Evidence-Based Design Thesis_PaulRamoie_2014

Dynamic Design:
How Evidence-Based Design
Creates a Happy, Healthy You
Paul A. Ramoie, Student ASID
The Illinois Institute of Art-
Chicago

Table of Contents
Artists Philosophy 3
Thesis Paper 4
wORKS CITED 19
ANNOTATED BIBLIOGRAPHY 23
PORTFOLIO PRESENTATION 26

Artists Philosphy
Since I was a young child, I have been fascinated with the world
of design and architecture. It started out with endless hours of play-
ing with Legos, connecting them together to build homes, buildings,
cities, castles, cars, and other things. From there, it progressed into
watching Bob Villa on TLC and other various construction and design
shows. It eventually evolved into architectural and design programs
for my computer, and I would draft out floor plans and build inte-
riors. It was a no brainer that I would choose Interior Design as my
life’s work.
Now that I am studying and working in the interior design field,
I’ve realized the impact that interiors and structures have on our ev-
eryday lives. My designs have the ability to shape the places we live,
work, shop, learn, play and heal.
My portfolio of work is very modern and structural. I love in-
corporating nature, texture, curvilinear and organic shapes into some
of my designs while contrasting them with clean, rectilinear spaces,
pops of color, and strong concepts. Each design has a unique focal
point to draw your attention. I believe that design transforms lives
and that interior design and architecture should be for everyone, and
that all people should have access to healthy, healing, positive spac-
es as a democratic right. It is my goal to use my skills to give back to
local communities through non-profit design work for the vulnerable
and those in need, including veterans and homeless people. I see this
as a social responsibility and why I am passionate about designing inte-
rior spaces. It not only humbles me, but brings gratitude and perspec-
tive to what I do.
As an interior designer, what sets me apart from the average
decorator is my education and my unique knowledge of industry re-
search, such as evidence-based design, well-being and sustainability,
social responsibility and the ways this knowledge impacts design and
its outcome for clients. This helps to showcase the positive impact of
design on the human experience and the value interior designers pro-
vide.
This is why implementing evidence-based design research into
my work is essential in setting me apart from the typical designer or
decorator. The built environment can have a tremendous impact on the
physical and psychological life experience of those that occupy the
space. Evidence-based design takes hard facts, research, and results
of previous designs into account when creating a new, fully functional,
aesthetically pleasing space. Every detail, every color and every ob-
ject has a specific purpose to improve the lives of the client, whether
that is a therapeutic approach, a sustainability approach, or a barrier-
free environment approach. Evidence-based design is used to aid and
assist in your design application. My designs bring healing and dignity
to my clients.
Interior design is a natural choice for me. It allows a hands-on
experience in a flexible, ever-evolving industry while remaining consis-
tent and challenging. The best part for me is creating functional living
spaces that people will be enjoying for years to come and walking away
feeling fulfilled. Little pieces of your heart, mind, and soul are left
behind everywhere you go. Who wouldn’t want a creative, rewarding ca-
reer like this?

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Research has become a vital, essential, and expected component of the design
process in the field of professional interior design. Research results in better design
solutions, and end-user satisfaction. As the profession has evolved and designers are faced
with new issues and challenges, the rise of the internet and DIY clients and TV shows, it has
become necessary to qualify design solutions with facts and evidence that results in safe,
healthy, and healing environments that pure aesthetics and decorating alone cannot
provide. In steps Evidence-Based Design (or, EBD), a revolutionary and innovative tool that
is both practical and philosophical.
Evidence-Based Design originated in the healthcare industry due to the importance
of evidence-based medicine culture. Its implementation of research and hard data focuses
on improving patient and staff outcomes, well-being, patient healing, safety, stress
reduction, environments, and psychology. Due to its phenomenal success with patient
outcomes in the healthcare design industry, evidence-based design is becoming a necessary
standard in residential and hospitality applications. Interior designers use EBD to collect
the best quality of research to apply to design problems for successful outcomes, to add
credibility and innovation to their designs, increase their worth and value to clients and
employers, and enhance the bottom line. Design decisions are directly based on
quantitative and qualitative research and knowledge and then applied as solutions.
(Nussbaumer).
So, what is evidence-based design? EBD is defined as “a process for 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 unique project.” (Nussbaumer). And “Evidence-based design is the process

