EVIDENCE-BASED DESIGN IN PRACTICE

Healthcare Design Case Studies from EDAC Champion and Advocate Firms

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Evidence-based design (EBD) is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes. EDAC Champion and Advocate Firms take an additional step, ensuring their healthcare teams become EDAC certified and actively incorporate EBD in their healthcare projects. Each of the projects highlighted in the EDAC Advocate Brochure describe how the evidence-based design process was applied to address challenges in their projects.

Steelcase Health is EDAC's Educational Partner, o!ering study sessions and other resources to help prepare for the EDAC exam.

Join our growing list of EDAC Advocate Firms.Champion Firms:Kahler SlaterHarley Ellis DevereauxCannonDesignCAMA, Inc.American Art ResourcesSalvatore Associates

Advocate Firms:ArchiMed Architecture+B+H ArchitectsBouygues Building CanadaBurns & McDonnellCBLH Design, Inc.CEI ArchitectureCorgan Associates, Inc. Czopek Design Studio, Inc.Davis Partnership ArchitectsEarl Swensson Associates, Inc.Erdenberger Design GroupERDMANGenslerGresham, Smith & PartnersHDR Architecture, Inc.

�'!£;,$!8'��8;��329<£ধ2+HGA Architects and EngineersHKS, Inc.Holland Basham ArchitectsHuelet Davis Healing DesignJAIN MALKIN, Inc.Kaiser PermanenteKasian ArchitectureLEO A DALY�!AA'ষT� 2$WParkin Architects LimitedPerkins+WillPeters & Associates, Architects, P.C.Plenary GroupProgressive AESilver Thomas HanleySkyline Art ServicesSpellman Brady & CompanyStantecT2 Designs, Inc.Visions in ArchitectureWellness Environments, Inc. ZGF Architects ���3ħ'8��8$,-;'$;9T� 2$W

To become an Advocate Firm, contact edac@ healthdesign.org

Define EBD Goals & Objectives

Find Sources for Relevant Evidence

Critically Interpret Relevant Evidence

Create & Innovate EBD Concepts

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Become EDAC certified. =-&'2$'f#!9'&��'9-+2��$$8'&-;!ধ32�!2&��'8ধ)$!ধ32�l���m�!99'99'9�@3<8�023>£'&+'�3(� ;,'�'=-&'2$'f#!9'&�&'9-+2� l��m�683$'99�!2&� -;9�!66£-$!ধ32�-2�;,'�&'9-+2�!2&�&'='£361'2;�3(�,'!£;,$!8'�'2=-8321'2;9W��,-9�'&<$!ধ32!£�683+8!1�;'!$,'9�@3<�,3>�;3�)2&T�<9'�!2&�$8'!;'�8'£'=!2;�8'9'!8$,�;3�-1683='�healthcare outcomes and add to the knowledge base of EBD.

Since its launch in 2009, more than 1,900 individuals worldwide have

3#;!-2'&�;,'�����$8'&'2ধ!£W��<88'2;£@T��¤�-2&<9;8@�38+!2-A!ধ329�'2&389'�;,'� 683+8!1W� �,!16-32� -819� 6!8ধ$-6!;'&� -2� ;,'� #';!� ;'9ধ2+� 6,!9'� !2&�>'8'�;,'�)89;�;3�$311-;�9;!ø�;3�;!0'�;,'�'?!1W��&=3$!;'�-819�&'&-$!;'�!�1-2-1<1�3(���¦�3(�;,'-8�,'!£;,$!8'�;'!19�;3�#'$31'�����$'8ধ)'&W�

Develop a Hypothesis

Collect Baseline Performance Measures

Monitor Design & Construction

Measure Post Occupancy Results

The evidence-based design process includes eight steps:

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�2'f@'!8�639;�3$$<6!2$@T�!2�32£-2'�9<8='@�3(�9;!øT�$£-'2;9�!2&�&'9-+2'89�>!9�$32&<$;'&�<9-2+�!��-0'8;�9$!£'T� 8!ধ2+�$3£38�'ø'$ধ='2'99� (831�[-2'ø'$ধ='�;3�='8@�'ø'$ধ='\W��'9632&'2;9�,!&�!2�!='8!+'�8!ধ2+�3(�z'ø'$ধ='z�>-;,�23�8!ধ2+�#'£3>�[(!-8£@�'ø'$ধ='zW��,'�32£@�2'+!ধ='�(''&#!$0�>!9�;,!;�;,'�<9'�3(�color didn't extend throughout the facility. Studies in 3-5 years will focus on: -(�;,'�<9'�3(�=-#8!2;�$3£38�683=-&'9�£!9ধ2+�639-ধ='�8'-2(38$'1'2;T�-(�,!#-;!ধ32�&-1-2-9,'9�;,'�#'2');9T�-(�;,'�8'96329'�;3�$3£38�&-ø'89�9'!932!££@T�!2&�-(�$3£38�,!9�!2@�1'!9<8!#£'�-16!$;�32�1'&-$!ধ32�8'&<$ধ32c&'6'2&'2$@W

The facility is an 89 bed forensic mental health care facility dedicated to the ;8'!;1'2;�!2&�8',!#-£-;!ধ32�3(�$£-'2;9T�>,3�&<'�;3�1'2;!£�-££2'99�,!='�#''2�/<&+'&�z$8-1-2!££@�23;�8'96329-#£'z�(38�;,'-8�!$ধ329�!2&�!8'�1!2&!;'&�;3�!�ধ1'�3(�,'!£-2+�!;�;,'�(!$-£-;@W��,'8'�!8'�;,8''�1!-2�$31632'2;9V�!�[,3<9'\T�[2'-+,#38,33&\� !2&� [&3>2;3>2\� 8'68'9'2ধ2+� ;,'� ;8!29-ধ32� ;3>!8&9�recovery and return to the community.

The challenge was to select colors that promoted healing for clients whose -££2'99� -9�=!8-'&�!2&�1!@�8'!$;�&-ø'8'2;£@�;3�$3£38�38� -1!+'�9ধ1<£-W� [�!0'8f�-££'8��-20\T�!9�&3$<1'2;'&�-2�!�9;<&@�#@��'22'ħ�l����m�;3�8'&<$'�!++8'99-32�38�!2ধf93$-!£�#',!=-38T�,!9� (381'&� ;,'�#!9-9�3(� -29ধ;<ধ32!£�$3£38�6!£'ħ'9W�The overuse of certain blues and greens in mental healthcare environments ,!9�#''2�8'638;'&�;3�'?!$'8#!;'�&'68'99-32�!2&�$8'!;'�!2�-29ধ;<ধ32!£�(''£�l�!£0'�';� !£WT� ���¤mW��3>'='8T� 931'� (3<2&� ;,'8'� -9�23� $£'!8� '=-&'2$'� ;,!;�$3£38�!ø'$;9�133&T�'13ধ329T�38�69@$,3£3+-$!£�>'££�#'-2+�-2�!2@�9@9;'1!ধ$�1!22'8�l=!29T�����mW�

A robust document review was undertaken including more than 30 journal papers as well as industry websites and design guidelines. Research found $3883#38!ধ2+�'=-&'2$'�;,!;�=-#8!2;�$3£389�$32;8-#<;'�;3�!�138'�$31(38;!#£'�,'!£-2+� '2=-8321'2;� >,-£'� 8'&<$-2+� ;,'� 9ধ+1!� !993$-!;'&� >-;,� 1'2;!£�,'!£;,�>-;,3<;�-2=30-2+�!+-;!ধ32�!2&�#',!=-38!£�3<;#8'!09�!993$-!;'&�>-;,�$3£38� 9;'8'3;@6'9W� �3�1!?-1-A'� ;,'� -16!$;� !2&� 639-ধ='� #'2');9T� $!8'(<£�$329-&'8!ধ32�>!9�+-='2�;3�!993$-!ধ2+�$3£389�>-;,�;,'�&'9-+2!;'&�!8'!9W

Input was collected from clinical users who had amassed their own body of knowledge, stakeholders who had experience with color therapy, as well as !2'$&3;!£�'=-&'2$'�(831�;,'-8�3>2�683('99-32!£�'?6'8-'2$'W��3£38�6!£'ħ'9�were presented to the clinicians for approval.

�38'�=-#8!2;�!2&�9!;<8!;'&�$3£389�>'8'�9'£'$;'&�(38�<9'�-2�;,'�z�3>2;3>2z�g�!$ধ='�93$-!£�,<#T�>,-£'�>!81'8�933;,-2+�$3£389�>'8'�<9'&�-2�;,'�8'9-&'2ধ!£�!8'!9T�9<$,�!9�;,'�[�3<9'\�-2$£<&-2+�6!ধ'2;�9£''6-2+�!8'!9W��!8+'8�96!$'9�used vibrant accent colors, such as indigo, red, and violet, juxtaposed with warm neutral shades to create vibrant spaces to encourage clients, while 9-1<£;!2'3<9£@�683=-&-2+�131'2;9�3(�$!£1W� 2�91!££'8�138'�-2ধ1!;'�96!$'9T�soothing shades, such as orange, were selected to promote self-esteem and 36ধ1-91�l�3+2-ধ='��',!=-3<8��,'8!6@��'£(��'£6��'93<8$'9T�����mW���$$'2;�colors in these spaces were limited to one wall. This strategy also reinforced >!@f)2&-2+�;3�2!=-+!;'�;,'�(!$-£-;@W

1 42 5 73 6 8

Solution:

Results:

Overview:

Challenge:

Parkin Architects LimitedSouthwest Centre for Forensic Mental Healthcare

St. Thomas, Ontario

EBD STEPS APPLIED:

EBD Goal:To challenge the aesthetic typically associated with a forensic detention facility and support the client’s heal-ing process by using color to enhance the environment and improve the staff work environment.

