trends in the extended care field have placed emphasis on the dignity and independence of residents and patients with designs featuring private rooms, each with their own toilet and bathing facilities. The “medical model” is being replaced with a more personalized environment with enhanced residential amenities. Peters and Associates’ has provided design services on other healthcare design projects including medical clinics, therapy rehab facilities, and wellness centers.

“Peters and Associates brings a new perspective with its experience in elder care to the EDAC program,” says Debra Levin, president and chief executive officer of The Center for Health Design. “Now that long-term care specialists are recognizing the need for EDAC, we’re hopeful that the program will reach its vision of seeing evidence-based design used in all healthcare environments.”

The Center for Health Design launched the EDAC exam in April 2009 after publishing a set of study guides to augment exam preparation. A second edition of study guides will be available in August 2010. EDAC’s mission is to develop a community of accredited industry individuals through education and assessment of an evidence-based design process. To date, more than 425 individuals among eight countries across the globe are now accredited. Peters and Associates is the twelfth advocate firm in addition to one educational partner, and six champion firms. For more information about the EDAC program, visit www.healthdesign.org/edac.

EDAC Study Guides are available to help individuals prepare for an exam, which then assesses their understanding of how to base healthcare design decisions on credible research evidence and project evaluation results.

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About The Center for Health Design
The Center for Health Design (CHD), formed in 1993, is a nonprofit research and advocacy organization of forward-thinking healthcare, elder care, design and construction professionals and product manufacturers who are leading the quest to improve the quality of healthcare facilities and create new environments for healthy aging. Its voluntary board of directors guides the work of paid staff that manages and directs the organization’s research, education, outreach and advocacy efforts. For more information, visit www.healthdesign.org

About Peters and Associates, Architects, P.C.
Peters and Associates, Architects, P.C. has continuous concentrated experience with a full range of projects within the eldercare environment. The firm’s completed works includes 80 individual projects in the eldercare field including skilled care, assisted living, independent living, Alzheimer’s care, and a host of related support projects. To learn more visit www.petersarchitects.com