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of basing decisions about the built environment on credible research to achieve the best
possible outcomes.” (EDAC/TCH). EBD links research to your design, helps to support the
decisions you ultimately make, and leads to innovative results that can be further studied
along with new discoveries.
Let’s learn about how EBD has evolved over the years. Evidence-based Design as a
concept originated in the 1970’s with basic research methods. In 1978, the Planetree model
was established. Planetree is a non-profit organization that aims to demystify the
healthcare experience and create a more personalized, humanized environment that
focuses on healing and nurturing the mind, body, and spirit. (Planetree). Planetree
Designation is the only program of its kind emphasizing patient-person-centered care
based on evidence and standards that is putting the needs of the individual first.
(Planetree). Patient-centered care has a direct relationship between the built environment,
its materials, and the physical well-being of the individuals in healthcare facilities. (Zengul,
et. al.).
Planetree’s Designation Program assists in making the patient-centered care
concept practicable, attainable, and measurable with clear guidelines and definitions of
what it means to be patient-centered. Patient-centered care is about safety, accessibility,
and high-quality environments that have a holistic feel to enhance and improve healing,
health, and well-being for all. (Planetree).
During the 1980’s Roger S. Ulrich, Ph.D., EDAC paved the way for innovative
research on healthcare facilities and healing environments. Dr. Ulrich’s study in 1984
revealed that surgical patients who had exposure to nature had fewer complications,
required less pain medication, and healed faster than in traditional hospital settings with

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no nature views. Other studies of his showed the psychological effects of lighting and noise
on care patients. (Ulrich, et. al.). Dr. Ulrich’s most recent studies address the effects of a
single bed vs. multi-bed patient room on infection transmission rates, the negative effects
of noise levels on patients and staff, and the benefit of nature and artwork. (The Center for
Health Design). These studies provide a direct link of the environment to the improvement
of patients and staff on duty, their wellness and happiness.
In 1993, The Center for Health Design was formed by a small group of pioneering
healthcare and design professionals. CHD leads the way in improving the qualities of
healthcare through the design of the built environment (healthdesign.org). CHD’s mission
is to transform healthcare environments for healthy aging, and a healthier, safer world
through design research, education, and advocacy. (The Center for Health Design).
By 2000, The Center for Health Design had a vision for a guide that the healthcare
industry, interior designers and architects could follow. The result of that vision was The
Pebble Project. The Pebble Project seeks to direct, teach and assist healthcare providers,
architecture and design firms, and industry partners to use an evidence-based design
process in their healthcare environment projects. (The Center for Health Design).
“As a Pebble Project Partner, the commitment to perform research on the effectiveness of the
design on clinical outcomes, patient and staff satisfaction has resulted in evidence that will
guide future design decisions as we strive to create the most healing environments.” ~ Sue Ann
BartonPrincipal, ZGF Architects, LLP (The Center for Health Design).
Research is focused in areas of quality of care, patient safety, staff safety, and
environmental safety. Evidence-based design features are used to improve outcomes such
as patient and staff satisfaction, fewer infections and injuries, better work flow and

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circulation, reduced noise and medical errors, and other areas of concern. (The Center for
Health Design).
In 2003, evidence-based design was officially “defined” and given standards by D.
Kirk Hamilton, FAIA, FACHA, EDAC. As of 2008, TCH has completed over 1200 post-
occupant studies that provide evidence for projects. Between 2004 and 2008, 650 rigorous
studies on staff and patient safety issues, the impact of the environment on stress, and
clinical quality outcomes were completed and followed by scholarly, peer-reviewed
journals and hundreds of citations. (Hamilton). Since 2008, healthcare designers can now
become certified via EDAC, Evidence-based Design Accreditation and Certification, created
by The Center for Health Design.
EBD is used from the beginning of a project to the end, from pre-design, design,
construction, and post-occupancy. (EDAC/TCH). EBD starts with the Design Process that is
divided into phases: programming, schematic development (concept), design development,
contract documentation and contract administration. EBD must be integrated throughout
the process of design and building. It requires a collaborative effort comprising of
architects, interior designers, health care professionals, and patients. EBD infuses
“principles, goals and expected outcomes throughout all steps of planning, designing and
operating buildings.” (Health Facilities Scotland).
The collaborating team should always ask themselves: “How will the proposed
project incorporate all relevant and proven evidence-based design innovations to optimize
patient safety, quality and satisfaction, as well as work-force safety, satisfaction,
productivity and energy efficiency?” (Health Facilities Scotland).
EBD’s Foundation: The Design Process