Small: Central Downtown SpaceMain: Neighborhood Patient Recreation SpaceShai Gil Fotography, 2013

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-89;T� ;,'� ;'!1� &'='£36'&� !2&� $<9;31-A'&� 7<'9ধ322!-8'9� (38� #3;,�(!1-£@�!2&�9;!ø�1'1#'89�3(�����;3�<2&'89;!2&�;,'�£'='£�3(�9!ধ9(!$ধ32�>-;,� =!8-3<9� $,!8!$;'8-9ধ$9� 8'£!;'&� ;3� <2-;� £!@3<;� !2&� 6!ধ'2;� 96!$'9W��,'� &!;!� >!9� !2!£@A'&� ;3� -&'2ধ(@� 9-+2-)$!2;� 68'&-$;38� =!8-!#£'9� !2&�$31132�;,'1'9W�38�'?!16£'T�68'&-$;38�=!8-!#£'9�(38�9;!ø�9!ধ9(!$ধ32�included noise level, electric light, the amount of work surface area and !=!-£!#-£-;@�3(�>3809;!ধ329W

Next, semi-structured focus groups were conducted. The topics were &-8'$;'&� #@� 9-+2-)$!2;� 7<'9ধ322!-8'� )2&-2+9W� 3$<9� +83<6� 1'1#'89�>'8'V�6!8'2;9�3(�68'=-3<9�� ���6!ধ'2;9T�� ���9;!øT�!2&�$<88'2;�6!8'2;9�3(�6!ধ'2;9W

2(381!ধ32�(831�;,'�7<'9ধ322!-8'9�!2&�(3$<9�+83<69�>'8'�<ধ£-A'&�;3�$8'!;'� !� $<9;31-A'&�&'9-+2� $8-;'8-32�3(� z2''&9z� !2&� z>!2;9z� ;,!;� ;8<£@�represents the VOC. Although not necessarily exclusive, the criterion &-&� $!6;<8'� -1638;!2;� &'9-+2� 7<!£-ধ'9� ;,!;� >'8'� (3<2&� 9-+2-)$!2;� #@�users of the space. This criterion was combined with project goals and 3#/'$ধ='9T�68'9'2;'&�;3�;,'�&'9-+2�;'!1�!2&�<9'&�;3�'=!£<!;'�683;3;@6'9�and design concepts.

The new 70-bed NICU at Kentucky Children’s Hospital has six pods of !6683?-1!;'£@����9-2+£'�(!1-£@�83319�-2�'!$,W��,'�63&9�$8'!;'�-&'2ধ)!#£'�$!8'�$311<2-ধ'9�!132+�9;!ø�!2&�(!1-£-'9�>-;,-2�;,'�£!8+'8�<2-;T�!�0'@����� )2&-2+W� �� &'&-$!;'&� ;'!1� ,<&&£'� 96!$'� ;3� (39;'8� $3££!#38!ধ32T�!£32+� >-;,� -11'&-!;'� !$$'99� ;3� 9<66£-'9T� 1'&-$!ধ329� !2&� -2(!2;� 1-£0�9;38!+'�;3�-2$8'!9'�'ă$-'2$@�!8'�(3<2&�>-;,-2�'!$,�$!8'�$311<2-;@W�

Visibility, safety and security were other VOC needs expressed by (!1-£-'9W� �-2+£'� (!1-£@� 83319� !8'� =-9-#£'� #@�1<£ধ6£'� 2<89'9�>-;,-2� ;,'�$!8'�$311<2-;@�(831�&'$'2;8!£-A'&�2<89-2+�9;!ধ329�639-ধ32'&�#';>''2�the sliding glass doors of two rooms. Caregivers also have access to #'&9-&'�$,!8ধ2+�!2&� £3$!£�9<66£-'9�>-;,-2�;,'�83319W��,'�(!1-£@�A32'T�per the request of the families, will have spaces for personal storage and 8331-2+f-2�$!6!#-£-ধ'9W

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�,'���T����97<!8'f(33;�� ���8'23=!ধ32�!;��'2;<$0@��,-£&8'2Z9��396-;!£�l���m�!;�;,'��2-='89-;@�3(��'2;<$0@��'!£;,�!8'�-2$£<&'9����#'&9�8'£3$!;'&�;3�;,'�)89;�*338�3(�;,'�,396-;!£W��,'�� ���683=-&'9�!�(<££�96'$;8<1�3(�$!8'�(38�$8-ধ$!££@f-££T�68'1!;<8'T�13&'8!;'£@�-££�!2&�$32=!£'9$-2+�-2(!2;9W

�3�!&&8'99�,3>�;,'�&'9-+2'&�'2=-8321'2;�-2*<'2$'9�;,'�&'£-='8@�3(�7<!£-;@�$!8'T� !� 9@9;'1!ধ$� !6683!$,� ;3� $3££'$;� 68'f3$$<6!2$@� 7<!2ধ;!ধ='� !2&�7<!£-;!ধ='�-2(381!ধ32�;,!;�8'68'9'2;9�;,'�z=3-$'�3(�;,'�$<9;31'8z�l���m�was devised.

Solution:

Overview:

Challenge:

HGA Architects and Engineers with Smith Hager Bajo, Inc.Kentucky Children’s Hospital at the University of Kentucky HealthCare Lexington, KY

Results:

1 42 5 73 6 8EBD STEPS APPLIED:

EBD Goal:To transform the University of Ken-tucky’s Neonatal Intensive Care Unit from a ward setting into a single fam-ily room unit that promotes family-centered care. This transformation requires careful consideration of staff and family’s needs and desires.

Main: Pod CorridorLeft: Mosaic Panel in NICU Corridor Right: Patient RoomHGA, Digital

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HDR Architecture, Inc.Baylor Scott & White McClinton Cancer Center Waco, TX

EBD Goal:To create a low-stress, positive healing en-vironment for oncology patients and staff through the implementation of evidence-based design strategies in the design of a new cancer center.

�!@£38��$3ħ�{��,-;'��'!£;,�>!2;'&�;3�&'9-+2�!�2'>�3<;6!ধ'2;�$'2;'8�32�;,'��-££$8'9;��!6ধ9;��'&-$!£��'2;'8�$!16<9W��3$!;'&�!;�;,'�'2;8!2$'�3(�;,'�1'&-$!£�center campus, the cancer center is an extension of the many services provided #@�;,'��-££$8'9;��!6ধ9;��'&-$!£��'2;'8��396-;!£W��,'�6<#£-$�96!$'�3(�;,'�$!2$'8�center is oriented toward the hospital, which is a familiar landmark in Waco.

�3�!$,-'='� ;,-9�+3!£T� ;,'�&'9-+2� ;'!1� -2;'+8!;'&� ;,'� £!;'9;� 8'9'!8$,�)2&-2+9�and evidence-based design strategies into the design of the cancer center. �6'$-)$!££@T� ;,'� ;'!1� ,@63;,'9-A'&V� ;,!;� 6!ধ'2;� 9!ধ9(!$ধ32� !2&� $!8'+-='8�'ă$-'2$@T�138!£'T�!2&�9!ধ9(!$ধ32�>3<£&�-1683='�#@�-2$38638!ধ2+�!$$'99�;3�2!;<8'T�2!;<8!£�£-+,;T�3<;&338�=-'>9T�!2&�8'96-;'�96!$'9�(38�68-=!$@�!2&�8'*'$ধ32W� 2$38638!ধ2+�;,'9'�'£'1'2;9�>,-£'�$8'!ধ2+�$32='2-'2;�!2&�!$$'99-#£'�96!$'9�that met the project budget and programming requirements was challenging. �,'�683+8!11-2+� 8'7<-8'1'2;9� -2$£<&'&V� 8!&-!ধ32� ;,'8!6@T���� 9'1-f68-=!;'�infusion therapy bays, imaging, CT Scanner, two linear accelerator vaults set up (38�;>3��!8-!2�[�8<'#'!1T\�&39-1';8@�96!$'T�;'!1�9;!ধ32T�'?!1T�$329<£;�!2&�;8'!;1'2;�83319T�£3##@T�$32('8'2$'�8331T�9;!ø�!8'!T�!2&�!�$,!6'£W

�,'�'2ধ8'�$'2;'8�-9�&'9-+2'&�;3�$8'!;'�!�£3>f9;8'99T�639-ধ='�'?6'8-'2$'�(38�6!ধ'2;9�8'$'-=-2+�;,-9�96'$-!£-A'&�$!8'�>-;,�$32='2-'2;�!2&�!$$'99-#£'�96!$'9W��,'�$'2;8!£�;'!1�!8'!�3ø'89�6!ধ'2;9�32'�9-2+£'�£3$!ধ32�;3�#'�!99'99'&�!2&�receive necessary services e.g. blood draws, prior to treatment. This concept !££3>9� 8!&-!ধ32� !2&�1'&-$!£� 32$3£3+@� 9;!ø� ;3� $3££!#38!;'� !2&�>380� >-;,�6!ধ'2;9�!2&�;,'-8�(!1-£@�32�;8'!;1'2;�36ধ329W��đ'8�6!ধ'2;9�!8'�!99'99'&�;,'@�$!2�,'!&�&-8'$;£@�;3�'-;,'8�8!&-!ধ32�38�1'&-$!£�32$3£3+@W��9�!2�!&&'&�#'2');T�6!ধ'2;9�;,!;�(8'7<'2;£@�8'$'-='�;8'!;1'2;�$!2�#@6!99�;,'�9;!2&!8&�6!ধ'2;� *3>� !2&� +3� &-8'$;£@� ;3� ;,'� $,!2+-2+� !8'!� !2&� ;,'� !668368-!;'�;8'!;1'2;�!8'!T�!đ'8�!�7<-$0�9;36�!;�;,'�1!-2�8'$'6ধ32�!8'!W

Natural light, views, and access to nature were emphasized as key strategies ;3�68313;'�,'!£-2+�!2&�-2$8'!9'�<9'8�9!ধ9(!$ধ32W���68-=!;'�+!8&'2�683=-&'9�9$'2-$� =-'>9� (38� 6!ধ'2;9� 8'$'-=-2+� ;8'!;1'2;� -2� 32'� 3(� ;,'� ��� -2(<9-32�#!@9T� >,-£'� !£93� $322'$ধ2+� ;,'� £!2&9$!6'� ;3� ;,'� '?-9ধ2+� $!16<9� +83ħ3W�The integrated facility also includes a dosimetry space, allowing specialists to pinpoint tumors and target treatment, and a dedicated pharmacy where 96'$-)$�$!2$'8�&8<+9�!8'�1-?'&�!2&�7<-$0£@�;8!29638;'&�;3�;,'�;8'!;1'2;�!8'!W���232f&'231-2!ধ32!£�$,!6'£�683=-&'9�!�8'96-;'�!8'!�(38�6!ধ'2;9�!2&�(!1-£-'9W

�� 639;f3$$<6!2$@� '=!£<!ধ32� -9� $<88'2;£@� #'-2+� $32&<$;'&� ;3� +!;,'8�(''&#!$0�(831�3$$<6!2;9�32�;,'-8�9!ধ9(!$ধ32�>-;,�;,'�#<-£&-2+�&'9-+2�!2&�1'!9<8'�;,'�'ø'$;�3(�;,'9'�!2&�3;,'8�&'9-+2�-2;'8='2ধ329W

Solution:

Overview:

1 42 5 73 6 8EBD STEPS APPLIED:

Challenge:

Results:

Scenic Infusion Bay © Dan Schwalm/HDR

98

Meditation Labyrinth, Tom Arban, 2013

�,'� 2'>� ��f9;38@T� �¤�f#'&T� ¤¥�T���f�� �8-&+'63-2;� �$ধ='� �396-;!£�provides a stepping point between acute care and a return to independent living. Built on an historic site, this referral hospital responds to the region's need for increasingly complex chronic healthcare while maintaining an important communal space that incorporates the roles of civic building, urban place, community center, and healthcare site.

