Healthcare Design - October 2015 - 37


Seeds of
change
multiple incubators. About seven years ago
the department was renovated to become a
single-family design layout, where even Level 3
babies (very premature and vulnerable, 24-28
weeks gestation), could be with their moms
within about four hours after C-section. Instead
of Mom being assigned a bed in a different unit,
Mom and Dad are now with the baby continuously in
a private room in the renovated unit. Even a 25-week

baby can be on their mother's chest for skin-to-skin
contact and bonding soon after delivery. Importantly, the clinicians developed and implemented an
integrated bundle of family-centered care interventions
and components. The architectural renovation is what
made implementing the new care model possible.
What made this project a game-changer is that the
researchers randomly assigned half of about 360 preterm infants to the new unit, and the other half to the
old-style unit that limited the presence of the mom and
dad and the amount of training and information they
could be given. The new unit cut length of stay in Level
3 intensive care by more than 10 days, and reduced
mortality. Several other clinical outcomes were also
improved: Infants got to healthier weights faster, and
the families were better informed and coped better.
This is a well-documented example where a carefully specified and integrated cluster of architectural and
care process changes greatly improved outcomes.
Obviously, when design can enable major improvements in outcomes in one of the more expensive
per-day contexts in healthcare, a lot of money can be
saved quickly. As shown in a recent article [Shepley et
al., 2014, Journal of Perinatology] the business case
that goes with this NICU renovation is powerful.
Some people in the industry, however, voice
frustration regarding EBD, suggesting that
there's nothing significant happening right now.
Why isn't there more awareness of EBD research,
or the progress I've been referring to? I've heard this
comment a couple of times myself in northern Europe
over the past year. When you hear it from informed
people or practitioners, it's worth stopping and thinking about why they have that view.

Preview

BY KRISTIN D. ZEIT

I think, frankly, part of the explanation goes back to a
critique that many university-based design researchers
and teachers have made over the years, that architects

"As a researcher, when I hear people
say there hasn't been anything new,
I think, oh, really?"
and designers generally don't read much research.
Perhaps some healthcare design practitioners do more
profession-related reading than average, and there's
a lot for them to read-trends in healthcare, management journals-a lot of diverse information is out there.
Not reading research is understandable up to a point;
it takes time. The great majority of original research
articles appear in scientific or medical journals. The
language is technical, descriptions of research methods
are complex and scientific... it can be hard slogging.
Nonetheless, I'm disappointed when I see design
articles or presentations that simply restate or recycle
lists of EBD guidelines from earlier literature reviews. The
last comprehensive literature review was in 2008.
For design practitioners who are busy, who aren't
trained in research, it would certainly be desirable to
have a way to bring them up to speed more quickly, and
put them more in touch with new stuff that's appearing.
EDAC [The Center for Health Design's evidence-based
design accreditation and certification program] is one
important way of doing this. But there's clearly a need
for a new comprehensive review of the literature.
The Center's website summarizes individual research
articles as abstracts and sometimes discusses the
design implications. That's important, and the abstracts
are useful. A good systematic review, though, goes

HCDmagazine.com 10.15

37


http://www.HCDmagazine.com

Table of Contents for the Digital Edition of Healthcare Design - October 2015

Healthcare Design - October 2015
Contents
hcdmagazine.com
Editorial
Show Talk
Monitor
Interiors
The Center
Adapt and Overcome
Seeds of Change
Site Seeing
State of Mind
Research
Special Advertising Section: 2015 Landscape Design Portfolio
First Look
Healthcare Design - October 2015 - Healthcare Design - October 2015
Healthcare Design - October 2015 - Cover2
Healthcare Design - October 2015 - 1
Healthcare Design - October 2015 - Contents
Healthcare Design - October 2015 - 3
Healthcare Design - October 2015 - hcdmagazine.com
Healthcare Design - October 2015 - 5
Healthcare Design - October 2015 - Editorial
Healthcare Design - October 2015 - 7
Healthcare Design - October 2015 - Show Talk
Healthcare Design - October 2015 - 9
Healthcare Design - October 2015 - Monitor
Healthcare Design - October 2015 - 11
Healthcare Design - October 2015 - 12
Healthcare Design - October 2015 - 13
Healthcare Design - October 2015 - 14
Healthcare Design - October 2015 - 15
Healthcare Design - October 2015 - 16
Healthcare Design - October 2015 - 17
Healthcare Design - October 2015 - 18
Healthcare Design - October 2015 - 19
Healthcare Design - October 2015 - Interiors
Healthcare Design - October 2015 - 21
Healthcare Design - October 2015 - 22
Healthcare Design - October 2015 - 23
Healthcare Design - October 2015 - 24
Healthcare Design - October 2015 - 25
Healthcare Design - October 2015 - The Center
Healthcare Design - October 2015 - 27
Healthcare Design - October 2015 - Adapt and Overcome
Healthcare Design - October 2015 - 29
Healthcare Design - October 2015 - 30
Healthcare Design - October 2015 - 31
Healthcare Design - October 2015 - 32
Healthcare Design - October 2015 - 33
Healthcare Design - October 2015 - 34
Healthcare Design - October 2015 - 35
Healthcare Design - October 2015 - Seeds of Change
Healthcare Design - October 2015 - 37
Healthcare Design - October 2015 - 38
Healthcare Design - October 2015 - 39
Healthcare Design - October 2015 - 40
Healthcare Design - October 2015 - 41
Healthcare Design - October 2015 - Site Seeing
Healthcare Design - October 2015 - 43
Healthcare Design - October 2015 - State of Mind
Healthcare Design - October 2015 - 45
Healthcare Design - October 2015 - 46
Healthcare Design - October 2015 - 47
Healthcare Design - October 2015 - 48
Healthcare Design - October 2015 - 49
Healthcare Design - October 2015 - 50
Healthcare Design - October 2015 - 51
Healthcare Design - October 2015 - 52
Healthcare Design - October 2015 - 53
Healthcare Design - October 2015 - Research
Healthcare Design - October 2015 - 55
Healthcare Design - October 2015 - 56
Healthcare Design - October 2015 - 57
Healthcare Design - October 2015 - Special Advertising Section: 2015 Landscape Design Portfolio
Healthcare Design - October 2015 - 59
Healthcare Design - October 2015 - 60
Healthcare Design - October 2015 - 61
Healthcare Design - October 2015 - 62
Healthcare Design - October 2015 - 63
Healthcare Design - October 2015 - First Look
Healthcare Design - October 2015 - Cover3
Healthcare Design - October 2015 - Cover4
Healthcare Design - October 2015 - SCover1
Healthcare Design - October 2015 - S1
Healthcare Design - October 2015 - S2
Healthcare Design - October 2015 - S3
Healthcare Design - October 2015 - S4
Healthcare Design - October 2015 - S5
Healthcare Design - October 2015 - S6
Healthcare Design - October 2015 - S7
Healthcare Design - October 2015 - S8
Healthcare Design - October 2015 - S9
Healthcare Design - October 2015 - SCover3
Healthcare Design - October 2015 - SCover4
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