Standardization and Knowledge-sharing Needed in Evidence-based Healthcare Design

Evidence-based design (EBD) has done much to improve patient outcomes, staff wellbeing and operational efficiency in healthcare. The next hurdle lies in the standardization of methods and tools, and the systematic translation of findings to further increase the credibility and impact of EBD.

Improving the Industry

At this fall’s Healthcare Design Expo + Conference, Debbie Franqui, LEO A DALY’s Miami-based healthcare market leader, presented during three sessions. Each presentation was aimed at improving standardization and knowledge sharing in EBD.


“The industry is hungry for research, and the bottom line question is always, ‘How can we best integrate research throughout the architectural process?’” Franqui said.

In her presentation, “An Evidence-Based Design Checklist to Inform Clinic Design,” Franqui, along with Clemson professor Dina Battisto, presented a standardized methodology to be used in evaluating completed healthcare designs against their stated performance goals.

“Empirical studies using a standardized post-occupancy evaluation (POE) methodology are needed to assess clinic design and determine the strengths and challenges of different clinic typologies,” she said. “While the use of POEs is climbing, the translation of lessons learned into usable tools, given the lack of standardized methods and tools across the Industry, is still the challenge.”

Knowledge sharing across the healthcare design industry depends on standardization, which requires collaboration among design firms, healthcare systems and researchers.

“If we could all agree on 10 key metrics that we should all collect equally, we can start heading toward a shared database and benchmarks,” Franqui said.

The EBD Checklist tool Franqui proposed, which was validated against available tools by the Center for Health Design and the American Medical Association, is a promising step toward true EBD. 

Bridging the Gap between Research and Practice

In another presentation, “Making the Case for Case Studies,” Franqui and Byron Edwards, chair of the AIA/AAH research Initiatives Committee, elaborated on a standardized case study methodology that would “bridge the gap” between research and practice.


“Standardizing case study methodologies across the industry using this framework would further strengthen the connection between design and outcomes,” Franqui said.

In a third presentation, “Ambulatory Care for the Medically Underserved,” Franqui and others applied the EBD Checklist and standardized case study format to develop best practices in clinic design for underserved populations. 

The presentation was the result of an NCARB-sponsored evidence-based learning initiative that paired researchers and students at Clemson University’s Architecture + Health Studio with practicing architects like Franqui.