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Solution:

Overview:

Challenge:

�3�9<6638;�!�6!;,�;3�,'!£;,T�!�[$!16<9�3(�>'££2'99\�(38�;,'�6!ধ'2;�!2&�;,'�8'+-32!£� $311<2-;@� >!9� $8'!;'&U� 32'� ;,!;� >3<£&� '2,!2$'� ;,'� 6!ধ'2;Z9�$322'$ধ32� ;3� $311<2-;@T� 2!;<8'T� !2&� ;,'� <8#!2� '2=-8321'2;� #@� -296-8-2+�6,@9-$!£�!$ধ=-;@�!2&�-2$8'!9-2+�$,!2$'9�(38�93$-!£�-2;'8!$ধ32�>-;,-2�;,'�96!$'W

�!2@�&'9-+2�9;8!;'+-'9�!2&�-223=!ধ329�>'8'�-2$£<&'&�!9�;,'�8'9<£;�3(�!$ধ='�!2&� -2;'29'� 6!8ধ$-6!ধ32� 3(� ,396-;!£� 8'68'9'2;!ধ='9T� $£-2-$-!29T� 6!ধ'2;9T�architects, engineers, and community members – all driven by the hospital's =-9-32�3(�!$ধ='�,'!£;,$!8'W��,'�,'!8;�3(�;,-9�683/'$;�-9�;,'�6!ধ'2;�'?6'8-'2$'T�which is designed to promote a sense of wellness, support, and empowerment. �6!$'9�!8'�36'2T�#8-+,;T�!2&�!$ধ='W��6'$-)$�&'9-+2�93£<ধ329�-2$£<&'V

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• New parks and a civic plaza complete the campus.

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• Therapy spaces are dispersed throughout the building for easy access.• Quiet, calm spaces are incorporated throughout for respite.• Barrier-free pool provides therapy with a glass wall, allowing clinicians to

easily monitor exercise. j����322'$ধ32�;3�2!;<8'�-2$£<&'9�!�1'&-;!ধ='�£!#@8-2;,W

!1-¡@�!2&�=-9-;38�(3$<9• Designs engage family members in the healing process. • Rooms provide ample space and furniture for visitors.j��'&-$!;'&�(!1-£@�£3<2+'�32�'!$,�*338W

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j���329-&'8!ধ32� 3(� !££� &'9-+2� (!$;389� (38� !� 639-ধ='� >380� '2=-8321'2;V�daylight, views, adequate space, noise, and privacy.

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Results:

Stantec Architecture / KPMB Architects – Design and Compliance Architect | HDR Architects / Diamond + Schmitt Architects

Bridgepoint Active Healthcare Toronto, Ontario Canada

1EBD STEPS APPLIED:

4 5 76 8

EBD Goal:To provide transforming care to individu-als who require rehabilitation and complex care when coping with chronic disease while pioneering research and incorporat-ing environmental elements that positive-ly contribute to the health and wellness of both patients and staff.

1110

�,-9�683/'$;� -9� !�13&'£� (38� ;,'� 8'23=!ধ32�3(�3;,'8� -26!ধ'2;�<2-;9� -2� ;,'��38;,��3>'8�!;�83'&;'8;��396-;!£W��,'�9,'££�3(�;,'�-26!ধ'2;�#'&�;3>'8�-9��f9,!6'&�!2&�'!$,�*338�-9�!6683?-1!;'£@���T����97<!8'�('';�>-;,�&3<#£'f£3!&'&�$388-&389W��,'�'?-9ধ2+�<2-;�,!&����9-2+£'�6!ধ'2;�83319T�>-;,�9<66£-'9�and support areas centrally located at the elbow of the unit.

�3� 9;8'!1£-2'� $!8'� &'£-='8@� !2&� 9;!2&!8&-A'� >380*3>T� �'!2� '?'8$-9'9�9<$,� !9� $8-ধ$!£f;3f7<!£-;@� 68-38-ধA!ধ32T� 6''8f;3f6''8� -2;'8=-'>-2+T� !2&�96!$'�!&/!$'2$@�&-!+8!11-2+�>'8'�,'£&�>-;,�<9'8�+83<69W� 2�!&&-ধ32T�;,'�evidence-base design process helped make informed design decisions and =!£-&!;'&�-16£'1'2;!ধ32�3(�683$'99�-1683='1'2;�9;8!;'+-'9W�

Early in the design process, a three-day data gathering event was $32&<$;'&� 32� ;,'� '?-9ধ2+� 1'&-$!£f9<8+-$!£� <2-;W� �;!ø� !2&� 6!ধ'2;9�>'8'�9,!&3>'&�!2&�-2;'8=-'>'&�;3�<2&'89;!2&�$<88'2;f9;!;'�>380*3>�6!ħ'829T�36'8!ধ32!£�2''&9T�!2&�<9'89Z�6'8$'6ধ329W��,'�7<!2ধ;!ধ='�!2&�7<!£-;!ধ='� &!;!� +!;,'8'&� >'8'� !2!£@A'&� !2&� 9-+2-)$!2;� )2&-2+9� >'8'�£-9;'&�!9�z2''&9zW��,'9'�z2''&9z�>'8'�$!;'+38-A'&�-2;3�$31132�;,'1'9�;3� &'='£36� !� $3168','29-='� £-9;� 3(� �8-ধ$!£f;3f�<!£-;@� l�;�m� 1';8-$9�l6!ধ'2;� 9!ধ9(!$ধ32T� (!1-£@f$'2;'8'&� $!8'T� 6,@9-$-!2� 9!ধ9(!$ধ32T�'ă$-'2$@T�*3>�!2&�<ধ£-A!ধ32T�!2&�6!;'2;�9!(';@mW��,'�683/'$;�;'!1�<9'&�;,-9� £-9;� ;3� +<-&'� &'9-+2� &'$-9-329� !2&� 36'8!ধ32!£� $,!2+'9T� '=!£<!;'�prototypes and assess mock-ups.

Common travel paths uncovered during shadowing were diagrammed in ;,8''�683639'&�683;3;@6'9�;3�$316!8'�&-ø'8'2$'9�-2�;8!='£�&-9;!2$'9W��,-9�exercise was paramount in receiving buy-in from key stakeholders for room $3<2;�!2&�9-A'W�<;<8'f9;!;'�68'&-$ধ329�>'8'�1!&'�#@�$316!8-2+�$<88'2;f9;!;'�8'9<£;9�-2�!�#'2$,1!80�&!;!#!9'W�38�'?!16£'T�32'�&'9-+2�!99<16ধ32�'9ধ1!;'&� ;,!;� !6683?-1!;'£@� ¤¦� ;3� �¦� 3(� 2<89'9Z� ধ1'� 96'2;� ;8!='£-2+�>3<£&�#'�9!='&�!2&�;8!29('88'&�;3�ধ1'�96'2;�-2�6!ধ'2;�83319W

�,'�2'>�<2-;�,!9����9-2+£'f6!ধ'2;�83319T�!6683?-1!;'£@�����97<!8'f('';�'!$,W� !$,� 8331� -2$38638!;'9� #'&9-&'� $,!8ধ2+T� ,!2&f>!9,-2+� 9;!ধ32T�family zone, and a private toilet room. Decentralized features include: a 2<89'9Z�$,!8ধ2+�9;!ধ32�!2&�9<66£@�9'8='8�3<;9-&'�'!$,�8331T�1'&-$!ধ32�dispensing and nourishment area in the middle of each corridor, and a central team and break area at the elbow of the unit.

The same research tools used during pre-design were implemented in a ;,8''f6,!9'&� 639;f3$$<6!2$@� '=!£<!ধ32W� �,!&3>� &!;!� >'8'� $3££'$;'&�!;��T�¥T�!2&����132;,9�639;f3$$<6!2$@� ;3�&';'81-2'� -(� !99<16ধ329�!2&�

HGA Architects and EngineersFroedtert & the Medical College of

Wisconsin Froedtert Hospital Milwaukee, WI

Solution:

Overview:

Challenge:

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�,'�6,!9'&�!6683!$,�9<$$'99(<££@�&3$<1'2;'&�,3>�2<89'9Z�>380*3>�#'$!1'�138'�'ă$-'2;�>-;,-2� ;,'�96!$'�3='8�ধ1'W��9�68'&-$;'&T�ধ1'�96'2;�;8!='£-2+�9-+2-)$!2;£@�&'$8'!9'&�l6���W���m�#@�¤¦�38��¤�1-2<;'9�per nurse. On average, a nurse traveled 2.08 miles per 10-hour &!@9,-đT� >,-$,� -9� 32'� 3(� ;,'� £3>'9;� 8'$38&'&� )2&-2+9� $316!8'&� ;3�3;,'8�#'2$,1!80�9;<&-'9W��<89'9�96'2;�!6683?-1!;'£@���¦�3(�;,'-8�ধ1'�683=-&-2+�&-8'$;�6!ধ'2;�$!8'T�!�¤¦�-2$8'!9'�!2&�¥�¦�3(�2<89'9Z�ধ1'�>!9�96'2;� 32� =!£<'f!&&'&� !$ধ=-ধ'9T� 'W+W� $,!8ধ2+� !2&� 8';8-'=-2+� 9<66£-'9�38�1'&-$!ধ329W��='8� ধ1'T� 9;!ø� 9<#9;!2ধ!££@� 8'&<$'&� ;,'� (8'7<'2$@�3(� ;8-69� ;3� !8'!9� 32� ;,'� <2-;T� 8'9<£ধ2+� -2� !� 138'� 'ă$-'2;� >380*3>W��-2$'�13=-2+�;3�;,'�2'>�<2-;T�;,'8'�,!9�#''2�!���¦�8'&<$ধ32�-2������l!='8!+'�£'2+;,�3(�9;!@m�!2&�!2�-2$8'!9'�-2�6!ধ'2;�9!ধ9(!$ধ32�;3�¥�¦W�

Results:

1 42 5 73 6 8EBD STEPS APPLIED:

EBD Goal:To enhance staff efficiency, delivery of care, and the patient experience by leveraging both Lean and EBD processes in a medical-surgical unit. It was imperative that project goals and objectives were well-defined and that final solutions achieved a level of success.

