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Healthcare Leadership White Papers (five)

The Business Case for Building Better Hospitals Through Evidence-Based design - October 2008

This paper offers an evidence-based design (EBD) toolkit to use when considering a major building project, as well as a return on investment framework to evaluate the business case for each EBD feature under consideration.

Implementing Healthcare Excellence: the Vital Role of the CEO in Evidence-Based Design - October 2008

This paper identifies 10 strategies that reflect leadership approaches shared by CEOs who bridged the gap between aspiration and reality.

Culture Change and Facility Design: A Model for Joint Optimization - October 2008

The inspirational stories in this paper address the benefits of productive dialogue between agents of culture change and those involved with facility design.

Maximizing the Impact of Nursing Care Quality - October 2008

Learn about the evidence relating to nursing work processes and their inseparability from physical space, infrastructure, and patient safety. This paper highlights potential solutions to promote transformational change in the nursing work environment.

A Review of the Research Literature on Evidence-Based Healthcare Design - October 2008

Building on a literature review conducted by Texas A&M University and Georgia Institute of Technology in 2004 that identified more than 600 evidence-based design studies, this update found nearly 600 new rigorous scientific studies that can guide hospital design.

The Center for Health Design CHER (Coalition for Health Environments Research) Paper

The Impact of Healthcare Environmental Design on Patient Falls - July 2008

A critical review of the research literature and development of recommendations for the design of environments for older persons in independent living, assisted living, skilled nursing facilities, and other healthcare settings.

The Center for Health Design CHER (Coalition for Health Environments Research) Paper

The Effect of Environmental Design on Reducing Nursing and Medication Errors in Acute Care Settings - November 2007

A comprehensive review of the empirical literature followed up with interviews with nurses at seven hospitals. The study concludes with specific recommendations about environmental interventions that can support the reduction of errors in the nursing unit.

The Center for Health Design CHER (Coalition for Health Environments Research) Paper

Limiting the Spread of Infection in the Health Care Environments - April 2007

A study of 14 common building materials and finishes in the healthcare environment. Inoculation of common harmful organisms is followed by rigorous testing in the laboratory to determine the ability of each material to sustain and propagate these organisms.

Issue Paper #4

Sound Control for Improved Outcomes in Healthcare Settings - January 2007

This paper examines how different aspects of sound—noise, speech privacy, speech intelligibility, and music—impact patient and staff outcomes in healthcare settings and the specific environmental design strategies that can be used to improve the acoustical environment of healthcare settings.

Issue Paper #3

The Role of the Physical and Social Environment in Promoting Health, Safety, and Effectiveness in the Healthcare Workplace - November 2006

The physical environment plays an important role in improving the health and safety for staff, increasing effectiveness in providing care, reducing errors, and increasing job satisfaction. Proper design of healthcare settings, along with a culture that prioritizes the health and safety of the care team through its policies and values, can reduce the risk of disease and injury to hospital staff and provide the necessary support needed to perform critical tasks.

White Papers

Designing the 21st Century Hospital:  Environmental Leadership for Healthier Patients, Facilities, & Communities - September 2006

The nation’s healthcare system is anticipating a hospital construction boom worth $200 billion over the next decade. At this pivotal moment, hospitals leaders are asking, what is the role of hospitals in the 21st century in improving patient and community health? Evidence suggests that when hospitals adopt green building and design approaches that minimize ecological harm, patient healing and staff satisfaction increases, and hospitals serve as leading environmental stewards in their communities.

Research Summary

Health Promotion by Design in Long Term Care Settings - August 2006

The prevalence of chronic conditions is projected to increase dramatically with the aging of the population. In fact, by year 2030, nearly 150 million Americans will have a chronic condition. Consequently, the need for quality long-term care will also increase in the years to come. This report, which was prepared for the Laguna Honda Foundation with funding from the California HealthCare Foundation, assesses the state of the science linking the physical environment with resident and staff outcomes in long-term care settings.

