Evidence-based design isn't just for new construction. Whether a project is large or small, new construction or a renovation, the process of basing design decisions on credible research can lead to better healthcare outcomes. While a renovation may impose additional constraints, evidence-based design can still be applied. At the Doyle Women's Pavilion (currently named the Sarah Walker Women's Center) of Morton Plant Hospital in Clearwater, Florida, evidence-based design was an important element in the selection of the project's design firm, Gresham, Smith and Partners (GS&P).
According to Beth Moser, director of construction at Morton Plant Hospital, “Evidence-based design is similar to evidence-based medicine in terms of basing decisions on credible research. This method fits well in the healthcare environment, as caregivers understand the concept and are already focused on achieving the best outcomes. With the remodel of the women's obstetrics services, we felt it important that we determine what is working in other facilities to assist us in making decisions for our team members, patients, and visitors to provide the highest level of healthcare.”
Established in 1916, the 687-bed hospital has been serving women and infants since its inception. In 2005, Morton Plant Hospital received the UNICEF/World Health Organization designation as a Baby-Friendly Hospital. This program is designed to ensure that hospitals support breast-feeding by following 10 specific steps, such as initiating breast-feeding within a half hour of birth and practicing rooming in.
The Doyle Women's Pavilion is an 81,000-square-foot project involving the renovation of the existing Adler Building with a new entry addition to create an identifiable, convenient, and welcoming birthing center with all services located in one building. The project spans four floors and includes assessment, antepartum, labor and delivery, C-section suites, postpartum, and a neonatal intensive care unit (NICU). The facilities and amenities will support patient- and family-centered care and operational efficiency while creating a therapeutic environment for women and infants.
The design process included nurses from all areas of practice in the women's center. Some were veteran committee members and problem solvers, while others were involved in project development and committee work for the first time. Ages of members from the nursing team varied from late 20s to early 60s. In addition, major ancillary departments have been involved.
Defining evidence-based design goals
Team members worked their way through the Evidence-based Design Review Checklist tool developed by the Military Health System (included in EDAC Study Guide 1, “An Introduction to Evidence-Based Design”) to identify more than 20 evidence-based design goals, including increased social support, increased bedside time, decreased stress, and improved communication.
Collecting evidence
Evidence-based design literature was considered when making many of the design decisions, but additional data collection methods also were utilized during the project.
Nurse Shadowing
Three team members-GS&P's project architect, and director of research, and Morton Plant's director of construction-completed several hours of nurse shadowing to gain greater insight into the operations of the healthcare staff. Tamara Rice, project architect, says, “By shadowing staff and directly observing them in their work environment, our design is more informed. We have a better understanding of the current space challenges and how to re-design a workspace that supports staff in providing high-quality care.”
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