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Evidence-based design (EBD) was popularized by the seminal study by Ulrich (1984) that showed the impact of a window view on patient recovery.<ref name=":1">{{Cite journal|last1=Ulrich|first1=Roger S.|last2=Zimring|first2=Craig|last3=Zhu|first3=Xuemei|last4=DuBose|first4=Jennifer|last5=Seo|first5=Hyun-Bo|last6=Choi|first6=Young-Seon|last7=Quan|first7=Xiaobo|last8=Joseph|first8=Anjali|date=2008-01-01|title=A review of the research literature on evidence-based healthcare design|journal=HERD|volume=1|issue=3|pages=61–125|issn=1937-5867|pmid=21161908|doi=10.1177/193758670800100306|citeseerx=10.1.1.1007.6433|s2cid=17170267}}</ref> Studies have since examined the relationships between design of the physical environment of hospitals with outcomes in health, the results of which show how the physical environment can lower the incidence of nosocomial infections, medical errors, patient falls, and staff injuries;<ref>{{Cite journal|vauthors=Leape LL, Brennan TA, et al|date=1991|title=The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II|journal=New England Journal of Medicine|volume=324|issue=6|pages=377–384|doi=10.1056/nejm199102073240605|pmid=1824793|url=https://journalhealthsciences.com/index.php/UDES/article/view/21|doi-access=free}}</ref><ref>{{Cite journal|vauthors=Zhan C, Miller MR|date=2003|title=Excess length of stay, charges, and mortality attribute to medical injuries during hospitalization|journal=Journal of the American Medical Association|volume=290|issue=14|pages=1868–1874|doi=10.1001/jama.290.14.1868|pmid=14532315|doi-access=free}}</ref> and reduce stress of facility users, improve safety and productivity, reduce resource waste, and enhance sustainability.<ref>{{Cite journal|vauthors=Berry LL, et al|date=2004|title=The business case for better buildings|journal=Frontiers of Health Services Management|volume=21|issue=1|pages=3–24|doi=10.1097/01974520-200407000-00002|pmid=15469120|citeseerx=10.1.1.496.6046|s2cid=19432345}}</ref>
''Evidence'' in EBD may include a wide range of sources of knowledge, from [[Systematic review|systematic literature reviews]] to practice guidelines and expert opinions.<ref name=":2">{{Cite journal|last=Stichler|first=Jaynelle F.|date=2010-01-07|title=Weighing the Evidence|journal=HERD|volume=3|issue=4|pages=3–7|issn=1937-5867|doi=10.1177/193758671000300401|pmid=21165847|doi-access=}}</ref> Evidence-based design was first defined as "the deliberate attempt to base design decisions on the best available research evidence" and that "an evidence-based designer, together with an informed client, makes decisions based on the best available information from research and project evaluations".<ref name=":3">{{Cite journal|last=Hamilton|first=Kirk.D.|date=2003|title=The four levels of evidence-based practice|journal=Healthcare Design|volume=3|issue=4|pages=18–26}}</ref> The Center for Heath Design (CHD), a [[Nonprofit organization|non-profit organization]] that supports healthcare and design professionals to improve the understanding and application of design that influence the performance of healthcare, patient satisfaction, staff productivity and safety, base their model on the importance of working in partnership with the client and interdisciplinary team to foster understanding of the client, preferences and resources.<ref name=":5"/>
The roots of evidence-based design could go back to 1860 when [[Florence Nightingale]] identified fresh air as "the very first canon of nursing," and emphasized the importance of quiet, proper lighting, warmth and clean water. Nightingale applied statistics to nursing, notably with "Diagram of the causes of mortality in the army in the East".<ref name=":4">{{Cite web|url=https://www.royalcollection.org.uk/collection/1075240/notes-on-matters-affecting-the-health-efficiency-and-hospital-administration-of|title=Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army|website=www.royalcollection.org.uk|access-date=2016-05-11}}</ref> This statistical study led to advances in sanitation, although the germ theory of disease was not yet fully accepted.
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Nightingale was also an enthusiast for the therapeutic benefits of sunlight and views from windows. She wrote: "Second only to fresh air … I should be inclined to rank light in importance for the sick. Direct sunlight, not only daylight, is necessary for speedy recovery … I mention from experience, as quite perceptible in promoting recovery, the being able to see out of a window, instead of looking against a dead wall; the bright colours of flowers; the being able to read in bed by the light of the window close to the bed-head. It is generally said the effect is upon the mind. Perhaps so, but it is not less so upon the body on that account ...."<ref>(Nightingale,F. (1860) Notes on Nursing, Harrison, London.</ref>
Nightingale’s ideas appear to have been influential on E R Robson, architect to the [[London School Board]], when he wrote: “It is well known that the rays of the sun have a beneficial influence on the air of a room, tending to promote ventilation, and that they are to a young child very much what they are to a flower.” <ref>E R Robson, (1874) School Architecture, John Murray, London.</ref>
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 [[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>
In the higher education sector, a review by CABE<ref>CABE, Design for Distinction: the value of good building design in higher education, 2005</ref> reports on the links between building design and the recruitment, retention and performance of staff and students. Fifty articles are reviewed, and five new case studies reported.
==Offices==
The offices sector has been widely studied with the major concerns focusing on productivity. A study in 2000 by [[Sheffield Hallam University]]<ref>Haynes, B., Matxdorf, F., Nunnington, N., Ogunmakin, C., Pinder, J. and Price, I., Does property benefit occupiers? An evaluation of the literature, Occupier.org report number 1, Facilities Management Graduate Centre, Sheffield Hallam University, 2000.</ref> reported that apart from surveys of occupants of individual offices, the evidence base on new workplaces was mainly journalistic and biased towards interviews with successes and failures. Some companies claimed that new spatial arrangements led to reduced costs, reduced absenteeism and easier recruitment, faster development of new ideas, and increased profitability. But others reported the exact opposite; and the reasons for this remained unclear.
CABE and the British Council for Offices published a joint study in 2005.<ref>CABE and the BCO, (2005) The impact of office design on business performance.</ref> The paper reports that four main issues have been studied: the largest is environmental and ergonomic issues related to the comfort of individual office workers; secondly research on the efficiency with which office space is used; thirdly adaptability and flexibility and finally research related to supporting work processes. The report is critical of the disproportionate focus on the performance of building services compared with other aspects of buildings.
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