Spacious and Private Inpatient Room,

HGA 2015

1312

CannonDesignSt. Louis Children's Specialty Care Center

Town and Country, MO

St. Louis Children's Hospital, BJC HealthCare, and Washington University Physicians decided to bring a full spectrum of services under one roof in the St. Louis Children's Hospital Specialty Care Center located in suburban St. Louis. The center serves children ranging in age from infant through teenager. Departments include surgery, pediatric acute wound service, pharmacy, imaging, lab spaces, orthopedics, infusion, pediatrics, audiology, 36,;,!£13£3+@T�69@$,3£3+@T�!2&�;,'8!6@�(<2$ধ329W

2+!+-2+� 6'&-!;8-$� 6!ধ'2;9� ;3� 1!0'� 8';<82� =-9-;9� (38� ;8'!;1'2;9� !2&�appointments can be challenging in part due to the anxiety-provoking encounter that medical appointments and procedures can induce. To support an improved experience, the team conducted a review of literature related to children’s preferences in healthcare environments. This revealed that children relate and understand their environments in a rather 936,-9ধ$!;'&�1!22'8W� 2�;,'�&'9-+2�3(�;,'�2'>��6'$-!£;@��!8'��'2;'8T�;,'�;'!1�&'='£36'&�&'9-+2� 9;8!;'+-'9� ;,!;�13='&�#'@32&�$8'!ধ2+� 9-16£-9ধ$T�9;!ধ$�=-9<!£�'2=-8321'2;9� ;3�$8'!ধ2+�&@2!1-$�'2=-8321'2;9� ;,!;�'2+!+'�1<£ধ6£'� !+'� +83<69W� �,'� �6'$-!£;@� �!8'� �'2;'8� &'9-+2� -9� #!9'&� 32� ;,'�;,'1'� 3(� Y-1!+-2!ধ32� !2&� &-9$3='8@ZU� (3$<9-2+� 32� 36638;<2-ধ'9� ;3� 6£!@T�socialize, fantasize, explore, and experience.

2;'+8!ধ32� 3(� $3£38T� )2-9,� 1!;'8-!£9T� !2&� +8!6,-$9� !8'� &'9-+2'&� ;3�support the theme and allow children to interact with their environment. Upon arriving at the Specialty Care Center, each child is given a special [6!99638;\� 32� >,-$,� ;,'@� 8'$'-='� &'9ধ2!ধ32� 9;!169� !9� ;,'@� [;8!='£\� ;3�&-ø'8'2;�&'6!8;1'2;9�;,83<+,3<;�;,'�#<-£&-2+�38�<2&'8+3�;'9;9T�9$!29T�38�683$'&<8'9T�;8!29(381-2+�!�63;'2ধ!££@�(8-+,;'2-2+�'?6'8-'2$'�-2;3�32'�>-;,�elements of surprise and delight.

To inform design decisions, the team surveyed clinical leaders in each of the &-ø'8'2;�$£-2-$9�;3�#'ħ'8�<2&'89;!2&�,3>�;8'!;1'2;9T�;,'8!6-'9T�!2&�683$'&<8'9�-16!$;� ,3>� $,-£&8'2� !8'� 6,@9-$!££@� 639-ধ32'&� &<8-2+� !2� !663-2;1'2;T�procedure, or therapy session. Engaging clinicians early-on in the design process can help inform how the built environment can go beyond providing 639-ধ='�&-9;8!$ধ329�;3�#'$31'�!�;33£�(38�$£-2-$!£�!2&�;,'8!6'<ধ$�$!8'W�-2&-2+9�-2(381'&�;,'�6£!$'1'2;�3(�+8!6,-$�'£'1'2;9�32�;,'�>!££9T�$'-£-2+9T�!2&�*3389�;3�683=-&'�639-ধ='�&-9;8!$ধ329�-2�;,'�139;�'ø'$ধ='�£3$!ধ329W�

�&&-ধ32!££@T� ;,'� #<-£;� '2=-8321'2;� 683=-&'9� #'2$,1!809� !2&� 1-£'9;32'9�-2� ;,'8!6@� !8'!9� g� (38� '?!16£'T� +8!6,-$� '£'1'2;9� -2� ;,'� *338-2+� $!2� #'�used to work through mobility issues. Iconography used throughout the $'2;'8�,'£69�!-&�>!@f)2&-2+�;3�&-ø'8'2;�$£-2-$9�>,-£'�*338-2+�6!ħ'829�!2&�

Solution:

Challenge:

+8!6,-$9� ,'£6� 6!ধ'2;9� !2&� (!1-£-'9� 2!=-+!;'� -2&'6'2&'2;£@� ;,83<+,� ;,'�$£-2-$9�;,'19'£='9W��8!6,-$�'£'1'2;9�<9'&�32�;,'�>!££9�9'8='�!2�'&<$!ধ32!£�(<2$ধ32�!2&�!8'�3đ'2�!$$316!2-'&�#@�2!88!ধ='�;'?;�;,!;�&'6-$;�9;38-'9�3(�the region.

�,'�2'>�(!$-£-;@�36'2'&�-2��<2'�3(������!2&�-9�8'$'-=-2+�639-ধ='�!2'$&3;!£�(''&#!$0�;,!;�-2&-$!;'9�;,'�&'9-+2�93£<ধ329�,!='�#''2�9<$$'99(<£W��'9'!8$,�and inquiry techniques used in the design process are being replicated in 2'>� -26!ধ'2;�683/'$;9� ;!0-2+�6£!$'�!;�����Z9�1!-2� $!16<9W��,'�,36'� -9�;,!;�;,-9�>-££�;8!29£!;'�;3�!�9-1-£!8�'?6'8-'2$'�!$8399�����Z9�9-;'9�8'*'$ধ='�3(�;,'-8�1-99-32�g�[�3-2+��,!;Z9��-+,;�(38��-&9zW

Overview:

Results:

Small: St. Louis Children's Specialty Care Center – ImagingMain: St. Louis Children's Specialty Care Center – LobbyAlise O’Brien Photography, June 2015

1 42 53EBD STEPS APPLIED:

EBD Goal:To address the need for outpatient pedi-atric services and to continue the brand of an integrated experience on the main hospital campus as a convenient alterna-tive to the disparate outpatient locations available to parents.

15��

Challenge:

Solution:

�32ধ2<!£�+83>;,�!2&�-2$8'!9-2+�6!ধ'2;�=3£<1'9�!;��0832��,-£&8'2Z9��396-;!£�drove the development of an extensive campus master plan with aggressive future growth strategies. In 2012, Akron Children’s announced a $200 million expansion to meet the current and future needs of children in northern Ohio !2&�;,'-8�(!1-£-'9V�;,'��!@��'>'£'89��!=-£-32T�!��¤¥T���f97<!8'f(33;�$8-ধ$!£�care tower. The seven-story Kay Jewelers Pavilion at Akron Children’s $316£';'9�;,'�)89;�6,!9'�3(�;,'�1!9;'8�6£!2W

2�!&&-ধ32�;3�;,'�(3<8���f#'&�2'32!;!£�-2;'29-='�$!8'�<2-;9T�;,'�2'>�$8-ধ$!£�care tower is comprised of: a special delivery unit for high-risk babies that -2$£<&'9� £!#38T� &'£-='8@T� 8'$3='8@T� !2&� 639;6!8;<1� l����m� 83319� >-;,�$322'$;'&� $'9!8'!2f9'$ধ32� !2&� (';!£� 36'8!ধ2+� 83319U� !2� '1'8+'2$@�&'6!8;1'2;�$329-9ধ2+�3(����'?!1�83319T�)='�#',!=-38!£�,'!£;,�83319T�!2&�;,8''�;8!<1!�83319U�!�2'>�3<;6!ধ'2;�9<8+'8@�$'2;'8�>-;,�'-+,;�68'f36'8!ধ='�83319T�(3<8�36'8!ধ2+�83319T�!2&�96!$'�(38�;>3�138'�-2�;,'�(<;<8'U�!2&�!2�'2$£39'&�$32$3<89'�;!0-2+�6!ধ'2;9�!2&�9;!ø�1'1#'89�(831�;,'��T���f96!$'�+!8!+'�;3�;,'�2'>�$8-ধ$!£�$!8'�;3>'8�!2&�'?-9ধ2+�,396-;!£W�

�,'�$,!££'2+'9�96'$-)$�;3�;,'�&'9-+2�!2&�36'8!ধ32�3(�;,'�2'32!;!£�-2;'29-='�$!8'�<2-;T�-2$£<&'&�!&!6ধ='�£'!82-2+U�>380-2+�'ă$-'2;£@�!2&�'ø'$ধ='£@�>-;,�!�2'>�>380*3>T�+!82'8-2+�9<6638;�9'8=-$'9�-2=3£='1'2;T�9;!2&!8&-A-2+�83319�across the units and within the support cores, and providing appropriate and 9'6!8!;'�96!$'�>-;,-2�;,'�6!ধ'2;�8331�(38�(!1-£@�!$ধ=-ধ'9W

�,'� >380*3>� ;8!29-ধ32� (831� 9-?f#'&� 63&� !88!2+'1'2;9� -2� ;,'� '?-9ধ2+�� ��9� ;3� ;,'� 2'>� !££f68-=!;'� 6!ধ'2;� 8331� <2-;9� $!<9'&� ;,'� +8'!;'9;�!13<2;�3(�<2$'8;!-2;@�>-;,�;,'�9;!øW��,'@�>'8'�$32$'82'&�;,!;�;,'�2'>�design would not allow similar access, visibility, and ability to communicate >-;,�(!1-£-'9�;,'@�,!&�>,'2�>380-2+�-2�;,'�1<£ধf#'&�63&9W��,'�6'8$'6ধ32�many of the nurses and physicians had about increases in travel distances added to the challenges to overcome.

