A few months back I was having dinner in Washington, DC, with two very intelligent and engaging women; Esther M. Sternberg, MD, the author of the new book Healing Spaces: The Science and Place of Well-being, and Jennifer Wilcox, the past director of education for the American Society of Interior Designers and currently responsible for creating the educational programming for The Center for Health Design (CHD)/Vendome joint conferences. The conversation ranged from pop culture to the challenges we face with healthcare reform.

At one point the conversation turned to green design and sustainable architecture, and Jen shared her experiences with a popular private school in the DC area. At this school, they look at the buildings on their campus as being an extension of their faculty. They build using sustainable materials and incorporate technology to reduce their negative impact on the community. The Board of Directors of the school considers the buildings themselves to be a part of the faculty that is teaching the student and leading by example about conservation, sustainability, and responsible architecture.

The conversation reminded me that this is exactly the opportunity we have with healthcare architecture. We count primarily on physicians and nurses to care for patients and keep them safe but in reality the building they are receiving care in is just as responsible, not only for the safety of our patients but for the safety of our caregivers as well. Studies have shown for decades that the environment has a direct impact on health and well-being, and through research we are starting to uncover the many ways that the building can be used as a tool for better health and economic outcomes. Architecture can inspire, it can teach, and it can lead by example. A well-designed building that is appropriately located in the community, can lead by example with walking paths and contemplation spaces; by showcasing local community art and locally grown fresh produce; and making education about healthy living convenient and accessible to its employees, patients and the general community at large. In reality, the building is likely to be the only faculty member that is paid a salary once and never paid again, and will likely stick with the organization for the longest tenure. Making the right decisions from the start is vital-this is not a faculty member that one can easily or inexpensively fire or replace.

Making the right facility decisions is not always a straightforward path but every year more and more resources become available to stack the odds in your favor. Key to the process is pulling together the right interdisciplinary team, doing your homework to understand what the current research says, and using an evidence-based process, like the one set forward in the EDAC materials to understand what outcomes you hope to achieve before you even start. As they say, every road leads to your destination if you don't know where you are going first.

Studies have shown for decades that the environment has a direct impact on health and well-being, and through research we are starting to uncover the many ways that the building can be used as a tool for better health and economic outcomes.

Where to look for more information:

Two Web sites that you should visit often for free downloads of white papers and research reports are The Center's site at http://www.healthdesign.org and InformeDesign out of the University of Minnesota at http://www.informedesign.umn.edu/.

Also just launched at The Center is a new Web site geared exclusively to primary care facilities. This new site, funded by the California HealthCare Foundation, features literature reviews, best practice clinic examples, recommended design and operational strategies, and tips from the field. It can be found at http://www.healthdesign.org/clinics. A fourth site to spend some time on is http://healthdesign.org/hcleader/. This multimedia Web site features videos, podcasts, and white papers that outline the business case for better facility design, as well as an updated literature review and an evidence-based design roadmap. The site funded by the Robert Wood Johnson Foundation is geared towards the C-suite of healthcare facilities, but the information is easily digestible and valuable to all. HD

The Center for Health Design is located in Concord, California.

For more information, visit http://www.healthdesign.org.

Healthcare Design 2009 December;9(12):8