Part Two - Office of Construction and Facilities Management

more healing for patients, and better places for staff to work.” 7 According to this
review, design characteristics have an effect on a variety of patient and staff
outcomes. Patient outcomes affected by physical design include infection rates,
falls, quality of sleep, pain, stress, anxiety, depression, and spatial disorientation.
The built environment also influences patient privacy and confidentiality,
communication with and between patients, providers, and families, patient social
support, length of stay, and patient/family satisfaction. Equally as important, the
built environment directly affects staff outcomes such as injuries, stress,
effectiveness, medical errors, ability to spend time in direct patient care activities,
ability to work as part of a team, and staff satisfaction.
Specific examples from published research 8, 9, 10 show that:
• Patients recover faster in private rooms.
• Rooms that include the patient and family as integral team members
achieve better outcomes.
• Providing positive distractions through music and art can improve the care
experience and the patient’s perception of pain.
• More access to natural lighting reduces patient anxiety and depression
and shortens length of stay.
• Access and exposure to nature substantially reduce stress and anxiety
and have a restorative effect.
• Single patient rooms reduce infection rates.
• Wider bathroom doors contribute to reducing patient falls.
• Adequate lighting levels reduce staff medication-dispensing errors.
• Variable acuity rooms reduce expensive and potentially dangerous patient
transfers.
• Well-designed units can reduce the time providers spend walking and
increase time spent in direct patient-care activities.
• A good acoustic environment can reduce patient and provider stress,
improve patient sleep quality, and increase staff productivity.
• Effective air quality control and ventilation systems help to reduce the rate
of air-born infections.
In renovating current facilities and planning future ones, VA will want to take into
account the profound impact that facility design can have on both health
outcomes and quality of service. Specific design recommendations follow.
7 Ulrich, R., C. Zimring, X. Zhu, J. DuBose, H-B. Seo, Y-S. Choi, X. Quan, and A. Joseph. 2008.
A Review of the Research Literature on Evidence-Based Healthcare Design (Part 1, Part 2, and
References). Health Environments Research & Design Journal 1: 61-125.
http://www.herdjournal.com
8 Ulrich et al. The Role of the Physical Environment in the Hospital of the 21st Century: A Oncein-a-Lifetime
Opportunity. http://www.healthdesign.org/research/reports/physical_environ.php
9 Research Reports & Papers. The Center for Healthcare Design. Retrieved 12/18/2008 from
http://www.healthdesign.org/research/reports/index/completelist.php
10 Sadler, B., J. DuBose, and C. Zimring. 2008. The Business Case for Building Better Hospitals
through Evidence-Based Design. Health Environments Research & Design Journal.
http://www.herdjournal.com
FINAL DRAFT Part 2-9
June 2009