Review of the Research Literature on Evidence-Based Healthcare Design

Sep 01, 2008

Objective: This report surveys and evaluates the scientific research on evidence-based healthcare design and extracts its implications for designing better and safer hospitals.

Background: This report builds on a literature review conducted by researchers in 2004.

Methods: Research teams conducted a new and more exhaustive search for rigorous empirical studies that link the design of hospital physical environments with healthcare outcomes. The review followed a two-step process, including an extensive search for existing literature and a screening of each identified study for the relevance and quality of evidence.

Results: This review found a growing body of rigorous studies to guide healthcare design, especially with respect to reducing the frequency of hospital-acquired infections. Results are organized according to three general types of outcomes: patient safety, other patient outcomes, and staff outcomes. The findings further support the importance of improving outcomes for a range of design characteristics or interventions, including single-bed rooms rather than multibed rooms, effective ventilation systems, a good acoustic environment, nature distractions and daylight, appropriate lighting, better ergonomic design, acuity-adaptable rooms, and improved floor layouts and work settings. Directions for future research are also identified.

Conclusions: The state of knowledge of evidence-based healthcare design has grown rapidly in recent years. The evidence indicates that well-designed physical settings play an important role in making hospitals safer and more healing for patients and better places for staff to work.

Roger S. Ulrich
Craig Zimring, PhD
Xuemei Zhu
Jennifer DuBose, MS
Hyun-Bo Seo
Young-Seon Choi
Xiaobo Quan
Anjali Joseph
Published & professionally reviewed by: 
The Center for Health Design

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