Evidence Based Design in Architecture
Using Credible Research to Enhance Building Design
Nov 27, 2008
Most visitors or patients in healthcare settings have known the experience of feeling lost navigating the halls. Hospitals are big, complex buildings not known for their hospitality factor. Health care environments are also associated with a high incidence of staff injury and burnout.
There is good news: designers are learning from past experience and are conscientiously researching how to design health care settings to promote healing, layout efficiency, and patient and employee safety and wellbeing. With a rigor characteristic of social sciences research, architectural firms are applying the principles of evidence based design (EBD) to improve building outcomes.
The Center for Health Design, an American institute, defines EBD as “the process of basing decisions about the built environment on credible research to achieve the best possible outcomes.” It is a design methodology that is proving itself in health care design by improving operational efficiencies and occupant comfort and well being.
EBD’s Place in the Design Process
Architecture is typically realized in four distinct stages:
- Pre-design, the information-gathering stage between client, user groups, and the architect
- Design, during which concept plans are created and a final design selected for detailing; architectural and engineering drawings are prepared; permission to build is sought from municipal authorities and the building is put out for tender to the construction trades
- Construction, during which infrastructure is installed and the building erected, and
- Post-construction and evaluation, a phase when occupants rate their experience in the building and fine-tuning occurs.
EBD typically occurs during the pre-design phase, and again during post-construction and evaluation. In the past, pre-design has often been a poor cousin to design, with clients reluctant to spend the resources on thorough research which is used to inform design. Health care facilities are so expensive to build, and have such a profound impact on health and wellness of both staff and patients, that paying lip service to pre-design is not an option.
Credible Research Informs Design
Research in health care settings takes different forms: from observation of staff at work to drawing exercises with children to uncover their unconscious fears about being in a hospital setting. Traditional design research methods such as focus groups, surveys and key informant interviews are being supplemented with innovative techniques like photography to help users better understand obstacles in their work environment.
Canadian architecture firm Cohos Evamy integratedesign™ has developed an approach involving three levels of practice in EBD. The firm’s approach distinguishes between entry-level research and more rigorous, peer-reviewed practices.
The three levels are Exploratory, Empirical, and Strategic Inquiry. With each progressive level, architects improve their original research and reporting practices, opening up their research methods to scrutiny from fellow practitioners.
In an effort to verify EDB’s value in buildings where it is deployed, Cohos Evamy has developed a framework entitled the Building Performance Evaluation Methodology. Conceived in response to the need of Alberta Infrastructure for a way of measuring return on investment, the framework incorporates the ideas of a balanced scorecard.
The framework recognizes that health care design impacts not only operational factors and the fiscal bottom line, but also length of patient hospital stays and employee recruitment, retention, and absenteeism. Cohos Evamy is currently utilizing the methodology in the design of its airport projects.
When it comes to health care design, EBD’s credentials are not in doubt. Its application in other fields of architecture will require that architects apply rigorous research in the pre-design phase more seriously. Clients will need to be educated about its merits. Ultimately, the public purse and building users will be the big winners.
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