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Understanding Green Building Design and Healthcare Outcomes: Evidence-Based Design Analysis of an Oncology Unit

Originally Published:
Key Point Summary
Key Point Summary Author(s):
Dickey, Andrew
Key Concepts/Context
The United States healthcare industry is a major part of the economy as well as a significant contributor to carbon dioxide emissions and other environmental issues. Green building design (GBD) attempts to offset environmental impacts of buildings, and recently designers have been combining GBD with evidence-based design (EBD) in order to create facilities that positively impact both the external and internal environment. 
This study investigates the extent to which green hospital building design and EBD affect employee performance, patient outcomes, satisfaction, and overall utilities in a women’s oncology unit.
Forty-five different metrics from a single women’s oncology unit were analyzed across a three-year period, both before and after GBD features were implemented. Additionally, a survey was distributed to assess staff and patient satisfaction and perceptiveness of the new GBD and EBD features.
Design Implications
Designers hired a staff nurse to help with the oncology unit’s new floor layout, resulting in a significant increase in employee satisfaction; this shows how multidisciplinary teams can help enhance the impact of design decisions. Additional windows within the unit generated a significant increase in satisfaction with lighting among staff members, implying that natural lighting can positively impact internal environments.
Patients responded positively to all EBD features, especially the quietness of the new oncology unit, which resulted from newly installed acoustic panels. Staff members voiced the most satisfaction with improved lighting quality, the new workspace layout, and the addition of a meditation room. Staff productivity levels remained unchanged before and after the implementation of GBD and EBD. GBD features resulted in a general downward trend in utilities per patient bed, while expenses increased due to a shift in patient cases (more patients on average).
The patient mix may have impacted results more than the authors anticipated. The authors also did not receive as many staff satisfaction survey responses as they had hoped, and also noted that the survey questions themselves were rather difficult to answer. Lastly, a single 28-bed oncology unit is a relatively small sample size. 
Design Category
Acoustic Environment|Building location/site optimization|Furniture, Fixtures & Equipment (FF&E)|Lighting (artificial and natural)|Unit configuration and layout|Ventilation and air-conditioning system
Outcome Category
Environmental impact|Patient / resident satisfaction and comfort|Staff health outcomes|Staff productivity / efficiency|Staff satisfaction|Organizational outcomes
Environmental Condition Category
Attractiveness of physical environment|Environmental hygiene|Lighting|Patient Satisfaction and Comfort|Sound|Thermal condition
Key Point Summary Author(s):
Dickey, Andrew
Primary Author
Campion, N.