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“An evidence-based designer, together with an informed client, makes decisions based on the
best available information from research and project evaluations.” (Hamilton).
“Evidence-based practice stands in contrast to approaches that are based on tradition,
convention, belief, or anecdotal evidence.” (National Registry of Evidence-based Programs
and Practices).
The first phase of EBD is programming. The programming phase is the most
significant part of the design process. This is where you’re problem seeking, setting goals
and objectives. During the programming phase you collect the relevant information needed
for the project, you identify the problem at hand, and you interview the client to confirm
their wants and needs. The programming phase is purely about gathering and analyzing
evidence. These data, facts and evidence, are collected and analyzed to assist in the design
process. Evidence comes from researching journals, periodicals, articles, and trade
publications and other publications as well as interviews, surveys, questionnaires and
observations. Facts are derived from current information or data, whereas research “seeks
to produce new knowledge in recognizable ways that can usually be applied regardless of
locale.”(Nussbaumer). There are two common types of research in EBD. Quantitative
research is a numerical measurement of observations, and qualitative research is
nonnumeric observations that describe meaning and patterns. (Nussbaumer). Variables are
also taken into consideration depending on the person. What works for one situation or
person may not work in another, and what does work may not work elsewhere. Once
you’ve collected all your information; you analyze the facts and organize them into a
program development. (Nussbaumer).

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The next step is the schematic development phase, where you use the data to inform
your design process, brainstorm ideas, and create sketches, plans and details. Next is the
design development stage, where the best possible solution is refined and final drawings,
details, sections, and elevations are produced. During the contract document phase, the
project is implemented. Construction drawings and specifications are made, tying in the
structural, architectural, mechanical and electrical aspects of the design including the
fixtures, finishes, and equipment (FF&E).This is for the general contractor to follow.
(Nussbaumer).
And lastly, the project implementation is completed in the contract administration
phase. Contractors, and sub-contractors are hired and construction occurs. Shortly after
move-in, a post-occupancy evaluation (or POE) is completed. A POE is defined as a means
to help “identify problem areas in existing buildings, to test new building prototypes and to
develop design guidance and criteria for future facilities.” POE’s help to improve current
and future projects. (Nussbaumer).
Evidence-based design research within the programming phase has 12 key areas.
You have the user needs, structural and context needs, sustainability needs (LEED,
environment), human factors (including physiological, anthropometrics, ergonomics,
psychological, and sociological needs), economics, functional needs, FF&E (furniture,
fixtures, and equipment), design types, diversity in design, historical precedents in design,
and finally develop program requirements and analyze various design theories.
(Nussbaumer). These research steps determine the effect of your design layout, the effect
of site and structure on your design, evidence on codes, social responsibility, indoor air

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quality, health concerns, socioeconomics, ergonomics, universal design, and more.
(Nussbaumer).
EBD in Healthcare Settings
“Your design decisions are memorialized in concrete and steel and effect patient outcomes,
how care is provided by nurses, physicians, and other healthcare professionals, and the
survivability of healthcare organizations who often must add additional resources to fix design
mistakes.” ~ Jaynelle F. Stichler (Stichler).
Hospitals have changed dramatically over the years, easing up on the institutional
look and feel by transforming into a warmer, welcoming place reminiscent of a hotel or
your own home. The use of EBD, however, goes far beyond pleasing aesthetics. Rather, the
focus of evidence-based design is to create hospitals that actually help patients recover and
be safer, and help staff do their jobs better. EBD is a process that provides a setting for a
caring, effective, safe, patient-centered environment. (Ulrich, et. al.).
Figure 1 (Children's Hospital Colorado). Figure 2 (Johnstone-Yellin).
Let’s explore the implementation of evidence-based design and the many ways it
has impacted and aided in the healing of patients.
The Effectiveness of Single-Bed Rooms
“The problem is not so much what we don’t know; it’s what we think we know that just ain’t
so.” (Attributed to Mark Twain).

