For the last two years, I have been focused on the writing and assembly of a book entitled Evidence-Based Healthcare Design, Wiley, 2009. It was my first foray into the creation of a complete manuscript, but like most new things in life, one must pause to go forward.

In my most contemplative moments documenting the process of evidence-based design, I thought long and hard about how the evidence-based process fosters innovation. As a healthcare interior designer, I have observed many a user seek nothing more than a better design for an old solution. It is a comfortable way to see improvement but often delivers nothing more than a better old building. Users need to be empowered to focus on defining a better way to deliver care and then collaborate with a broader team on the design of an innovative solution in order to improve an outcome. Fear of risk or the cost of something unknown usually gets in the way and innovation is squelched in an industry that desperately needs to move forward.

Life cycle of an interior in the acute care market must survive at least 15 years. Therefore a new idea or an innovative concept has to be grounded with a base of credible knowledge and aligned with an institution's long-range financial goals. This process must use evidence-based design.

This issue of HEALTHCARE DESIGN is focused on innovative product designers. As I delved into this topic for my book, I turned to others who have written on the topic of innovation. Most of what is written is about industrial design. Tom Kelley, from IDEO, wrote the book The Art of Innovation: Lessons in Creativity From IDEO, America's Leading Design Firm about the process they use to create new solutions for a particular need. He attributes the IDEO process to the following 5 steps:

  • Understand the market
  • Observe real people
  • Visualize new-to-world concepts
  • Evaluate and refine prototypes
  • Implement the concepts

As I looked to others like Joe Pine and his consulting team at Starizon, and studied his book The Experience Economy: Work Is Theater & Every Business Is a Stage, and Daniel Buros and his book Technotrends: How to Go Beyond Your Competition, which discusses the kit of parts available in the IT world that fosters innovation, I found that they all referred to a similar process much akin to the process used in evidence-based healthcare design.

Taking Kelley's concepts for innovation I find they parallel evidence-based design nicely:

  • Assess gathered intelligence as you understand your market
  • Conduct deep dives or visioning sessions with real people
  • Map and hypothesize your informed design solutions
  • Translate designs or mock-up in order to evaluate and refine
  • Measure and share outcomes as design concepts are implemented

This analysis helped me to deduce that the evidence-based process, if used properly, leads a design team toward innovative solutions that improve outcomes and the experience as well.

Can the process, if evidence-based, reduce risk? If the process is adopted by the culture of an interdisciplinary team, the broadened perspective coupled with a foundation of credible knowledge builds a safety net that is likely to support the next-best idea. If the idea is truly innovative, the literature will not support the new concept, but more than likely, will support the foundation of the idea that fueled the synapse.

So where do industrial designers fit into our evidence-based design process? We seem to run parallel and are not often assigned to the solution of a problem at the same time. Architects and interior designers sometimes operate in a vacuum and only create new and measurable solutions with an existing base of products. The opportunity to bring industrial designers to our evidence-based drawing table to integrate our collective goals and accelerate the innovation cycle is welcomed. It is a partnership that is needed to improve the way healthcare is delivered; a way for all disciplines to come together for the betterment of the task at hand for an integrative solution-truly an interdisciplinary team.

Since writing my book, I have thought of a list of products that need to be designed to improve or augment evidence-based interior design solutions. I look forward to seeing how evidence-based design will marry our aligned but separate professions. A special supplement in this issue of HEALTHCARE DESIGN looks at the most innovative product designers. Look for evidence of a familiar process in the work that lead to their discoveries. Find ways to include their skills into your interdisciplinary team. Let us know when you do so and how the evidence-based process fosters an innovative solution. HD

Rosalyn Cama, FASID, is Board Chair for The Center for Health Design. Her book, Evidence-Based Healthcare Design is available through John Wiley & Sons. The Center for Health Design is located in Concord, California.

For more information, visit

Healthcare Design 2009 May;9(5):10