Thanks to a grant from the Agency for Healthcare Research and Quality (AHRQ), The Center for Health Design (CHD) has embarked on a three-year quest to make hospitals safer for patients and staff. As part of this project, CHD and partners the Facilities Guidelines Institute (FGI) and MedStar Institute for Innovation invited industry experts from a wide variety of disciplines to a meeting in Washington, D.C., earlier this year.

Such a gathering isn’t necessarily new to our industry, but the spirit and energy at this meeting was unique in so many ways. The goal of the event was to come to a consensus on a variety of approaches that would, in time, find their way into a safety risk assessment (SRA) toolkit. As anyone involved in a consensus-building exercise knows, they’re complicated and challenging. Add to the mix close to 100 professionals—all experts in their fields—and a complex set of variables not easily compartmentalized, and you have what could easily have been a disaster.

But far from that, what actually happened was a bit magical. Throughout the two days, people approached me to say that they could feel a tidal shift at this meeting. There was a sense of camaraderie and collaboration that seemed to break through old barriers and help form new alliances.

The focus and the ultimate goal of the project is to funnel all the energy and expertise from these industry experts into the creation of the SRA toolkit to supplement FGI’s Guidelines for Design and Construction of Health Care Facilities and significantly strengthen the focus on patient and worker safety in healthcare environment design.  The charge during this first year, specifically, has been to develop the structure and format that the toolkit will take, which included coming to consensus on the key hazards and latent conditions to be considered and the degree of risk associated with different environmental design features.

Early on in the process, the group cast a wide net and over the course of the year worked to narrow down that focus to core areas to be considered. The in-person meeting allowed the volunteers to discuss face-to-face the merits and complexities of each of the final six areas identified and come to a decision on what would be included in the complete structure.

Those six core areas are: healthcare-associated infections, patient falls and immobility, medication errors, patient handling and movement, behavior health, and security. In all of these, the physical environment can play a supportive role in creating safer environments and reducing the potential for errors.

Beyond developing the content for the toolkit, the group was also charged with taking a strategic look at how it could be successfully and readily adopted once complete. Breakout groups looked at how the toolkit might be used in the healthcare design process, how it would be adopted, its impact on workflow, and potential barriers to successful implementation. The hope is that by 2015, the toolkit will be available, and easily and quickly find its way into application.

There are still two more years of work ahead on this project and many pieces yet to be developed, designed, and made intuitive to use. The group will continue to meet by phone over the course of the year and come together again in person in mid-2014.

If this work interests you and you’d like to learn more about it or keep abreast of progress, email me your thoughts. I’d love to hear from you.


Debra Levin, EDAC, is president and CEO of The Center for Health Design. She can be reached at