Issue Paper #2

The Impact of Light on Outcomes in Healthcare Settings - August 2006

Studies show that higher light levels are linked with better performance of complex visual tasks and light requirements increase with age. By controlling the body’s circadian system, light impacts outcomes in healthcare settings by reducing depression among patients, decreasing length of stay in hospitals, improving sleep and circadian rhythm, lessening agitation among dementia patients, easing pain, and improving adjustment to night-shift work among staff. This issue paper was funded by a grant from the Robert Wood Johnson Foundation.

Issue Paper #1

The Impact of the Environment on Infections in Healthcare Facilities - July 2006

Hospital-acquired infections, or nosocomial infections, are one of the leading causes of death in the United States —- killing more Americans than AIDS, breast cancer, or automobile accidents. In 1995 alone, nosocomial infections contributed to more than 88,000 deaths -- one death every six minutes -- and cost $4.5 billion. This issue paper was funded by a grant from the Robert Wood Johnson Foundation.

CHER (Coalition for Health Environments Research) Paper

The Impact of Single-Room Neonatal Intensive Care on User's Health and Satisfaction - 2006

A recent trend in the design of neonatal intensive care facilities has been to increase the number of private patient rooms for neonates and their families. The purpose of this study is to explore the implications of single family rooms (SFRs) relative to open-bay arrangements in neonatal intensive care units (NICUs).

Research Summary

The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity - June 2004
The hospital industry is in the throes of a major building boom:  In the next decade, an estimated $200 billion will be spent on new hospital construction across the United States.  At the same time, a new analysis of more than 600 research studies by The Center for Health Design shows a direct link between patient health and quality of care and the way a hospital is designed. This research summary was funded by a grant from the Robert Wood Johnson Foundation.

CHER (Coalition for Health Environments Research) Paper

Color in Healthcare Environments: A Critical Review of the Reserach Literature - 2004

Many healthcare providers, designers and practitioners in the field have questioned the relationship between people and color in the environment and searched for empirical reasoning for the various color guidelines in healthcare settings. The evidence-based knowledge, however, for making informed decisions regarding color application in the designed environment has been sporadic, fragmented, conflicting, anecdotal, and loosely tested.

CHER (Coalition for Health Environments Research) Paper

The Use of Single Patient Rooms vs. Multiple Occupancy Rooms in Acute Care Environments- 2004

A study funded by The Facility Guidelines Institute. Simon Fraser University (SFU) was selected for the project, Habib Chaudhury, PhD, Assistant Professor, Gerontology Programs and Research Centre is the principal investigator.

CHER (Coalition for Health Environments Research) Paper

The Nature and Rate of Change in Clinical Laboratories - September 2003

Advances in information and automation systems, as well as services and point-of-care testing are influencing laboratory workplaces nationwide. This 56-page report is a must-read for those who want to know how these changes are affecting the need for flexible building designs and furnishings.

Research Report

An Investigation to Determine Whether the Built Environment Affects Patient's Medical Outcomes - 1998
Is it possible to save money and realize a greater payback from the built environment if design decisions were grounded in scientifically valid information? Based on an extensive review of existing literature in the late 1990s, this initial review of evidence-based design studies includes suggested design applications and a list of credible studies.

Research Report

Consumer Perceptions of the Healthcare Environment -- An Investigation to Determine What Matters - 1998
What do patients notice in the built environment when they go to a doctor's office, a hospital, or a nursing home? This research report is based on focus-group interviews with patients, families, and healthcare professionals.

Research Report

Gardens in Healthcare Facilities: Uses, Therapeutic Benefits, and Design Recommendations - 1995
What specific elements and qualities in hospital gardens seem to be the most related to a change of mood? Based on a number of case study evaluations, this award-winning report provides convincing evidence.

Research Report

A Guide to Conducting Healthcare Facility Visits - 1994
If you are spending thousands of dollars to do a site visit, don't you want it to be worthwhile? Over 40 professionals in the architecture and healthcare fields were interviewed for this report to find out how to make the investment in site visits be more worthwhile.

Research Report

Design Evaluation of Six Primary Care Facilities for the Purpose of Informing Future Design Decisions - 1993
Primary care is a diverse, changing, and critically important part of America's healthcare system. This case study research identifies a set of critical design issues faced by many involved in the design, development, and operation of primary care facilities.