to design and build health care facilities founded on research or the best available information, ensuring that the relatively permanent physical environment facilitates the delivery of quality care, thereby improving patients' outcomes and safety. 2
Review of the Literature on EBD in Critical and Acute CareSubstantial support exists for the view that a health care structure itself affects quality of care, patients' safety and satisfaction, as well as staff satisfaction and service efficacy. 3 In a report to the Center for Health Design funded by the Robert Wood Johnson Foundation, Ulrich and associates 4 identified more than 600 studies that link hospital design with clinical outcomes. In recent years, evidence-based design (EBD) has become a more pronounced guiding principle in health care. The concept of EBD is BACKGROUND In 2 landmark publications, the Institute of Medicine reported on significant deficiencies in our current health care system. In response, an area of research examining the role of the physical environment in influencing outcomes for patients and staff gained momentum. The concept of evidence-based design has evolved, and the development of structural guidelines for new hospital construction was instituted by the American Institute of Architects in 2006.OBJECTIVE To determine perceptions of patients and their families of evidence-based design features in a new heart center.METHODS Hospitalized patients and their families, most of whom were in intensive care and step-down units, were surveyed and data from the Hospital Consumer Assessment of Healthcare Providers and Systems were reviewed to determine perceptions of evidence-based design features incorporated into a new heart center and to assess patients' satisfaction with the environment. RESULTS Responses were reviewed and categorized descriptively. Five general environment topics of focus emerged: privacy, space, noise, light, and overall atmosphere. Characteristics perceived as being dissatisfying and satisfying are discussed.CONCLUSIONS Critical care nurses must be aware of the current need to recognize how much the physical environment influences care delivery and take steps to maximize patients' safety, satisfaction, and quality of care. This article has been designated for CE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:1. Discuss the concept of evidence-based design in health care environments 2. Identify evidence-based design features associated with improved patient care 3. Recognize the role of physical environment in influencing patient outcomes