1 / SPK / archives@tulane.edu

The quality of human life is eternally dependent on the harmony of man and his environment. Man’s basic needs are food, clothing and shelter. As society has advanced his expectations of life has grown to enhancement and fulfillment. This is only possible through what is “justly referred to as the most complex of contemporary social institutions.” 1 The hospital. Conversely where man finds life he also finds one of the leading causes of death. One in every twenty five hospital patients are affected by a hospital-acquired infection (HAI).2 The architects behind hospitals are not only responsible for impacting the emotional experience of the space but the health of the patients being cared for and the staff who is tending to them. The design is thereby crucial to the hospital’s success at treating patients and keeping them healthy. The current design process begins with new relationships between each of the essential entities. The design suffers from these “tabula rasa” connections when they could be improving exponentially with each project through a continuously transformative process. The static logic of space is used in an effort to overcome the inherent complexities of each project. Hospital-acquired infections can be prevented through a new paradigm of collaborative hospital construction. Can changing the approach to hospital design be a catalyst to preventing HAIs? Incorporating LEAN principles from both healthcare and construction will evolve the current framework in which hospitals are constructed. This will break many of the current boundaries and setup a new platform for future hospital developments. / 0 / SPK / specialcollections@tulane.edu

Since the 1960s, researchers have been exploring how the design of the built environment impacts the health and well-being of occupants and users. By the 1980s, further research began to focus on healthcare facilities in particular and how design could influence patient healing and medical staff performance (Alfonsi, 2014). Evidence-Based Design (EBD) is "the process of basing decisions about the built environment on credible research to achieve the best possible outcomes" (CHD, 2016). The desired outcomes of Evidence-Based Design recommendations include improvements in the following: patient healing, patient experience and comfort, medical staff performance, and medical staff job satisfaction (CHD, 2017). Extensive research has been done on the subject of EBD; however, the question remains whether or not the latest research findings are being utilized by the design and construction industries in practice. The purpose of this research is to determine whether or not the latest scientific knowledge and research findings are being implemented into hospital renovation projects by the healthcare design and construction industries. A list of recommendations from existing EBD literature was compiled. Construction documents from 30 recent healthcare facility renovation projects across the United States were then obtained and analyzed. The findings indicate that EBD recommendations are being adopted in practice at consistently high levels. These findings also reveal that there are still areas of potential improvement which could inform those who influence or determine building and design codes, standards, and guidelines. The results are instructive to owners, designers, and contractors by providing a glimpse into how well the industry is recognizing and implementing known best practices. The findings likewise open up new opportunities for further research which could lead to additional improvement in the healthcare facilities of the future.