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Scientific studies and peer reviewed journals have proven and stressed the
importance of single-bed rooms in all hospitals. Single-bed rooms greatly reduce the risk of
hospital-induced nosocomial infections, such as MRSA, diarrhea and gastroenteritis or
SARS. Single-bed rooms help to limit person-to-person and person-surface-person spread
of infection because they are far easier to decontaminate after patient discharge than
multibed rooms. Incorporating sinks and alcohol-gel dispensers into each room
encourages staff and patients to wash hands regularly. (Ulrich, et. al.).
Figure 3 (CBRE Healthcare). Figure 4 (Kotzer).
A single-bed room also reduces room transfers and medical errors, reduces noise
levels, improves patient confidentiality and privacy, facilitates social support by families,
improves staff communication to patients, and increase patients’ overall satisfaction with
health care. (Ulrich, et. al.).
Single-bed rooms combined with good air quality significantly reduce infections and
mortality amongst patients and staff, therefore making them far safer in single rooms than
in multibed spaces. (Ulrich, et. al.).
Research and evidence show that hospitals designed with portable high-efficiency
particulate air (HEPA) filters have lower rates of airborne infections amongst patients and

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immunocompromised patients compared to hospitals that didn’t implement HEPA. HEPA
filters are especially effective in operating-rooms and rooms that need to be ultra clean to
house immunocompromised patient populations. (Ulrich, et. al.). Proper ventilation and
airflow is also important. It is critical to combine HEPA filters with enhanced cleaning and
decontamination methods such as hydrogen peroxide vapor (HPV), the sealing of windows,
and barriers between patient-care areas and other areas. (Health Facilities Scotland). Also,
furniture and material choices play an important role. They should be easy to clean and
reduce the ability of holding contaminates.
What’s That Noise?
Hospitals are typically very noisy, caused from numerous sources such as alarms,
beds, bedrails, telephones, voices and the interior materials like floors, walls, and ceilings
that reflect sound rather than absorb it. These sounds travel down corridors, linger into
patient rooms and often create loud echoes. This creates an uncomfortable acoustic
atmosphere. (Ulrich, et. al.).
Installing high-performance sound absorbing ceiling tiles and providing single-bed
rooms are shown to be more effective in eliminating noise sounds compared to adopting
quiet hours or educating staff. Peer-reviewed studies have proven that noise levels are
much lower in single-bed than multi-bed rooms. Eliminating double-occupancy in rooms
reduces distractions and noise significantly from staff, medical equipment, and family
visiting. (Ulrich, et. al.).
The results of these findings came from a study in 2003, in which survey data from
2,122,439 patients in 1,462 healthcare facilities was collected. Surveys showed universally
patients were very satisfied with “noise levels in and around your room”, 11.2 percent

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higher nationally compared with patients in multi-bed rooms. Noise-level measurement
studies also support this data. (Ulrich, et. al.).
Reducing and eliminating unnecessary noises has a positive impact on infants in
ICU’s, particularly eliminating the common need for oxygen support therapy as a result of
oxygen loss, prevention of high blood pressure, increased heart and respiration rate, and
poor sleep. Noise also causes stress, high blood pressure, increased heart rate and poor
sleep in adults and children. By implementing these effective design changes we can
directly impact healthcare patients and staff in positive ways. (Ulrich, et. al.).
The Internal Impact of Lighting.
Figure 5 (Children's Hospital Colorado). Figure 6 (Kotzer).
Lighting design has a direct link to reducing clinical depression in patients. Patients
exposed to bright natural and artificial light, predominantly in the morning, had reduced
depression, agitation and improved sleep and circadian rhythms. Studies strongly show
improved lighting conditions have a greater impact on dementia patients, patients with
seasonal affective disorders (SAD) and bipolar disorder. Improved lighting conditions
reduce the length of stay for patients compared to poorly lit rooms by an average of 3 days.
Intense sunlight in hospital rooms significantly decreases stress, pain and the need for pain
medication by 20-22 percent. This is an important consideration to take into account when

