Putting Evidence-Based Design Into Practice
When the design team of HDR Architecture and Young+Co. started working on the new Naval Hospital at Camp Pendleton, it was right after the Surgeon General had mandated in 2007 that all new military hospitals be built using evidence-based design (EBD) principles.
“The military loves lists, so we developed an EBD matrix,” Jean Young, president of Young+Co., told attendees during her part of a panel presentation, “Landmark Solution for Navy Design Challenge: The Camp Pendleton Naval Hospital,” on the project during the 2014 Healthcare Design Conference in San Diego.
Core to the matrix were four EBD principles and expected outcomes, which Young spoke about in detail while showing project images (read more about the Camp Pendleton article in “Camp Pendleton Replacement Hospital Mirrors Military Traditions”.
1. Improve quality and safety of healthcare delivery
To reduce infections spread by contact, prevent patient falls, and improve speech intelligibility, Young explained that the team used 11 design strategies, some of which were:
- Use of materials to designate high-contact areas as a cue for cleaning teams
- Close placement of bathrooms relative to patient beds to decrease steps
- Use of high-performance sound-absorbing gypsum wallboard and decibel-reducing flooring in special areas, such as the NICU.
2. Create a patient and family-centered environment, focused on the whole person
Young outlined 15 design strategies that the team incorporated to increase social support, reduce spatial disorientation, improve patient sleep and rest, and decrease patient stress, including:
- Waiting rooms and lounges with comfortable, movable furniture arranged in small flexible groupings
- Visible and easily understood signage
- Single patient rooms
- Access to nature with healing gardens and central “green” zones.
3. Create a positive work environment
The desired outcomes for this principle were to reduce staff back pain and work-related injuries, as well as decrease staff stress by eliminating noisy, chaotic environments. Among the seven design solutions Young covered were:
- Ceiling-mounted lifts
- Evaluation of work areas for human factors and ergonomics
- Adequate space for private work
- Visual connection to patients
4. Design for maximum standardization, flexibility, and LEED certification
Among the four, this principle is more operations focused, with goals to expand the utility of public spaces and meet LEED certification. Strategies to achieve this were:
- Create flexible public spaces to support multiple missions, such as health fairs and military events
- Facilitate surge capacity for possible natural or man-made disasters and wars
- Use a LEED checklist. (The building achieved LEED Gold.)
Young ended her part of the presentation by sharing that the Navy asked each member of the project team to write a note to the people who were going to use the hospital. The notes were collected, put on collage panels, and displayed on a wall. “It became a piece of artwork,” she said. “I’ve never done anything like this before on a project, and it was really neat.”