Evidence-based design: Difference between revisions

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The evidence-based design movement began in the 1970s with [[Archie Cochrane|Archie Cochranes's]] book ''Effectiveness and Efficiency: Random Reflections on Health Services''.{{sfn|Cochrane|1972}} to collect, codify, and disseminate "evidence" gathered in randomised controlled trials relative to the built environment. A 1984 study by Roger Ulrich<ref>{{Cite journal|last=Ulrich|first=R. S.|date=1984-04-27|title=View through a window may influence recovery from surgery|journal=Science|language=en|volume=224|issue=4647|pages=420–21|doi=10.1126/science.6143402|issn=0036-8075|pmid=6143402|bibcode=1984Sci...224..420U|citeseerx=10.1.1.669.8732}}</ref> seemed to support Nightingale's ideas from more than a century before: he found that surgical patients with a view of nature suffered fewer complications, used less pain medication and were discharged sooner than those who looked out on a brick wall; and laid the foundation for what has now become a discipline known as evidence-based design. Studies exist about the psychological effects of lighting, carpeting and noise on critical-care patients, and evidence links physical environment with improvement of patients and staff safety, wellness and satisfaction.<ref name=":1" /> Architectural researchers have studied the impact of hospital layout on staff effectiveness,<ref>{{Cite journal|vauthors=Clipson CW, Johnson RE |date=1987|title=Integrated approaches to facilities planning and assessment|journal=Planning for Higher Education|volume=15|issue=3|pages=12–22}}</ref><ref>{{Cite book|title=Planning for cardiac care: A guide to the planning and design of cardiac care facilities|author1=Clipson, CW |author2=Wehrer, JJ |name-list-style=amp |publisher=Health Administration Press|year=1973|___location=Ann Arbor, MI}}</ref> and social scientists studied guidance and [[wayfinding]].<ref>{{Cite book|title=Design that cares: Planning health facilities for patients and visitors, 2nd edition.|vauthors=Carpman J, Grant M |publisher=American Hospital Publishing|year=1993|___location=Chicago, IL}}</ref> In the 1960s and 1970s numerous studies were carried out using methods drawn from behavioural psychology to examine both people’s behaviour in relation to buildings and their responses to different designs – see for example the book by David Canter and Terence Lee <ref>Canter, D and Lee, T, (1974) Psychology and the Built Environment, Wiley, New York.</ref> More recently, architectural researchers have conducted [[post-occupancy evaluation]]s (POE) to provide advice on improving building design and quality.<ref>{{Cite book|title=Building evaluation techniques |editor=Baird, G. |editor2=Gray, J. |editor3=Isaacs, N. |editor4=Kernohan, D. |editor5=McIndoe, G. |publisher=McGraw-Hill|year=1996|___location=New York}}</ref><ref>{{Cite book|title=Handbook of environmental psychology|last=Zimring, CM|publisher=Wiley|year=2002|editor1=Bechtel RB |___location=New York|pages=306–23|chapter=Postoccupancy evaluation: Issues and implementation}}</ref> While the EBD process is particularly suited to healthcare, it may be also used in other fields for positive health outcomes and provision of [[healing environments]].

While healthcare proved to be one of the most prominent sectors to examine the evidence base for how good design benefits building occupants, visitors and the public, other sectors also have considerable bodies of evidence. And, many sectors benefit from literature reviews that draw together and summarise the evidence. In the UK some were led by the UK Commission for Architecture and the Built Environment, a government watchdog established by [[Labour Party (UK)|the Labour Party]] following its election in 1997 and commitment to improving the quality of the UK stock of public sector buildings. Other reviews were supported by various public or private organisations, and some were undertaken in academia. Reviews were undertaken at the urban scale, some were cross-sectoral and others were sector based (hospitals, schools, higher education). An academic paper by [[Sebastian Macmillan]]<ref>Macmillan, S, (2006) Added Value of Good Design, Building Research and Information, 34 (3) 257-271.</ref>) gives an overview of the field as it was in 2006.

==A cautionary note about the strength of evidence in the built environment==

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A comprehensive review of the literature was undertaken in 2005 for the Design Council.<ref>Higgins, S., Hall, E., Wall, K., Woolner, P., and McCaughey, C. (2005) The Impact of School Environments: a literature review, produced for the Design Council by the University of Newcastle.</ref> It concluded that there was evidence for the effect of basic physical variables (air quality, temperature, noise) on learning but that once minimum standards were achieved, further improvements were less significant. The reviewers found forceful opinions on the effects of lighting and colour but that the supporting evidence was conflicting. It was difficult to draw generalizable conclusions about other physical characteristics, and the interactions between different elements was as important as single elements.

Other literature reviews of the education sector include two by [[PwC|Price Waterhouse Coopers]] <ref>

Price Waterhouse Coopers, (2001) Building Performance: an empirical assessment of the relationship between schools capital investment and pupil performance, Research Report 242, Department for Education and Employment, London.</ref><ref>PricewaterhouseCoopers, (2003) Building better performance: an empirical assessment of the learning and other impacts of schools capital investment, Research Report No 407, Department for Education and Skills, London.</ref> and one by researchers at the [[University of Salford]].<ref>Barrett, P and Zhang, Y. Optimal Learning Spaces: Design Implications for Primary Schools, Salford Centre for Research and Innovation in the built and human environment, 2009.</ref>

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== {{anchor|Current state|Research centers|Accreditation and certification}}Research and accreditation==

As EBD is supported by research, many healthcare organizations are adopting its principles with the guidance of evidence-based designers. The Center for Health Design developed the Pebble Project,<ref>{{Cite web | url=https://www.healthdesign.org/research-services/pebble-project | title=Becoming a Pebble Partner | publisher=The Center for Health Design| date=20 July 2010| author1=Apuccinelli | work=The Center for Health Design }}</ref> a joint research effort by CHD and selected healthcare providers on the effect of building environments on patients and staff. ''Health Environment Research & Design'' journal and the Health Care Advisory Board<ref>{{Cite web | url=https://www.advisory.com/research/health-care-advisory-board | title=Health Care Advisory Board}}</ref> are additional sources of information and database on EBD.

The Evidence Based Design Accreditation and Certification (EDAC) program was introduced in 2009 by The Center for Health Design to provide internationally recognized certification and promote the use of EBD in healthcare building projects, making EBD an accepted and credible approach to improving healthcare outcomes.<ref name=":5" /> EDAC identifies those experienced in EBD and teaches about the research process: identifying, hypothesizing, implementing, gathering and reporting data associated with a healthcare project.