Those of us who are advocates of evidence-based ____ understand the difficulty of establishing what's evidence-based and what's not. This happens even in medicine, where evidence-based management is several years ahead of such methods in many other fields. It takes a substantial body of evidence to eventually iron out conflicts in research findings. And by the time that happens, there's new evidence to consider. But regardless how complex the evidence is, it's a good idea to develop guidelines and resources that help people figure out for themselves for what really works and what doesn't: So they can avoid strategies that simply won't move things in the right direction, and be strong advocates for evidence-based management.
Along those lines, there's now an accreditation program for evidence-based design in the healthcare field, which means using evidence to protect patient safety, improve the level of care, and provide good working environments for caregivers. Brought to you by the Center for Health Design, "Evidence-based design (EBD) is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes." The Center is a non-profit organization, so it should be able to function effectively as a clearinghouse for evidence on healthcare building design.
The Evidence-Based Design Accreditation & Certification (EDAC) program "educates and assesses individuals on their understanding of how to base design decisions on available, credible evidence." These professionals "will demonstrate a clear understanding of these components and use an evidence-based design process to meet and/or exceed the recommended minimum requirements. The program's goal is to test on the proper process to identify, hypothesize, implement, gather, and report the data associated with their project. Once an individual is EDAC accredited, he or she will have an ethical obligation to employ an evidence-based design process in his or her work."
Covering the gamut. This had me wondering if they are emphasizing the how of finding and interpreting evidence, or the what contained in the body of evidence (or both). I took a look at their study guides and the content outline describing what's on the certification exam (8-page pdf here). The examination has five sections: evidence-based design for healthcare, research, predesign, design, and construction and occupancy. Here's what the study guides cover:
- Study Guide 1: An Introduction to Evidence-Based Design: Exploring Healthcare and Design. It "explores the history and evolution of evidence-based design through its present defintion and defines the key steps of the EBD process. Once the context is set, the guide will explore the components of the healthcare delivery system, the trends affecting it and the various settings in which delivery occurs."
- Study Guide 2: Building the Evidence Base: Understanding Research in Healthcare Design. "Guide two explores the role of research in evidence-based design. The types of research and evidence will be discussed as well as methodologies for doing that research. The guide covers the value of using credible evidence in healthcare projects, and how through research design solutions are empirically evaluated and scientific evidence is generated."
- Study Guide 3: Integrating Evidence-Based Design: Practicing the Healthcare Design Process. "Guide three pulls together the EBD process to walk you through the key steps of the design process in detail from pre-design, design, construction and occupancy. Practical examples demonstrate key areas and show how EBD is practically applied."
The content outline covers a wide range of stuff: There's everything from "how evidence-based design can contribute to attributes of a therapeutic environment" to "describe the role of the Board of Directors in understanding and championing evidence-based design processes" -- and lots in-between. Overall, I'd say this definitely demonstrates an understanding of the importance of following the evidence.
Teaching them how to fish? There's no one way to design a medical facility, and the body of evidence will always be changing -- so testing on specific design elements would be tricky. EDAC seems to be focused on the process stuff, so that's good: Their study materials include a section on critical evaluation, saying "Determine the relevance of evidence to the project based on one or a variety of
factors (e.g., sources, author qualifications and / or experience, appropriateness of research methodology, replication, composition of sample, reliability, validity, generalizability)". Excellent.
ECAD is discussed in Evidence-Based Design, a nice article appearing in a publication called NEXT (Spring 2009). (Alas, it's viewable in a particularly un-reader-friendly online magazine format.) The author, C. Richard Hall, says "As awareness increases and the body of evidence grows, more and more people are seeking to build hospitals with the guidance of those skilled in the practice. But up until now, there was no standard definition of evidence-based design." He explains that the EBD discipline has emerged over the past 15 years.
EDAC's stated mission is to "develop a community of accredited industry professionals through education and assessment of an evidence-based design process." And the vision statement says they want to see "a world where all healthcare environments are created using an evidence-based design process."
Getting the word out. Besides this certification process, the Center does a nice job of explaining to healthcare providers why they should pay attention to evidence-based design. Their web site has a section for healthcare leadership, presenting "evidence-based design resources for healthcare executives." This includes a white paper on the role of the CEO in evidence-based design, and guidance on establishing the business case for EBD.
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