In planning new buildings, it is important to analyze previously
completed projects to determine the effect of specific design features on operational performance, patient outcomes, and the nurses and other provider experience. Until recently, many completed projects only published the total cost of the project, pictures of the beautiful interior features accompanied by a floor plan, and written description of the final project penned in the most positive marketing language.
Descriptions of what did not work after occupancy of the building and how the design affected daily operations were rarely described. In essence, a new building was a multimillion dollar experiment. With new emphasis placed on an evidence-based design approach, the nurse executive must work in partnership with the design professionals to ensure that all sources of possible evidence (published studies, opinion papers, experience from other projects, and best-practice examples) are researched and critically appraised before research questions are asked and hypotheses developed related to specific design features. As an example, for medical-surgical patients in a hospital, what is the effect of the all private room configuration on total project cost as compared to the semiprivate room configuration? The words total project cost can be substituted for patient satisfaction, nosocomial infection rates, patient fall rates, medication error rates, nurses satisfaction rates, or a many other dependent variables of interest to nurse leaders. The use of the evidence-based design approach can be used to test some of the assumptionsincalculatingthetotal project cost of a project or in testing assumptions about the
return on investment in terms of quality and cost outcomes.