�'9ধ2+�9$'2!8-39�!2&� 8<22-2+�=!8-3<9�9-1<£!ধ329� -2� ;,'� (<££f9$!£'�13$0<6�3(�;,'�� ���8'£-'='&�1!2@�3(�;,'�<2$'8;!-2�6'8$'6ধ329�9;!ø�1'1#'89�,!&�!#3<;� ;,'� ;8!29-ধ32� !2&� 8'='!£'&� 8')2'1'2;9� ;,!;� '2,!2$'&� ;,'� &'9-+2�3(� ;,'� <2-;9� !2&� -2&-=-&<!£� 83319W� �&&-ধ32!£� 9;8!;'+-'9� &'='£36'&� #@� ;,'�;'!1� -2$£<&'&V� 2<89'� $,!8ধ2+� !£$3='9� 3<;9-&'� '='8@� 8331� l8'96329'� ;3�=-9-#-£-;@mU�,-+,�23-9'f8'&<$ধ32�$3'ă$-'2;�l���m�$'-£-2+�ধ£'�-2�6!ধ'2;�83319�!2&� $388-&389� l8'96329'� ;3�23-9'mU� !� 9'6!8!;'� (!1-£@� A32'�>-;,-2� ;,'� 8331�l8'96329'� ;3� (!1-£@�!$ধ=-ধ'9� -2� ;,'� 8331mU�!2&� (!1-£@�23<8-9,1'2;c£3<2+'�96!$'9�32�;,'�<2-;�l8'96329'�;3�(!1-£@�!$ধ=-ধ'9�-2�;,'�8331mW

Overview:

�,'�<2-;�36'2'&�-2��!@T�����W� ;�-9�$8<$-!£�;3�;,3<+,Ĥ<££@�68-38-ধA'�!2&�6£!2�0'@����+3!£9�!2&�3#/'$ধ='9�(831�;,'�9;!8;T�-2�38&'8�;3�9<$$'99(<££@�8'!£-A'��;,'�1!2@�2''&'&�(<2&!1'2;!£�&'9-+2�$32$'6;9W� (�;,'�'ø38;�;3�$8-ধ7<'�;,'�-2-ধ!£�#8!-29;381'&� £-9;�3(����+3!£9�!2&�$32)81� ;,'�!668368-!;'2'99� ;3�meet the unique aim of the NICUs had not been done, the design would ,!='�9<ø'8'&T�!9�;,'�$32$'6;9�>3<£&�,!='�#''2�;33�#83!&W�

With the aim clearly determined, the design developed and evolved naturally ;3� 8'93£='�!2&�!&&8'99�'!$,�+3!£� '9;!#£-9,'&�!;� ;,'�329';W��,'� [-$-2+�32�;,'�$!0'\�>-££�#'� ;3�$32&<$;�!�639;f3$$<6!2$@�'=!£<!ধ32� ;3�=!£-&!;'� ;,'�'ø'$ধ='2'99�3(�'!$,�&'9-+2�9;8!;'+@�!2&�;,'�3='8!££�&'9-+2�93£<ধ32�!+!-29;�the project goals. Two studies are underway — one on the Lean integrated 683/'$;�&'£-='8@�l ��m�9@9;'1T�>,-$,�,!9�9,3>2�$329-&'8!#£'�$39;�9!=-2+9�<9-2+�!�$3££!#38!ধ='�683$'99T�!2&�!23;,'8�32�9;!ø�'2+!+'1'2;�&<8-2+�;,'�;8!29-ধ32�683$'99W

Results:

HKSAkron Children’s Hospital, Kay Jewelers Pavilion, NICU

Akron, Ohio1 2 3EBD STEPS APPLIED:

8EBD Goal:

To implement all-private patient room units (with the exception of enlarged rooms for twins/multiples); provide clear visibility and direct line of sight to all patients; increase privacy and offer greater support for mothers to nurse and have “kangaroo care” time with their newborns; improve family and nurse/physician communication; and reduce overall noise levels on the units.

Akron Children's NICU Private Room, Blake Marvin/HKS, Inc.

17�¤

Healthcare Art Consulting LLCCharleston Area Medical Center Cancer Center Charleston, WV

Top: Second Floor Overview – Ashley Taetz, 2015Bottom: Season of Hope – Jonathan Cox, 2015

�,'��,!8£'9;32��8'!��'&-$!£��'2;'8� l����m��'!£-2+��8;9��83+8!1�>!9�;,'�8'9<£;�3(�;,'�$311<2-;@Z9�$!6-;!£�$!16!-+2�683/'$;V�[�3>'8�3(��!2@\W��'!£;,$!8'��8;��329<£ধ2+�!2&������#<-£;�;,'�683+8!1�;3�$8'!;'�!�,'!£-2+�journey from the lobby, through the hallways, and into the treatment areas.

�,'� )89;� 9;'6� 3(� ;,'� 683$'99� 9;!8;'&� #@� (381-2+� !� &-='89'� $311<2-;@f#!9'&��'!£-2+� �8;9� �'£'$ধ32��311-ħ''� $3168-9'&� 3(� $!2$'8� 9<8=-=389T�local business leaders, art philanthropists, and caregivers. Next, the 683/'$;� ;'!1� ;,!;� -2$£<&'&� ;,'� ����� 3<2&!ধ32T� $329;8<$ধ32� 683/'$;�management, an art consultant, an interior designer, and the Healing Arts �'£'$ধ32��311-ħ''� -&'2ধ)'&�96'$-)$� £3$!ধ329�(38�'!$,�!8;� -29;!££!ধ32W��,'�$,!££'2+'�>!9�'2+!+-2+�;,'�$311<2-;@�!2&�$8'!ধ2+�!�$£'!8�1'99!+'�;3�!8ধ9;9�!#3<;�;,'�,396-;!£Z9�=-9-32�!2&�2''&9W�

�'!£;,$!8'��8;��329<£ধ2+T�!£32+�>-;,�;,'�������'!£;,��@9;'1T�68313;'&�!� 9;!;'>-&'� [$!££� ;3� !8ধ9;9\W� �£-2&� 9<#1-99-329� >'8'� 8'=-'>'&� ;3� 2!883>�;,'� 9'£'$ধ32� 3(� !8ধ9;9W� �đ'8� !8ধ9;9� >'8'� $32)81'&� (38� $32;'2ধ32T��'!£;,$!8'��8;��329<£ধ2+�>380'&�>-;,�'!$,�!8ধ9;�;3�683=-&'�;,'�683+8!1�=-9-32T� -2;'8-38� )2-9,'9T� !2&� 96!$'� 96'$-)$!ধ329� ;3� -2(381� ;,'-8� &'9-+2�ideas for commissioned artwork. All design ideas were presented to the �'£'$ধ32� �311-ħ''� (38� )2!£� 9'£'$ধ32� 3(� ;,'� >-22-2+� &'9-+2� $32$'6;9W�38� 9-?� 132;,9T� �'!£;,$!8'� �8;� �329<£ধ2+� $338&-2!;'&� >-;,� ;,'� !8ধ9;9T�$329;8<$ধ32� 683/'$;� 1!2!+'1'2;T� !2&� ;,'� �'!£-2+� �8;9� �'£'$ধ32��311-ħ''�;3�3='89''�(!#8-$!ধ32�!2&�683&<$ধ32�3(�9-;'f96'$-)$�>3809�3(�!8;�$8'!;'&�(38�;,'�������!2$'8��'2;'8W�831�$338&-2!ধ2+�>!££�#£3$0-2+T�£-+,ধ2+T�!2&�(8!1-2+T�;3�-29;!££!ধ32�,!8&>!8'T�;,'�!8ধ9;9�$3££!#38!;'&�>-;,�;,'�683/'$;�;'!1�;3�)2!£-A'�;,'�)2!£�!8;�-29;!££!ধ329W�

Today, CAMC contains twelve commissioned works of art created by seven !8ধ9;9� >,39'� 9;@£'9� !8'� &-='89'� !8;� 1'&-<19� l+£!99T� >33&T� 3-£� 6!-2ধ2+T�6,3;3+8!6,@mW��'9-+2'&�;3�'2,!2$'�;,'�'2=-8321'2;�3(�$!8'�!2&�8'*'$;�;,'�&-='89-;@�3(�;,'�$311<2-ধ'9�>,-$,�;,'����T����97<!8'�(33;�������!2$'8��'2;'8�9'8='9T�;,'�!8;�'=30'9�1'99!+'9�3(�,36'�!2&�,'!£-2+�(38�6!ধ'2;9T�=-9-;389T�!2&�9;!øW�!$,�6-'$'�,!9�&''6'8�1'!2-2+�#'$!<9'�'!$,�!8ধ9;�,!9�!�$322'$ধ32�;3��'9;��-8+-2-!�!2&�$!2$'8W�

2�!&&-ধ32�;3�;,'�;>'£='�$311-99-32'&�>3809�3(�!8;T�3='8�����6,3;3+8!6,9�3(� ,'!£-2+� 2!;<8'� -1!+'9� >'8'� -29;!££'&� -2� 6!ধ'2;� ;8'!;1'2;� !8'!9� !2&�9;!ø�>38096!$'9� ;3� $32;8-#<;'� ;3� ;,'� 3='8!££�1-99-32� 3(� ;,'� ,'!£-2+� !8;9�683+8!1W��,'�'2&�8'9<£;�-9�!�,'!£-2+�'2=-8321'2;�;,!;�8'*'$;9�;,'�=-9-32�3(�;,'�[�3>'8�3(��!2@\W

Challenge:

Solution:

Overview:

1EBD STEPS APPLIED:

EBD Goal:To bring the local West Virginia community together and IXO÷OO�&KDUOHVWRQ�$UHD�0HGLFDO�&HQWHUÚV� �&$0&��KHDOLQJ�vision for their Cancer Center by bringing the outdoors into their environment.

1918

!9;��38+!2��3<2;@��396-;!£�l���m�-9�!�$8-ধ$!£�!$$'99�,396-;!£W��,-9�>!9�an expansion project to support the growth of this rural community.

