http://smartech.gatech.edu/handle/1853/23970 Papers, Pre/Post-Prints, and Presentations by Faculty in the College of Architecture Search the Channel search http://smartech.gatech.edu/simple-search http://smartech.gatech.edu/handle/1853/25676 Title: A Review of the Research Literature on Evidence-Based Healthcare Design <br/> <br/>Authors: Zimring, Craig M.; Ulrich, Roger S.; Zhu, Xuemei; DuBose, Jennifer Robin; Seo, Hyun-Bo; Choi, Young-Seon; Quan, Xiaobo; Joseph, Anjali <br/> <br/>Abstract: 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: It 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. Key Words: Evidence-based design, hospital design, healthcare design, healthcare quality, outcomes, patient safety, staff safety, infection, hand washing, medical errors, falls, pain, sleep, stress, depression, confidentiality, social support, satisfaction, single rooms, noise, nature, daylight http://smartech.gatech.edu/handle/1853/25539 Title: The new demand-driven post-occupancy evaluation <br/> <br/>Authors: Zimring, Craig M.; Wineman, Jean Davison; Carpman, Janet Reizensten <br/> <br/>Abstract: Post-Occupancy Evaluation (POE) has become increasingly accepted and influential among client organizations responsible for large building management and construction programs. Managers and administrators look to POE to provide answers to important facilities questions. This increased focus on decision-making has resulted in a number of changes to the way in which POEs are conducted, including changes in the relationship between evaluator and client, the range of issues addressed, and the salience of certain methodological concerns. These issues are considered in light of current uses for POE information and some strategic choices faced by evaluators and clients. <br/> <br/>Description: Copyright 1988, Locke Science Publishing Co., Chicago, IL, All Rights Reserved. http://smartech.gatech.edu/handle/1853/25462 Title: The Business Case for Building Better Hospitals Through Evidence-Based Design <br/> <br/>Authors: Zimring, Craig M.; Sadler, Blair L.; DuBose, Jennifer Robin <br/> <br/>Abstract: Purpose: After establishing the connection between building well-designed evidence-based facilities and improved safety and quality for patients, families, and staff, this article presents the compelling business case for doing so. It demonstrates why ongoing operating savings and initial capital costs must be analyzed and describes specific steps to ensure that design innovations are implemented effectively. Background: Hospital leaders and boards are now beginning to face a new reality: They can no longer tolerate preventable hospital-acquired conditions such as infections, falls, and injuries to staff or unnecessary intra-hospital patient transfers that can increase errors. Nor can they subject patients and families to noisy, confusing environments that increase anxiety and stress. They must effectively deploy all reasonable quality improvement techniques available. To be optimally effective, a variety of tactics must be combined and implemented in an integrated way. Hospital leadership must understand the clear connection between building well-designed healing environments and improved healthcare safety and quality for patients, families, and staff, as well as the compelling business case for doing so. Emerging pay-for-performance (P4P) methodologies that reward hospitals for quality and refuse to pay hospitals for the harm they cause (e.g., infections and falls) further strengthen this business case. Recommendations: When planning to build a new hospital or to renovate an existing facility, healthcare leaders should address a key question: Will the proposed project incorporate all relevant and proven evidence-based design innovations to optimize patient safety, quality, and satisfaction as well as workforce safety, satisfaction, productivity, and energy efficiency? When conducting a business case analysis for a new project, hospital leaders should consider ongoing operating savings and the market share impact of evidence-based design interventions as well as initial capital costs. They should consider taking the 10 steps recommended to ensure an optimal, cost-effective hospital environment. A return-on-investment (ROI) framework is put forward for the use of individual organizations. http://smartech.gatech.edu/handle/1853/25452 Title: Accommodating Paradigm Change in Large Institutions: Layout, Circulation and Wayfinding in Emerging Healthcare Facilities <br/> <br/>Authors: Zimring, Craig M. <br/> <br/>Abstract: Changes in financing, regulation, technology and philosophy have led to significant alterations in the ways healthcare facilities are planned, programmed and designed. Outpatient services are increasing, while the remaining inpatients tend to be much more acutely ill. Although budgets are shrinking, facilities are experiencing much greater competition and demands for higher levels of service. We examine how healthcare facilities are linking these organizational goals - greater competitiveness, higher efficiency, better and more caring customer service, decentralization of departments-to their spatial decision making and discuss how environmental design research might contribute to these efforts. In particular, we present brief case studies to provide a common basis for discussion, then explore tools and approaches that link these organizational goals to planning, programming, design and evaluation. Although this working session touches on a range of concerns, the focus will be on layout, circulation and wayfinding, issues that are particularly influenced by recent trends in healthcare. A particular concern is the impact of providing outpatients services such as day surgery as well as inpatient surgery within a single campus. How does this affect layout, circulation and wayfinding? Case studies include, at least: (1) redevelopment of National Health Service hospitals in Great Britain; (2) pre-occupancy evaluation of the new Santa Clara County Valley Medical Center North Tower; (3) redevelopment of Grady Memorial Hospital (Atlanta). Although this session focuses on healthcare, it also allows the group to consider more broadly how environmental design can be linked to major changes in policy. The session addresses such questions as how can policy be formulated in spatially-relevant terms and how can key organizational decision-makers understand the -importance of spatial decisions? Participants include Cheryl Fuller (Fuller Coe Associates), Bruce Nepp (Anshen + Allen), Kent Spreckelmeyer (Kansas), Saif-ul Hag, Mohammed Shraim and Sharon Tsepas (Georgia Tech). <br/> <br/>Description: Public and private places : proceedings of the Twenty-seventh Annual Conference of the Environmental Design Research Association : Salt Lake City, Utah, June 12-June 16 / editors, Jack L. Nasar, Barbara B. Brown.