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designing hospital layouts. Optimize sunlight exposure in patient rooms by using an east-
facing orientation. (Ulrich, et. al.).
A Growing Need for Nature.
Figure 7 (Oudeman). Figure 8 ( Mastorakos: SmithGroupJJR).
Figure 10 (Rendering courtesy CO Architects).
Figure 9 (Fouts, et. al.).
Furthermore, scientific studies have consistently shown that exposure to natural or
simulated nature settings have positive emotional and physiological effects. Negative
emotions such as stress are quickly replaced with positive feelings. Views of nature can
also positively influence heart rate and blood pressure, compared to increase stress and
heart rate for those who aren’t exposed to nature artwork or natural views. Patients

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exposed to landscape scenes experienced less stress, anxiety and required lower dosages of
pain medication when compared to those who viewed no paintings, abstract art or faced
buildings or parking lots. These encounters, regardless of how brief, make a world of
difference in all people, regardless of setting. (Ulrich, et. al.).
Figure 11 (Lurie Children's Hospital of Chicago). Figure 12 (Sheffield Children's Hospital).
Therapy gardens in hospitals, both indoors and outdoors, are one way to expose
patients and staff to a serene environment. Therapy gardens allow for calmness, a place of
escape and recuperation from stress, and uplifting moods for healthcare staff thus leading
to better patient satisfaction of care. We can foster health by incorporating simulated
nature views in hospital settings to reduce stress, and provide distractions from pain.
(Ulrich, et. al.).
Case Study: The Children’s Hospital of Denver, Colorado.

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“We envision a world where every hospital, health clinic, treatment center, doctor’s office, and
residential care facility is designed to improve both the quality of care and outcomes for
patients, residents, and staff.” (The Center for Health Design).
Photo Credit: (EDAC/TCH).
Photo Credit: (Kotzer).

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The Children’s Hospital, located in Denver Colorado, was collaborative project
between TCH and two architectural design firms, Zimmer Gunsul Frasca Architects and
H+L Architecture. Work on the project began in 2003, and construction was completed in
September 2007. The hospital spans an impressive 1.44 million square feet over multiple
stories, with capacity of 240 beds, includes 4 trauma rooms, 14 operating rooms, and a
helipad on the rooftop. TCH also became a Pebble Project member as a research
collaborative to enhance the design of children’s hospitals across the country and is a key
instrument in improving research data for evidence-based design. (Kotzer). TCH is ranked
as one of the Top 10 children's hospitals in the country. (Zacharakis).
The designers on the project wanted to emphasis the “experience” of the space as a
theme, enhancing the hospital with use of artwork, nature, light, color, touch, sound, and
scale to positively influence health and care amongst patients and staff. (Zacharakis). To
gain insight and to better solidify a design concept for the new TCH, the design teams
visited over twelve hospitals, including Texas Children's Hospital in Houston; Doernbecher
Children's Hospital in Portland, Oregon; Children's Hospital Central California in Madera;
Vancouver General Hospital in Vancouver, British Columbia; Good Samaritan Hospital in
Cincinnati; Vanderbilt Medical Center in Nashville; Parker Adventist Hospital in Parker,
Colorado; and Children's Hospital of Omaha. (Zacharakis).
These visits provided a first-person experience on how other health care facilities
were designed and used and or lacked evidence-based design. They studied important
areas and key environmental elements, such as finish materials used, amenities for patients
and staff, location of nurses stations, circulation and flow, patient room layouts, and
operating rooms. (Zacharakis).