�,'�'?-9ধ2+�0-;$,'2�!2&�&-2-2+�96!$'�>!9�8'13;'£@�£3$!;'&�(831�;,'�1!-2�entrance, had limited natural daylight, and was too small. EMCH’s vision was to create a welcoming space that would provide respite from the stress ;,!;� 6!ধ'2;9� !2&� (!1-£-'9� '2$3<2;'8'&� !2&� !� 6£!$'� (38� 9;!ø� ;3� 8'$,!8+'�&<8-2+�#8'!09W��,'�0-;$,'2�9;!ø�2''&'&�!2�'ă$-'2;�96!$'�;3�9<6638;�(33&�68'6!8!ধ32�!2&�9'8=-2+�>-;,3<;�>380!83<2&9�38�#3ħ£'2'$09�!2&�!&'7<!;'�96!$'�>-;,�$£'!8�9'6!8!ধ32�3(�(33&�68'6!8!ধ32�!2&�$£'!2-2+�(<2$ধ329W

�3�-&'2ধ(@�<9'8�+83<6�+3!£9�!2&�>380�;3>!8&9�!�93£<ধ32T�;,'�;'!1�8'!£-A'&�;,!;�£330-2+�!;�96!$'9�;>3f&-1'29-32!££@�>!9�&-ă$<£;�(38�9;!ø�;3�=-9<!£-A'�and hindered their engagement in decision-making. An alternate means (38� $32)81-2+� !2&� ;'9ধ2+� &'9-+2� $32$'6;9� >!9� 2'$'99!8@� ;3� +!;,'8�input and gain buy-in.

In the early design phase, Davis Partnership referenced literature for 36ধ1-A-2+� ;,'� 9'='2�*3>9� -2�,'!£;,$!8'�'2=-8321'2;9�!2&�!66£-'&� ;,'1�;3�0-;$,'2�!2&�&-2-2+�9'ষ2+9W��&&-ধ32!£�8'9'!8$,�32�;,'�9;8'99f8'&<$-2+�#'2');9�3(� 2!;<8'� =-'>9�#'$!1'�!� +<-&-2+�68-2$-6£'� (38� ;,'�683/'$;W� �,'�-2-ধ!£�6£!2T�$8'!;'&�>-;,�;,'�0-;$,'2�9;!øZ9�-26<;T�>!9�!2!£@A'&�!+!-29;�;,'�9'='2�*3>9�!2&�9,3>'&�1!/38�*3>�$32*-$;9W�

�,'�;'!1�<9'&��!6-&��83;3;@6-2+�;3�!-&�;,'�9;!ø�-2�=-9<!£-A-2+�!2&�<2&'89;!2&-2+�&'6!8;1'2;!£� *3>9W� �,-9� '='2;� -2$£<&'&� ;,'� -2;'8&-9$-6£-2!8@� ;'!1V� 0-;$,'2�9;!øT� 9<66£@� $,!-2� 9;!øU� $311<2-;@� 1'1#'89U� ,396-;!£� !2&� �!22'8� �'!£;,�1!2!+'1'2;�;'!19U�$!8'�683=-&'89U�!2&�&'9-+2T�'2+-2''8-2+T�!2&�$329;8<$ধ32�team members. There was one simple ground rule: everyone had an equal =3-$'�-2�;,'�683$'99W��,-9�>!9�!2�'?$'££'2;�;33£�(38�[/<9;f-2fধ1'\�8'9'!8$,T�>,'2�published research is lacking to quickly inform design.

Over two days, a full-scale cardboard mock-up was built so the users could 83£'f6£!@T�'?!1-2'�-2'ă$-'2$-'9T�!2&�'!9-£@�1!0'�!&/<9;1'2;9�-2�8'!£�ধ1'W��,'�13$0f<6�>!9�$32ধ2<!££@�1!2-6<£!;'&�<2ধ£�;,'�'ă$-'2$@�+3!£9�!2&�-&'!£�9;!ø�!2&�=-9-;38�*3>9�>'8'�!$,-'='&�!2&�!+8''&�<632�#@�!££�6!8ধ$-6!2;9W

�,'�93£<ধ32�-9�!2�36'2�&-2-2+�!8'!�;,!;�-9�6!8!££'£�;3�!�+!££'@f9;@£'�0-;$,'2W���serving counter runs lengthwise between the spaces bringing them together =-9<!££@T� >,-£'� 1!-2;!-2-2+� !� &-9ধ2$;� 9'6!8!ধ32� (38� 9;8'!1£-2'&� [329;!+'�!2&� 3ø9;!+'\� *3>W� �3� $8399f;8!ă$� !££3>9� =-9-;389� ;3� '2/3@� !� 6'!$'(<£T�$31(38;!#£'� &-2-2+� '?6'8-'2$'W� �,'� 0-;$,'2� -9� 38+!2-A'&� (38� 36ধ1<1�

Overview:

Challenge:

Solution:

Davis Partnership ArchitectsEast Morgan County Hospital Kitchen and Dining

Brush, Colorado

'ă$-'2$@�>-;,� $£'!2� 9;38!+'� 32� 32'� 9-&'� !2&� &-9,>!9,-2+� 32� ;,'� 3;,'8�>-;,� &'&-$!;'&� '2;8@� 63-2;9� (38� ;,'9'� (<2$ধ329� ;3� '£-1-2!;'� #3ħ£'2'$09�!2&�6399-#£'�$8399f$32;!1-2!ধ32W

�,'� 96!$-3<9� &-2-2+� !8'!� -9� *33&'&�>-;,� 2!;<8!£� £-+,;�>-;,� =-'>9� 3(� ;,'�3<;&338�6!ধ3�!2&�+!8&'2T�'!9-£@�!$$'99-#£'�(831�;,'�1!-2�,396-;!£�'2;8@�!2&�2<89-2+�<2-;W��!ধ'2;9T�(!1-£@�1'1#'89T�9;!øT�!2&�'='2�+'2'8!£�$311<2-;@�members use the new dining area as if this space always existed as the heart of the community.

1 42 3EBD STEPS APPLIED:

EBD Goal:To create a dining area that would serve as a hub in the local community, with an adjoining kitchen designed for SHDN�HI÷FLHQF\�

EMCH Kitchen, Paul Brorkering, May, 2015

Left: "Current State" Kitchen and Dining Flows Before Rapid Prototyping, Right: "Future State" Kitchen and Dining Flows after Rapid Prototyping'DYLV�3DUWQHUVKLS�$UFKLWHFWV��0DUFK�����

2120

�,'� )89;� 3(� -;9� 0-2&� -2� ;,'� 8'+-32T� ;,'� ��T¥��� 97<!8'� (33;� $!2$'8� $'2;'8�683=-&'9� 9;!;'f3(f;,'f!8;� 8!&-!ধ32� ;,'8!6@T� $,'13;,'8!6@T� $£-2-$!£� 8'-search, and support services. Twenty chair infusion pods are in a spa-like '2=-8321'2;� 3='8£330-2+� !2� 3<;&338� ,'!£-2+� +!8&'2W� �!&-!ধ32� 32$3£3+@�is equipped with a linear accelerator and a CT simulator. On-site clinical 8'9'!8$,�96!$'�!££3>9�6!ধ'2;9�;,'�36638;<2-;@�;3�6!8ধ$-6!;'�-2�$!2$'8�8'-9'!8$,� 9;<&-'9W��36'�-8$£'T� <2-7<'� ;3� ;,'�����!6ধ9;��!2$'8��'2;'8T� -9�!�(8''�����!6ধ9;��,!8-;!#£'�3<2&!ধ32�683+8!1�;,!;�9<6638;9�6!ধ'2;9�and families with cancer.

Overview:

Challenge:

Solution:

Results:

�2'f9-A'f&3'9f23;f);f!££� (38� '='8@� 6!ধ'2;� $!2$'8� ;8'!;1'2;� !2&� $!8'W��31'�$!2$'8�6!ধ'2;9�68'('8�68-=!$@�8'+!8&-2+�;,'-8�$32&-ধ329�!2&�&<8-2+�treatments, while others want to socialize for support.

�,'�!$,-'='1'2;�3(�68-=!$@T�>,-£'�1!-2;!-2-2+�*'?-#-£-;@�3(�36'22'99� (38�93$-!£-A!ধ32�>!9� !� $,!££'2+'� -2� ;,'� 3='8!££� &'9-+2� 3(� ;,'� (!$-£-;@� (38� ;,'�&'9-+2�;'!1W��!8ধ$<£!8£@�$,!££'2+-2+�>!9�683=-&-2+�#3;,�36ধ329�(38�;,'����infusion bays.

Having a freestanding cancer care center on the medical campus allows $!2$'8� 6!ধ'2;9T� >,39'� -11<2'� 9@9;'19� !8'� $316831-9'&T� ;3� ,!='� !�private experience that is away from transmission of possible viruses or other illnesses that might be associated with the campus hospital and clinic. �!80-2+�-9�2'!8�;,'�(832;�&338�(38�'!9@�2!=-+!ধ32W

�3� 3ø'8� ;8'!;1'2;� 68-=!$@T� ;,'� -2;'8-38� &'9-+2� ;'!1� $<9;31� &'9-+2'&�*338f;3f$'-£-2+� $<#-$£'� $<8;!-2� 9;38!+'� >-;,-2� $!#-2';8@� ;,!;� 9'6!8!;'9�$,'13;,'8!6@�-2(<9-32�#!@9T�>,-$,�!8'�-2�63&9�3(�)='W��,'2�6!ধ'2;9�>!2;�privacy during infusion, the side door on the cabinetry in each bay can #'�36'2'&T�!2&�;,'�$<8;!-29�6<££'&�3<;�!2&�!$8399�;3�$32$'!£�;,'�6!ধ'2;W�The infusion lounge chairs are equipped with small monitors, empowering 6!ধ'2;9�>-;,�$32;83£�;3�>!;$,�;,'-8�$,3-$'�3(�;'£'=-9-32�9,3>9T�9,3<£&�;,'@�23;�&'9-8'�;3�93$-!£-A'�>-;,�3;,'8�-2(<9-32�6!ধ'2;9W

When not in use, the cubicle curtains are out of sight. Openness between ;,'�#!@9�;,'2�!££3>9�!�9'29'�3(�$311<2-;@�!132+�;,'�6!ধ'2;9W�38�36ধ1!£�£-+,;�;8!29('8T�!'9;,'ধ$9T�!2&�!�$322'$ধ32�;3�;,'�8'+-32!£�!8'!T�;8!29£<$'2;�3form panels in the cabinetry encapsulate indigenous plant life.

These 3form panels with alternate open spaces are also included in the nurse work areas. The infusion chairs back up to these panels. This allows ;,'� 2<89-2+� 9;!ø� ;3� >!;$,� 6!ধ'2;9� &<8-2+� ;,'� -2(<9-32� 683$'99� !2&� 9ধ££�provide them a sense of privacy.

