Business Case for Building Better Hospitals Through Evidence-Based Design

by Blair L. Sadler, J.D.; Jennifer R. DuBose, M.S.; Eileen B. Malone, RN, MSN; Craig M. Zimring, Ph.D.

Published by The Center for Health Design and Georgia Institute of Technology, College of Architecture, 2008

This paper is adapted from a full-length article, “The Business Case for Building Better Hospitals Through Evidence-Based Design” by Blair L. Sadler, Craig Zimring, and Jennifer DuBose originally published in the spring 2008 issue of HERD (Health Environments Research and Design Journal), Vol. 1, No. 3. For more information about HERD, visit the Web site at www.herdjournal.com.

EXECUTIVE SUMMARY

Building a new hospital or undertaking a major renovation is likely to be the biggest financial decision that a CEO or hospital board of trustees will ever make. There is a growing body of evidence that now links the physical environment with safety and quality outcomes for patients and staff. As part of their management and fiduciary responsibilities, hospital leaders and boards must base decisions about built-environment investments that include cost-effective evidence-based design (EBD) interventions in their strategic plan and investment portfolio or risk suffering the economic consequences in an increasingly competitive and transparent environment.

This paper provides an EBD toolkit for leaders to use when considering a major building project, as well as a proposed return-on-investment framework to evaluate the business case for each EBD feature included. These features, when combined with a transformation of the organization’s culture and processes, maximize the capital investment by quantifiably improving patient safety and quality, enhancing workforce recruitment and retention, and producing a significant multiyear return on investment.