The role of physical design and informal communication

extraordinary opportunity to apply the findings of research aimed at improving the
quality of healthcare’s physical environment.
1.2 Evidence-Based Design
The current boom in the construction of hospitals is a reaction to the existing
condition of the healthcare environment in the U.S. New facilities are needed to
replace the outdated “Hill-Burton era” buildings of the mid 20 th century and will
address issues such as the nursing shortage, the rising expectations of consumers, the
aging of baby boomers, advancements in information and medical technology, and the
increase in life expectancy. Occurring alongside this transformation of the industry
and its consumers is public concern for the shockingly high prevalence of medical
errors in U.S. hospitals reported by the Institute of Medicine (IOM) in To Err is
Human: Building a Safer Health System (1999). This report and others like it (IOM,
2001; IOM, 2003) have revealed the fact that hospitals are needlessly unsafe and
stressful for both patients and staff.
The construction boom presents hospital executives and architects with an
opportunity to embrace the practice of using evidence-based design – “a deliberate
attempt to base design decisions on the best available research findings” (Hamilton,
2004). Thanks to advocacy from the Center for Health Design, there is a growing
respect for the idea that a carefully considered and well-designed healthcare
environment - based on the findings of research - can have a positive impact on the
well-being of patients and staff. The Center for Health Design is promoting the use of
evidence-based design to create healing environments through a pioneering initiative
known as the Pebble Project. The goal of this project is to provide documented
examples of how using evidence-based design can improve the quality of care as well
as financial performance (The Center for Health Design, 2006). To date, a collection
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