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The design team was dedicated to thinking like a child would and how children
would react, perceive and experience the environment. Seven designers from Zimmer
Gunsul Frasca Architects spent several diligent weeks shadowing and investigating
patients, staff, and families across all healthcare departments in the current TCH. This
shadow and interview period gave the designers a view of the daily conditions of the
hospital that staff and patients endure. Some of the results were simply awful. Excessive
noise, congested circulation and poor patient room layouts were quick design observations
needing addressing. (Zacharakis).
Patient rooms lacked storage space, were crowded and provided no
accommodations for parents. In the surgery department, overlapping and crowded waiting
areas with lack of privacy were all issues. The emergency department was inconvenient,
loud, overcrowded, stressful, uncomfortable and evoked feelings of chaos. Each of these
observations were documented and compared to the other health care facilities and
evidence-based design literature and research literature that existed at the time to create
satisfying design solutions. (Zacharakis).
These issues were addressed and made manifest in the new design of the hospital.
The new hospital designates three individual “zones”; patient, family, and staff.
(Zacharakis). The private, single-bed rooms provide a toilet, and various hospitality
amenities such as internet service and room service. Storage was implemented to provide
supplies at the bedside and includes patient care equipment in each room. Private rooms
include custom-designed sofa sleepers, gliders, recliners, and sleep chairs. Each inpatient
and critical care floor provides a “family zone” Family Center featuring private sleeping
rooms, kitchen, laundry areas and lounge space for parents and siblings of all ages.

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(Zacharakis). Each floor provides access to nature and “healing” gardens. These new design
changes give the patient and parent a sense of control and calmness. (Kotzer).
The hospital also features a young adult safe-space for teens that includes a movie
theater, pool table, arcades, basketball quart, music and reading areas, a kitchen, cell phone
areas and a computer lab. Child Life and Creative Play areas offer parents a break from
kids. A 24-hour cafeteria connects to outdoor seating, with a gelato and espresso bar
adjacent to a sun-lit atrium. (Zacharakis).
Hospital staff was not neglected. Personal lounge areas, private showers, workout
and gym facilities, bike racks, conference rooms and staff-only patio terraces allows staff to
recuperate from stress and fatigue. (Zacharakis).
Decentralized nursing stations were implemented while still maintaining a
centralized “hub” area for staff to communicate and consult privately, complete
administrative tasks and accommodate visitors. Decentralized stations improve efficiency,
contact with patient and reduces distraction. (Zacharakis). The goal was to increase
patient-nurse interaction by 70%. (Kotzer). The new surgery rooms improved circulation,
reduced walking distances and fatigue, and includes a skylit interior with nature and
artwork integrated into the waiting space for pre-operative and post-operative patients
and families. (Zacharakis).
Emergency rooms were designed to have south-facing views that attach to outdoor
gardens, sunlight, and clean fresh air. The space provides a safe, secure entry with easy
check-in. Additionally, food services are accessible 24-hours a day. This reduces stress and
chaos by providing a calm, relaxing, and therapeutic environment. (Zacharakis).

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Color has a strong psychological and subliminal effect on human behavior and
emotions. Color theory and scientific research was used to consider the amount, intensity,
and value of colors used throughout the hospital. (Zacharakis). From this research, the
designers composed five color palettes to use throughout the hospital; Community, Social,
Spirited, Tranquil, and Work. (Zacharakis). Each of the color palettes were inspired by
Colorado’s geography and natural scenery, with specific colors chosen for their therapeutic
and healing qualities and used in areas most helpful to the patient and staff.
Active areas, such as the cafeteria, express the Social Palette with vibrant, rich reds,
oranges, greens, and yellows complimented with images of Colorado. In contrast, the
Tranquil Palette creates a tranquilizing environment, consisting of a variety of pastel colors
like sky blue, mint green, butter yellow, and lavender, strategically used in the chapel,
intensive care units (ICU), and some waiting areas. Adventurous and daring colors such as
turquoise, magenta, apple green, and sunflower yellow comprise the Spirited Palette
located in clinic spaces and on inpatient floors. Lastly, the circulation areas and the atrium
have fun splashes of color contrasting with neutral undertones that make up the
Community Palette. (Zacharakis).
In light of the research available at the time, the designers designed an interior
court-yard and six-story atrium to take advantage of the sunlight’s ability to reduce pain,
depression, agitation and improve sleeping patterns. Lots of windows and various interior
light fixtures illuminate patient rooms, corridors, offices, and staff areas. (Zacharakis).
Final analysis and case study results show a significant decrease in noise levels and
satisfying results on lighting perceived by patients and staff compared to the previous
location. Staff retention rates have dramatically increased.

