Seek out more evidence in evidence based design

The phrase “evidence-based medicine” is common and important in the world of healthcare.  Designers have adopted the same idea, which we call  “evidence-based design.” 

The idea is simple.  We should design spaces based on solid, proven scientific principles so that we know the space will work for the patients it serves.  Unfortunately, there really isn’t much science to support evidence-based design in behavioral healthcare.  My firm has teamed up with Eve Edelstein, PhD, to engage in a research project that we hope will change that.

In the meantime, it is important to understand how much science there is (or isn’t) behind your decisions.  The way I see the world, there are three categories of evidence:  There is what we know; what we think; and what we believe. 

What we know refers to those things that are supportable by science.  There isn’t enough of this, but there is some.  What we think are the things that we haven’t proven with research, but most people in the industry seem to agree on. What we believe unfortunately is often what is mistaken for evidence. 

A lot of people are very sure about the way behavioral health facilities should be designed, but there is a lot disagreement.  This is the realm of opinion, and it is these opinions that we are hoping to move into the other two categories.

This does require a deeper understanding of the typology because generalizations can be dangerous.  For example, there is a commonly held belief that private rooms are better for psychiatric patients.  But which ones?  For some patient types, this is an excellent idea, and for others it is not. 

We have talked to numerous clinicians with a wide variety of opinions, but we haven’t found one yet that would agree that private rooms are universally better.  Most clinicians that we have talked to prefer a mix so that they can make choices based on their evaluation of a specific patient.  We will be publishing more on this topic later in the year once we have more hard data to share, but is a good example of how things aren’t always as simple as they seem.