The Hospital Built Environment

What Role Might Funders of Health Services Research Play?

A literature review and interviews with architects, designers, academics, and health care executives were conducted between February and May of 2005, in an attempt to determine if associations exist between hospital building design elements and patient and staff safety, health outcomes, and patient and staff satisfaction levels. The findings were used to bring focus to the challenges of evidence-based hospital design and the roles that funders might play in the development and transfer of knowledge related to the constructed hospital environment.

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Contents

Acknowledgments
Summary
Chapter 1. Introduction
Chapter 2. Methodology
     Literature Review
     Informant Interviews
Chapter 3. Background
Chapter 4. What is Currently Driving the Market for Hospital Design and Construction?
Chapter 5. Are Hospitals Requesting Evidence-based Design?
Chapter 6. What is the Research Base for the Hospital Built Environment?
     Patient Outcomes
     Patient Satisfaction
     Patient Efficiency
     Patient and Staff Safety
     Staff Efficiency
     Staff Satisfaction
     Summary of the Research Base for the Built Environment
Chapter 7. What are the Major Challenges in Building the Field of Evidence-based Hospital Design?
     Insufficient Resources in Conducting Evaluations of the Built Environment
     Provider Input
     Information Sharing
     Laws and Regulations Regarding Hospital Design
     Capital Costs of Evidence-based Design
Chapter 8. Where are the Gaps in Current Research and Areas for Future Focus
     Patient Privacy and Confidentiality
     Patient Safety and Environmental Factors
     Staff Health, Safety, and Performance
Chapter 9. What are Appropriate Future Roles for Funders in Advancing Evidence-based Hospital Design and Architecture?
     Funding Empirical Research
     Transferring Evidence-based Research Output to Decisionmakers
References

Tables
1. Summary of articles by main topic and source
2. Response results by key informant group
3. Articles by study design and key topic

Figures
1. Study design
2. The status of the research scorecard related to reduce staff stress/fatigue
3. The status of the research scorecard related to patient safety and quality of care improvement

Appendixes
A: Key Informants Interviewed
B: Organizations with Staff Expertise in the Built Environment
C: The Built Environment—Determining AHRQ's Niche Interview Protocol

AHRQ Publication No. 05-0106-EF