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The built environment and its impact on health outcomes and experiences of patients, significant others and staff—A protocol for a systematic review
Aim This review will identify, evaluate and synthesize the literature related to evidence‐based design of healthcare environments and to identify impacts of the built environment on the outcomes and experiences of patients, significant others and staff. Design A mixed‐method systematic review of literature 2010–2018. Methods Database searches for evidence in peer‐reviewed journals will be conducted electronically using CINAHL, Medline, SCOPUS and Web of Science. , full‐text screening and data extraction will be completed independently by the reviewers. Quality assessment will follow Swedish Agency for Health Technology Assessment and Social Services Assessment. Results This review will offer knowledge for informed decisions about the design of the healthcare environment. The review is comprehensive, includes a large volume of literature various research designs and will highlight the knowledge gap in evidence‐based design and provide a breadth of knowledge about the built environments and its impact on health and well‐being.
Journal Article
Design Quality in the Context of Healthcare Environments: A Scoping Review
Objective:
We explored the concept of design quality in relation to healthcare environments. In addition, we present a taxonomy that illustrates the wide range of terms used in connection with design quality in healthcare.
Background:
High-quality physical environments can promote health and well-being. Developments in healthcare technology and methodology put high demands on the design quality of care environments, coupled with increasing expectations and demands from patients and staff that care environments be person centered, welcoming, and accessible while also supporting privacy and security. In addition, there are demands that decisions about the design of healthcare architecture be based on the best available information from credible research and the evaluation of existing building projects.
Method:
The basic principles of Arksey and O’Malley’s model of scoping review design were used. Data were derived from literature searches in scientific databases. A total of 18 articles and books were found that referred to design quality in a healthcare context.
Results:
Design quality of physical healthcare environments involves three different themes: (i) environmental sustainability and ecological values, (ii) social and cultural interactions and values, and (iii) resilience of the engineering and building construction. Design quality was clarified herein with a definition.
Conclusions:
Awareness of what is considered design quality in relation to healthcare architecture could help to design healthcare environments based on evidence. To operationalize the concept, its definition must be clear and explicit and able to meet the complex needs of the stakeholders in a healthcare context, including patients, staff, and significant others.
Journal Article
Transforming Building Criteria to Evidence Index
There is increasing pressure from developers toward architects and engineers to deliver scientifically sound proposals for often complex and cost-intensive construction products. An increase in digitalization within the construction industry and the availability of intelligently built assets and overall sustainability make it possible to customize a construction product. This servitization of construction products is assumed to perform much preferably in satisfying stakeholders’ physical, psychological, and social needs. The degree to which these products are performing can be evaluated through an evidence index. This article aims to introduce a conceptual model of an evidence index and test it in the programming stage of a case study. The investigation follows the evidence-based design approach and renders evidence through key performance indicators in the programming stage of the building process. For testing the concept, a case study investigation was performed by simulating a novice research assistant, and the amount of evidence was collected and appraised for evidence index. The case study showed that key performance indicators of a servitized project could be evaluated on a four-point scale. The quality of the evidence index generation depended on the level of expertise the evaluator has in research and the skilful use of scientific databases.
Journal Article
Evidence-Based and Value-Based Decision Making About Healthcare Design
Objective:
This study describes a vision and framework that can facilitate the implementation of evidence-based design (EBD), scientific knowledge base into the process of the design, construction, and operation of healthcare facilities and clarify the related safety and quality outcomes for the stakeholders. The proposed framework pairs EBD with value-driven decision making and aims to improve communication among stakeholders by providing a common analytical language.
Background:
Recent EBD research indicates that the design and operation of healthcare facilities contribute to an organization’s operational success by improving safety, quality, and efficiency. However, because little information is available about the financial returns of evidence-based investments, such investments are readily eliminated during the capital-investment decision-making process.
Method:
To model the proposed framework, we used engineering economy tools to evaluate the return on investments in six successful cases, identified by a literature review, in which facility design and operation interventions resulted in reductions in hospital-acquired infections, patient falls, staff injuries, and patient anxiety.
Results:
In the evidence-based cases, calculated net present values, internal rates of return, and payback periods indicated that the long-term benefits of interventions substantially outweighed the intervention costs. This article explained a framework to develop a research-based and value-based communication language on specific interventions along the planning, design and construction, operation, and evaluation stages.
Conclusions:
Evidence-based and value-based design frameworks can be applied to communicate the life-cycle costs and savings of EBD interventions to stakeholders, thereby contributing to more informed decision makings and the optimization of healthcare infrastructures.
Journal Article
Informing Healthcare Waiting Area Design Using Transparency Attributes: A Comparative Preference Study
Objective:
This study aimed to explore people’s visual preference for waiting areas in general hospital environments designed with transparency attributes that fully integrate nature.
Background:
Waiting can be a tedious and frustrating experience among people seeking healthcare treatments and negatively affect their perception of the quality of care. Positive distractions and supportive designs have gained increasing attraction to improve people’s waiting experience. Nature, which has shown therapeutic effects according to a growing amount of evidence, could be a distinguished positive distraction in waiting areas. Additionally, the theory of transparency was operationalized to indicate a spatial continuity between the external nature and the built interiors in general healthcare waiting area design.
Method:
A survey method was adopted in the study. Twenty-one images of general healthcare waiting areas depicting three design typologies were preselected following a strict procedure, including designs with (a) no window views, (b) limited window views to nature, and (c) transparent spaces with maximum natural views. Ninety-five student participants rated the images based on their visual preference using a Likert-type scale.
Results and Conclusions:
The results showed that transparent waiting areas were significantly preferred. A significant positive relationship existed between the level of transparency and people’s preference scores. The factor analysis indicated additional supportive features that may affect people’s preferences, including daylight, perceived warmth, noninstitutional furniture arrangement, visual orientation, and the use of natural materials for interior design. However, these tentative results need to be furthered tested with the real patient population as the next step of this study.
Journal Article