The space for HopeCircle anchors the front of the center and is rounded and -11'&-!;'£@�!&/!$'2;� ;3� ;,'� £3##@�>!-ধ2+�96!$'W�?;'29-='�683+8!11-2+�(38� ;,'� 96!$'� @-'£&'&� #3<ধ7<'� 9,'£=-2+� (38� ;,'� &-96£!@� 3(�>-+9T� 9$!8='9T�!2&�1<£ধ6£'�8'('8'2$'�93<8$'9W��-;,�9'29-ধ=-;@�;3�;,'�6!ধ'2;�'?6'8-'2$'T�'=-&'2$'f#!9'&�&'9-+2�$32$'6;9�,'£6'&� -2*<'2$'� ;,'�683/'$;y9�&'9-+2� ;3�-2$£<&'�2!;<8!£�£-+,;�;,83<+,3<;�;,'�(!$-£-;@T�96!$'9�(3$<9'&�32�6!ধ'2;�!2&�(!1-£@f$'2;'8'&�$!8'T�!2&�,<1!2�;3<$,�!2&�-2;'8!$ধ32W

2�;,'�)89;�@'!8T�6!ধ'2;�9!ধ9(!$ধ32�9$38'9�839'�;3�!2�<268'$'&'2;'&�£'='£T�;3� ;,'� ��8&� 6'8$'2ধ£'� -2� ;,'� 2!ধ32� >,'2� $316!8'&� >-;,� 3;,'8� $!2$'8�$'2;'89W��,'�9$38'9�3(�;,'�68'=-3<9�£3$!ধ32�>'8'�#'£3>���W��&&-ধ32!££@T�9;!ø�8'638;�-2$8'!9'&�=-9-;9�;3�;,'��36'�-8$£'�!8'!�#'$!<9'�-;�8'68'9'2;9�!�$!£1�,!='2�2'?;�;3�;,'�£3##@�>!-ধ2+�!8'!W

Earl Swensson Associates – ESaNEA Baptist Cancer Center/Fowler Family Center for Cancer Care Jonesboro, Arkansas

Left: HopeCircle Space Right: Infusion Bay Michael Peck, January 2014

1 42 3EBD STEPS APPLIED:

EBD Goal:To create a soothing, comfortable environment that would envelope patients and families and function well for the center's staff, while providing ease of access for patients. 7R� GHVLJQ� HI÷FLHQFLHV� WKDW� ZRXOG�translate to fast response times and streamlining of service lines that would lead to cost reduction.

2322

CAMA, Inc. and IOA Healthcare Furniture

Cama Healing Touch Collection – Family Bed Chair Thomasville, NCApplying the evidence-based design process, CAMA, Inc. determined a

need for family to physically connect with a bed-ridden hospitalized loved-32'W��2!#£'� ;3�)2&�!�683&<$;�32�;,'�1!80';T������6!8;2'8'&�>-;,� ���Healthcare Furniture to develop, test, and bring to market a new category of healthcare furnishing and designed the Family Bed Chair. The chair would #'�<9'&�#@� (!1-£@�1'1#'89� !2&�!&/<9;� ;3�,396-;!£� #'&�,'-+,;�68313ধ2+�eye-to-eye contact and hand holding.

�,'� $,!££'2+'� >!9� (38� !� &'9-+2� )81� ;3� '2+!+'� >-;,� !� 1!2<(!$;<8'8� -2�product design. The concept came primarily from parents interviewed for ;,'� 2<1'83<9� 6'&-!;8-$� (!$-£-ধ'9� ����� ,!9� &'9-+2'&W� ?-9ধ2+� 683&<$;9�>-;,�9-1-£!8�(<2$ধ32�>'8'�-&'2ধ)'&�#<;�232'�1';�;,'�2''&9W�

�đ'8� 8'=-'>-2+� 2<1'83<9� 93<8$'9� (38� 8'£'=!2;� '=-&'2$'T� ;,'� -&'!� >!9�presented to the manufacturer and design work began. The healing power of touch is an outcome that has not yet been fully explored in acute care -2;'8-38�&'9-+2W��,-£'�2<1'83<9�9;<&-'9�$32)81�1!2@�;,'8!6'<ধ$�#'2');9�associated with touch, including reduced stress, improved sleep, improved memory, and improved pain management, Western medicine has been slow to harness its healing powers.

The team's hypothesis is that physical touch will improve the state of >'££#'-2+�(38�!�#'&f8-&&'2�6!ধ'2;�!2&�8'&<$'�9;8'99�(38�!�$32$'82'&�£3='&�32'W��'!£;,$!8'�&'9-+2'89�<2&'89;!2&�;,'�639-ধ='�-16!$;�3(�93$-!£�9<6638;�32�,'!£-2+�!2&�6£!2�(38�-;�9<6'8)$-!££@�>-;,�;,'�!&&-ধ32�3(�(<82-;<8'T�;@6-$!££@�chairs, to clinical and recovery spaces. Rarely do healthcare designers dig deeper and explore how the built environment can encourage actual 6,@9-$!£�;3<$,�#';>''2�6!ধ'2;9�!2&�£3='&�32'9T�6!ধ'2;9�!2&�$!8'+-='89T�!2&�'='2�(831�$!8'+-='8�;3�$!8'+-='8W��';�;,-9�9<#;£'�9,-đ�-2�;,-20-2+�1!@�9-+2-)$!2;£@�;8!29(381�,'!£-2+�96!$'9W

�,'�'2+-2''8-2+�;8-!£9�>'8'�;,'�139;�$,!££'2+-2+W��8'!ধ2+�;,'�8-+,;�683;3;@6'�took hours in the factory with skilled labor, engineering know-how, and a &'9-+2� ;,!;� >3<£&� 1!0'� !� &-ø'8'2$'� ;3� !2� -2;'8'9;'&� 636<£!ধ32W��!80';�9;<&-'9�>'8'�$32&<$;'&�;,83<+,�!�9'8-'9�3(�(!$;f)2&-2+�&'1329;8!ধ329�>-;,�!�=!8-';@�3(�9;!0',3£&'89�!2&�(3$<9�+83<69W��,'-8�$8-ধ$!£�!2!£@9-9�>!9�#83<+,;�#!$0�;3�;,'�&8!>-2+�#3!8&�!2&�;,'2�8';'9;'&�-2�;,'�)'£&W��'='8!£�-;'8!ধ329�3(�this process occurred across a geographically diverse area giving the team the necessary feedback to deliver a product that would improve healing.

�đ'8� ;,'� $329<1'8� (3$<9� +83<69�>'8'� 9!ধ9)'&T� ;,'� 683&<$;� <2&'8>'2;�6'8(381!2$'� ;'9ধ2+� ;3�1'';� -2&<9;8@� 9;!2&!8&9� (38� 9!(';@� !2&� £-('$@$£'�

Solution:

Challenge:

Overview:

8'7<-8'1'2;9� (38� ,'!£;,$!8'W� �£;,3<+,� !� &-ø'8'2;� 683$'99� (831� #<-£&-2+�architecture, the evidence-based process was remarkably the same and a +8'!;�'?!16£'�(38�1-ধ+!ধ32�3(�;,'�8-909�-2�-223=!ধ32W

Family Bed Chair: a new category of furniture that is not a recliner or a sleep $,!-8�-2�;,'�;8!&-ধ32!£�9'29'U�-;�-9�!2�!8ধ$<£!ধ2+�$,!-8�-2;'2&'&�(38�(!1-£@T�23;�;,'�6!ধ'2;9W� ;�,!9�;,8''�!66£-$!ধ329V�['@'f;3f'@'\T�>,'8'�6!ধ'2;9�!2&�(!1-£@�#3;,�$!2�'2+!+'�>-;,�$£-2-$-!29�9,!8-2+�$8-ধ$!£�1'&-$!£�-2(381!ধ32U�[;Í;'f!f;Í;'\T�>,'8'�6!ধ'2;�!2&�(!1-£@�9-;�,'!&�;3�;3'�(38�9<9;!-2'&�'@'�$32;!$;�-&'!£�(38�6'8-3&9�3(�>!0'(<£2'99U�!2&�[£<££!#@\T�>,'8'�6!ধ'2;�!2&�(!1-£@�£-'�,'!&�to head for reading, watching television or computers together, or sleeping.

�,'� $,!-8�>-££� #'� 3ø'8'&� -2� !££� ����� !2&�3;,'8� 6-'$'9�>-££� #'� !&&'&� ;3�$8'!;'�;,'��'!£-2+��3<$,��3££'$ধ32W�

1 42 53EBD STEPS APPLIED:

EBD Goal:To harness the healing power of touch between a bed-ridden patient and a concerned loved one in order to promote healing.

A Family-Bed Chair – I0A Healthcare Furniture/Douglas Milloway

25��

�,'� �-£-;!8@� �'!£;,� �@9;'1� 3ă$-!££@� !&36;'&� '=-&'2$'f#!9'&� &'9-+2�68-2$-6£'9�2'!8£@� !�&'$!&'�!+3W��;!0',3£&'89� !;��!8ধ2��81@��311<2-;@��396-;!£� !£93� '?6'$;'&� ;3� 9''� !2� '2=-8321'2;� >-;,� =-9<!£� $£<'9� 96'$-)$�;3�1-£-;!8@�9'8=-$'�!2&�9!$8-)$'T�,3238-2+�6!ধ'2;9�!2&�;,'-8� (!1-£-'9�>-;,�6!;8-3ধ$�8'1-2&'89�3(�;,'-8�!ħ!$,1'2;�;3�;,'�2!ধ32T�;,'�!81@T�!2&�'='2�;,'-8�8'+-1'2;W��,'�!8;�683+8!1�'1#8!$'&�#3;,�&-8'$ধ='9W�

�,'� 9@1#3£9� !2&�13ধ(9� ;,!;� 9-+2-(@� ,3238T� 6!;8-3ধ91T� !2&� 68-&'� -2$£<&'�'!+£'9T�,-9;38-$!£�6,3;3+8!6,@T�1-£-;!8@�-29-+2-!T�!2&�'='2�8'68'9'2;!ধ329�3(�1!2'<='89�-2�)'£&�;8!-2-2+W��,'�,396-;!£Z9�&'9-+2�;'!1�&')2'&�;,'�'=-&'2$'f#!9'&�&'9-+2� !8;� '£'1'2;9� ;3� -2$£<&'� 8'('8'2$'9� ;3�2!;<8'T� !� =!8-!ধ32� -2�1'&-!� !2&� 9$!£'T� !2&� 36638;<2-ধ'9� (38� 639-ধ='� &-9;8!$ধ32W� �,'9'� -&'!9�>'8'�-2-ধ!££@�7<'9ধ32'&�#@�'2&f<9'89W��!;'8-!£�68'£-1-2!8@�$32$'6;9�>'8'�68'9'2;'&�-2�6'8932�;3�#'�#'ħ'8�<2&'89;33&�!2&�;3�+!-2�!$$'6;!2$'W�

;�>!9�&'$-&'&�;3�6£!$'�;,'�139;�£-;'8!£�!2&�6!;8-3ধ$�9<#/'$;9�-2�;,'�6<#£-$�and entry spaces, reserving calming and nature-based imagery for interior 96!$'9T� >,'8'� 6!ধ'2;9� >3<£&� $31'� -2;3� $32;!$;� >-;,� ;,'-8� ,'!£;,$!8'�683=-&'89W� �,'� &'9-+2� 93£<ধ32� ,@63;,'9-A'9� ;,!;� -2$38638!ধ2+� '£'1'2;9�;,!;� 8'*'$;� !� 96'$-)$� =-9<!£� $<£;<8'�h�'='2� -(� 23;� $31132£@�<2&'89;33&�as healing art — may support healing and promote a sense of wellbeing for those who belong to that culture.

