JONA Volume 37, Number 1, pp 1-4 Copyright B 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins Using Evidence-based Design to Improve Outcomes Jaynelle F. Stichler, DNSc, RN Nearly $200 billion of healthcare construction is expected by the year 2015, and nurse leaders must expand their knowledge and capabilities in healthcare de- sign. The goal of this bimonthly department is to prepare the nurse leader in using the evidence-based design process to ensure that new, expanded, and renovated hos- pitals facilitate optimal patient outcomes, enhance the work envi- ronment for healthcare providers, and improve organizational per- formance. In this article, the author introduces the concept of evidence-based design and its importance to nurse executives as a decision-making framework for healthcare design. An estimated $200 billion will be spent on the design and construc- tion of new hospitals or the reno- vation and expansion of existing hospitals by the year 2015. 1 Driving forces for this health- care construction boom include (1) competition for patients, phy- sicians, nurses, and other health- care providers; (2) increased space to accommodate newer technol- ogy; (3) facility improvements to improve patient safety and opera- tional efficiency; and (4) new regulatory guidelines for seismic requirements and surge capacity in response to natural and man- made disasters. Aging buildings and the designs of previous years no longer support contemporary practice or conventional knowl- edge about the effects of the healthcare environment on patient health and safety, care efficiency, staff effectiveness, and the work experience. Although designing and build- ing a new facility is exhilarating, it presents an awesome responsi- bility and an opportunity of a lifetime for the nurse executive. Many nurse executives have little formal education in health design or construction yet must assume leadership in the design process to ensure an optimal outcomes. New Environments for Care and Work Hospital design and construction is one of the biggest capital invest- ments made by healthcare organi- zational and system leaders. The design decisions they make have the potential to affect patient out- comes, the work life of the care providers, and organizational per- formance. Although healthcare providers want to provide the best care possible to patients, the physi- cal environment itself can increase the probability of adverse patient outcomes due to medical errors, hospital-acquired infections from poor hand-washing because of improperly placed sinks or hand cleaner dispensers or airborne con- tamination from inadequate me- chanical systems, or patient falls from inadequately sized door openings or rooms too small to accommodate all the necessary furniture and equipment. It is critical to design hospitals that address specific ways to reduce stress, prevent patient and staff injury, promote healing, and sup- port professional practice. Healthcare Facilities as Healing Environments The vision of building hospitals and health facilities as ‘‘healing environments’’ is gaining momen- tum, and the notion that hospitals must be ‘‘hospitable’’ is becoming reality. The overall aesthetics and feel of the healthcare facility are critical and can be determinants Evidence-based Health Facility Design JONA  Vol. 37, No. 1  January 2007 1 Author’s affiliations: Associate Professor School of Nursing, Concentration Chair for Nursing Systems Administration, San Diego State University, and Senior Healthcare Consultant and Evidence-based Design Researcher, NTDStichler, Architects, Inc, San Diego, Calif. Correspondence: PO Box 28278, San Diego, CA 92198 (jstichler@aol.com). Copyr ight © Lippincott Williams & Wilkins. Unauthor iz ed reproduction of this article is prohibited.