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As one of The Center for Health Design's Pebble Projects, The Children's Hospital is
a part of an ongoing research study to determine if the new designs meet objectives for
healing, reduced infection rates, staff recruiting and retention rates, and reduction in
operating costs and how these changes can be implemented in other hospitals across the
country. (Zacharakis).
In conclusion, we have learned about the significant impact that design and the
many components that make up our environment has on our health, mind, and well-being.
We’ve reviewed what evidence-based design is, how it’s evolved over the years, and its
implementation in healthcare settings. We’ve also learned the importance of evidence-
based design and the research designers should consider during the design process.
Evidence-based design doesn’t just end in healthcare. Recently, the American
Society of Interior Designers published a research study, “Researching Home: Evidence-
based Residential Design”, that implements EBD in residential interiors in practical,
meaningful ways, creating healing, therapeutic environments right in our own homes!
Welcome to the innovative, dynamic design of the future!

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What is evidence-based design?
“Evidence-based design is the process of bas-
ing decisions about the built environment on
credible research to achieve the best possible
outcomes.”
“An evidence-based designer, together with
an informed client, makes decisions based on
the best available information
from research and project evaluations.”

The Evolution of evidence-based design

ebd’S Foundation: The Design Process
“How will the proposed project incorporate all relevant
and proven evidence-based design innovations to optimize
patient safety, quality and satisfaction, as well as work-force
safety, satisfaction, productivity and energy efficiency?”

Single-Bed Rooms
“Your design decisions are
memorialized in
concrete and steel and effect
patient
outcomes, how care is provided
by nurses,
physicians, and other health-
care
professionals,and
the survivability of healthcare
organizations
who often must add additional
resources to fix design mis-
takes.”

Single-Bed Rooms
“The subliminal effect of your
environment can influence your
emotions and thoughts.”

The Internal Impact of Lighting

Modern Hospital Interiors
“Architecture and interior design is not just a job. It is a responsible
commitment in community service; a responsibility to the enduring and
creative advancement of humankind and environmental preservation.”

Case Study: The Children’s Hospital of Denver, Colorado
“We envision a world where every hospital, health clinic, treatment
center, doctor’s office, and residential care facility is designed to improve
both the quality of care and outcomes for patients, residents, and staff.”

Works Cited
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DESIGN JOURNAL. 7.1 (2013): n. page. PDF file. 18 Mar. 2014.
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search & Design Journal. (2013): page 2-3. PDF file. 18 Mar. 2014.
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JPEG File. 18 Mar 2014.
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Sheffield Children's Hospital. Oncology garden, Sheffield Children's Hospital. 2014. Photograph. Sheffield Children's, Western
Bank, Sheffield, UK. Web. 18 Mar 2014.
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Works Cited
Stichler. “Applying Different Processes for Evidence-Based Design.” HEALTH ENVIRONMENTS RESEARCH &
DESIGN JOURNAL. 7.1 (2013): n. page. PDF file. 18 Mar. 2014.
ZGF Architects LLP, . The Children’s Hospital, Denver, Colorado. 2007. Photograph. n.p. Web. 20 Mar 2014.
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Cardon Children's Medical Center, . N.d. Photograph. Banner Health Web. 20 Mar 2014.
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Renown Health, . Renown Children's Hospital. 2014. Photograph. RenownWeb. 20 Mar 2014.
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sWeb. 20 Mar 2014.
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Children's Rehabilitation Center, . Children's Rehabilitation Center. N.d. Photograph. The Pediatric CenterWeb. 20 Mar 2014.

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