The nature of evidence utilized in healthcare architectural design decisions at five Midwestern critical access hospitals
Abstract
Building a replacement hospital is a once in a lifetime experience for any healthcare administrator and the design decisions made during the building process can have a lasting impact on stake holders and end users for years to come. Improving healthcare design is integral to improving healthcare itself, and it is essential that healthcare administrators make informed architectural design decisions that will ensure organizational success and improve patient outcomes. Evidence-based design (EBD) practice is the conscientious, explicit and judicious use of current best evidence from research and practice in making critical decisions, together with an informed client, about the design of each individual and unique project. Utilizing a multi-site case study consisting of critical access hospitals that were in the process of or had built a replacement hospital in five Midwestern states, I sought answers to two questions: (1) how do hospital administrators and architects define and use EBD during the healthcare design process, and (2) what is the nature of the evidence that is used in this design process? I learned from these case studies that the tenets of EBD were not well understood by either the hospital administrators or the architects, and that decisions on designs were heavily weighted towards experiential evidence as compared to evidence from empirical research, which may have contributed to certain design missteps in the built replacement hospitals. Use of an EBD process, as proposed and supported by the Center for Health Design, may provide for knowledge transfer of evidence and allow healthcare administrators to participate in evidence-informed decision making, provided participating architects are knowledgeable in EBD and its potential benefits.
Degree
Ph. D.
Thesis Department
Rights
OpenAccess.
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