Accordingly, the most acclaimed component of Fort Benning — its jump-;3>'89� (38� ;8!-2-2+�6!8!;8336'89�h�>'8'�68'9'2;'&�!9� ;,'�68'&31-2!ধ2+�subject within the main atrium, complete with parachute treatments for the 3='8,'!&�£-+,ধ2+W��;,'8�!8'!9�('!;<8'&�,-9;38-$!£�1'138!#-£-!T�6,3;3+8!6,@�3(�!$ধ='�9'8=-$'T�!2&�8'('8'2$'9�;3�96'$-)$�&-=-9-329�!2&�<2-;9�,3<9'&�!;�38;��'22-2+W��9-2+�&!;!�3ø'8'&�#@�'2&f<9'89T�8')2'1'2;9�;3�!8;�9'£'$ধ32T�£3$!ধ32T� !2&� +8!6,-$� &'9-+2�>'8'�1!&'W� £9'>,'8'T� !8Ĥ<£� 8'('8'2$'9� ;3�£3$!£�*38!�!2&�(!<2!�!8'�68'9'2;'&�;,83<+,�!�=!8-';@�3(�1'&-!W

�!ধ'2;f$'2;'8'&� &'9-+2� 8'7<-8'9� 96'$-)$� 93£<ধ329� ;3� 96'$-)$� 9'ষ2+9T�6!8ধ$<£!8£@�>,'2�6!ধ'2;9�#'£32+�;3�!�,-+,£@�&-9ধ2$;�$<£;<8'T�>-;,�-;9�3>2�visual vocabulary. EBD precepts, as commonly understood can make room for other subjects and meanings. Further research is needed to test the hypothesis that a healing art program may incorporate elements not yet !993$-!;'&�>-;,����!8;W� 2� !&&-ধ32� ;3� 8'('8'2$'9� ;3�2!;<8'T� =!8-!ধ32� -2�1'&-!� !2&� 9$!£'� !2&� 36638;<2-ধ'9� (38� 639-ধ='� &-9;8!$ধ32T� !� =-9<!£� !8;�683+8!1� 1!@� 3ø'8� '2$3<8!+'1'2;� ;,83<+,� 683<&� !ă£-!ধ32T� ,3238T� !2&�8'$3+2-ধ32�3(�9'8=-$'W

Solution:

Overview:

Challenge:

Results:

1EBD STEPS APPLIED:

4 53EBD Goal:

To combine two sometimes-competing ob-jectives: to offer positive distraction for patients with proven EBD principles, while honoring the mandates of the U.S. Military’s YLVXDO� FXOWXUH�� &XOWXUDO� VSHFL÷FLW\� LQ� WKLV�case meant incorporating subjects, styles, and media not commonly associated with evidence-based design.

Flag Assemblage Artwork in Main LobbyJudd Haggard, November, 2014

Skyline Art Services Martin Army Community Hospital Fort Benning, GA

27�¤

ERDMANFamily Healthcare of Hagerstown

Hagerstown, Maryland

!1-£@��'!£;,$!8'� 3(��!+'89;3>2T� !� ('&'8!££@� 7<!£-)'&� ,'!£;,$!8'� $'2;'8�l���mT� >!9� (381'8£@� 023>2� !9� ;,'� �!£2<;� �;8'';� �311<2-;@� �'!£;,��'2;'8�!2&�,!&�3<;+83>2�;,'-8�£'!9'&�96!$'�>-;,-2�!�1<£ধf;'2!2;�#<-£&-2+W��,'�#3!8&�1!&'�;,'�&'$-9-32�;3�8'23=!;'�!2�'?-9ধ2+�#<-£&-2+� -2�38&'8� ;3�$8'!;'�!�9;!;'f3(f;,'�!8;�3<;6!ধ'2;�,'!£;,$!8'�$'2;'8�>,'8'�6!ধ'2;9�$!2�!$$'99�1<£ধ6£'� 9'8=-$'9� !;� !� 9-2+£'� £3$!ধ32W� �,-9�13='� ;3� !� 2'>T� ,-+,£@�=-9-#£'�9-;'�-2�!�£!8+'8�#<-£&-2+�>!9�2'$'99!8@�;3�9'8='�;,'-8�+83>-2+�6!ধ'2;�636<£!ধ32�!2&�-16£'1'2;�!�6!ধ'2;f$'2;'8'&�1'&-$!£�,31'�13&'£W�

�8-='2�#@�;,'�&'!&£-2'�3(�;,'�;,'-8�'?6-8-2+�£'!9'T�;,'�ধ1-2+�3(�;,'�!=!-£!#£'�6836'8;@T� !2&� ;,'� 9$,'&<£'� 3(� ধ1'� 2''&'&� ;3� '?6£38'� 63;'2ধ!£� 683/'$;�partners, the decision was made to use an integrated project delivery method. The budget also had to absorb the purchase of the building, design, $329;8<$ধ32T�(<82-;<8'T�)?;<8'9�!2&�'7<-61'2;T� -2�!&&-ধ32�;3�;,'�$39;�3(�;,'�13='�(831�;,'-8�'?-9ধ2+�(!$-£-ধ'9�-2;3�;,'�2'>�#<-£&-2+W�

�,'� 38+!2-A!ধ32� 6<8$,!9'&� !� 6836'8;@�>-;,� ;,'� ,36'� ;,!;�1<$,� 3(� ;,'�'?-9ধ2+� -2(8!9;8<$;<8'�!2&�'?;'8-38� 90-2�$3<£&�#'� 8'<9'&� ;3�9<6638;� ;,'-8�2'>� #<-£&f3<;W� �9� ;,'� 6£!22-2+� !2&� &'9-+2� >380� #'+!2� -2� $338&-2!ধ32�>-;,�9'£'$ধ='�&'13£-ধ32�>380T� -;�#'$!1'�'=-&'2;�;,-9�+3!£�>3<£&�23;�#'�achieved, due to prior vandalism of wiring and a compromised exterior ;,!;�,!&�9<ø'8'&�>!;'8�&!1!+'W��&&-ধ32!££@T�#<-£&-2+�$3&'9�>'8'�23;�1';�#@�931'�'?-9ধ2+�('!;<8'9T�8'7<-8-2+�;,'�;'!1�;3�>380�>-;,�!<;,38-ধ'9�;3�)2&� 93£<ধ329W� �,'� ;'!1� 8'9632&'&� ;3� ;,'� '?-9ধ2+� #<-£&-2+Z9� $,!££'2+'9�by assessing the costs of repairs and replacements, and bringing that knowledge into the project scope.

The owner insisted the design team recognize and respect the center’s 6!ধ'2;9�!2&�;,'-8�(!1-£-'9�!2&�>!2;'&�;,'�)2!£�&'9-+2�!'9;,'ধ$�;3�!$,-'='�a balance between a clean, modern and professional image without being too extravagant in spite of budget constraints and the unique challenges.

�,'� &'9-+2� 38+!2-A'&� $£-2-$9� !83<2&� !2� -2;'+8!;'&� $!8'� ;'!1� 93£<ধ32�3ø'8-2+�!2�32f9;!+'�c�3øf9;!+'�!6683!$,�;3�;,'�(<2$ধ32!£�36'8!ধ32W�!$,�$£-2-$� 63&� l;>3� 6'8� *338m� ,!9� !� $31132� $38'� 3(� -2;'+8!;'&� '?!1� 83319�l#';>''2� #',!=-38!£� ,'!£;,T� $329<£;!ধ='� !2&� 1'&-$!£c$£-2-$mT� !$$'99-#£'�(831�;,'�1!-2�£3##@W��,'�[(832;\�3(�'!$,�63&�,!9�!2�-2;'+8!;'&�$!8'�;'!1�96!$'�!2&�683=-&'8�>380�96!$'W��<6638;�(<2$ধ329�!8'�£3$!;'&�;3>!8&�;,'�#!$0�-2�!�$31132�$38'�!8'!�9,!8'&�#';>''2�;>3�63&9W��!ধ'2;9�!2&�;,'-8�(!1-£-'9�!8'�8'$'-='&�32�;,'�1!-2�*338�>,'8'�8'+-9;8!ধ32T�)2!2$-!£T�93$-!£�$329<£;!ধ='�9'8=-$'9T�!2&�£!#38!;38@c;'9ধ2+�9'8=-$'9�!8'�£3$!;'&�!£32+�>-;,�!�8';!-£�6,!81!$@W��!ধ'2;9�$!2�8'+-9;'8�-2�6'8932�38�!;�!�0-390�!2&�!8'�;,'2�

Solution:

Challenge:

Results:

Overview:

moved to the clinic or dental pods located on the second, third or fourth *3389W�!$,�*338�!2&�63&�-9�$3£38f;,'1'&�;3�!99-9;�>-;,�>!@)2&-2+W�

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EBD Goal:To create a best-in-class patient-centered medical home model, while overcoming the challenges of rebranding and relocating the organization into a new location in renovated space.

Family Healthcare of Hagerstown Reception Andrew Harris/ERDMAN, August 2015

1 42 53 6EBD STEPS APPLIED:

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