18 Jun Acoustic

The 8 steps of evidence-based healthcare design

Evidence-based Design (EBD) for healthcare is on the rise. Two recent examples where EBD has been used for designing healthcare institutions in Australia are the Fiona Stanley Hospital in Perth and the Gold Coast University Hospital. Many more examples from all over the world can be found in a collection of case studies published from the Center for Health Design documents containing 14 EBD case studies.

The following points will give you a better understanding what exactly EBD is, how using EBD can improve the project outcome and what the best procedure is to start using it?

EBD is a movement that was started in 1972 by Professor Archie Cochrane and his book "Effectiveness and Efficiency: Random Reflections on Health Services". The idea of the movement is to puts focus on basing decisions affecting the design and the build of a project on reliable scientific research, with the goal to obtain the optimal result for all stakeholders of the building.

Recent examples that can demonstrate how EBD has improved the outcome of projects with measurable benefits to the key stakeholders of the building have put the process into the limelight. Particularly in the design of hospitals and other healthcare facilities, where a variety of stakeholders have to be considered, there seems to be much to gain via this approach. If the healing of people’s physical or mental issues during their stay at a health facility can be accelerated or if the design of the health facility improves the conditions and wellbeing for patients, visitors and for those who work there, this has a direct and positive impact on the community.

The Butler County Health Care Center in David City, Nebraska is one example where using evidence-based design (EBD) has improved patient outcomes and staff work environment, while being more cost efficient. Measurable benefits of this project include patient and staff wellbeing, patient healing, stress reduction and safety.


The following eight step approach suggested by Healthcare Design Knowledge Expert Sara Marberry is meant to serve as an initial guide on EBD and delivers information about where to start when designing a healthcare facility founded on scientific research:
  1. Define EBD goals & objectivesThe overall goal might be related to the buildings’ purpose and its functionality within the community. Reducing patient and staff stress, improving safety and quality and increasing operational efficiency should also be relevant goals.
  2. Find sources for relevant evidenceThere is a plethora of research papers out. A good place to start to look is through ‘research journals’ or on ‘dedicated health design or EBD sites’. Also check out the Knauf e-book on Healthcare design.
  3. Critically interpret relevant evidenceMake sure the findings are the outcome of repeatable and reputable scientific methods. Avoid findings that do not provide a source of their findings and the statistical details and methods that were used for the study.
  4. Create and innovate EBD conceptsPlay with what has been done and explore how going a step further could be beneficial for your project.
  5. Develop a hypothesisUse existing knowledge and build on it.
  6. Collect baseline performance measuresWhere available use existing data from a building before refurbishment or from comparable health facilities as a baseline performance measure.
  7. Monitor implementation of design and constructionThe project team is responsible for monitoring the implementation of the EBD interventions during the construction phase and has to make sure that the defined goals and objectives will not be compromised. Any alternate design solutions that might be suggested for cost reasons, should always take into account the impact on the project outcome. Any actual design changes should be documented and potential impacts on the project outcomes should be pointed out and captured.
  8. Measure post occupancy performance resultsMeasure levels or changes in noise, light, traffic, aesthetics, staff satisfaction, patient healing rate, average bed occupancy rates etc. to evaluate key performance indicators defined in point 1 of this list.

As explored above, using evidence-based design for building healthcare facilities can be an effective approach to set and achieve the objectives and goals of a project. With this new understanding of evidence-based design you might consider using it for your next healthcare project.

If this was helpful for you why don’t you check out our e-book on Healthcare design