An Introduction to
Evidence-based Design
Accreditation and
Certification - EDAC
from The Center for Health Design
Evidence-based Design and EDAC
•
•
•
The Center for Health Design’s internationally recognized EDAC program awards credentials to
individuals who demonstrate a thorough understanding of how to apply an evidence-based
design process in the design and development of healthcare settings.
The EDAC exam establishes standards and tests individuals on the EBD process.
Use of the EDAC appellation distinguishes your knowledge and practice of EBD in healthcare.
EDAC Mission and Vision
Mission: To develop a community of certified industry professionals through
education and assessment of an evidence-based design process.
Vision: A world where all healthcare environments are created using an
evidence-based design process.
EDAC was created to:
• Provide a definition of EBD and define a standard process for
implementing EBD
• Establish expectations for individuals who are or will be using an EBD
process
• Institutionalize EBD as an accepted and credible approach to improve
healthcare outcomes
The EDAC Exam
from The Center for Health Design
Exam Structure
• The exam consists of 110 items with stems, keys, and distracters
– Stem: The stem may contain several sentences that provide
background information and will end with a question. The candidate
must read the stem carefully to avoid selecting the wrong answer
based upon a misunderstanding of the question.
– Key: The most appropriate or correct answer from the four choices.
– Distracters: The other choices that may not be entirely incorrect,
however, they are NOT the most appropriate or correct choice to
answer the question written in the stem.
Types of Exam Questions
ANALYSIS
•
•
•
requires candidates to draw
from memorized facts
does not have answers that
vary with the situation
characteristics: the question
or statement is short with
one variable
•
•
•
asks the candidate to
consider how the EBD
process is applied in various
scenarios or situations and
requires the candidate to
interpret, classify, translate,
or recognize relationships
between a situation or other
variables
has correct answers that vary
based upon the situation
characteristics: statements
and questions will have more
than one variable and will
require careful reading and
correlation of the answers
with the variables in the
statements or question.
•
•
•
•
requires information synthesis,
problem solving, analysis of
the situation and selection of
the best response
has correct answers that vary
based upon the situation
candidates act on a problem
and identify clues contained in
the question or statement
characteristics: the longest
question/statement and will
ask candidates to select the
best answer and requires
careful reading to establish the
relationship between variables
in the question and the
answers.
Exam Content
Outline
Five Domains:
•
EBD for Healthcare
•
Research
•
Pre-Design
•
Design
•
Construction & Occupancy
The exam content outline can be downloaded from www.healthdesign.org/edac
Preparing for the Exam
Read all three study guides to:
•
Gain an overview about the healthcare industry
•
Understand the trends and challenges that impact healthcare design
•
Learn information about finding, using and conducting research
•
Understand how to integrate the evidence-based design process
Study Guide 1: An Introduction to EvidenceBased Design: Exploring Healthcare and
Design
Guide 1 provides an introduction to
evidence-based design (EBD) and an
overview of the healthcare delivery
system. Topics include:
•
•
•
•
•
History and evolution of EBD
Trends impacting healthcare
Role of key stakeholders
An introduction to research
EBD in practice - Military Health
System
Study Guide 2: Building the Evidence Base:
Understanding Research in Healthcare Design
Guide 2 explores the role of research
in evidence-based design. Topics
include:
•
•
•
•
•
•
•
What is research?
Research process
Research methodologies
Finding and using research
Research Plan
Creating new evidence
Measurement Tools
Study Guide 3: Integrating Evidence-Based
Design: Practicing the Healthcare Design
Process
Guide 3 integrates the evidence-based
design process into the typical steps
of the design process in detail from
pre-design, design, construction and
post occupancy. Topics include:
•
•
•
•
•
•
•
•
Creating the interdisciplinary team
Establishing vision and goals
Developing design strategies
Gathering baseline data
Developing hypotheses
Monitoring construction
Implementing the research plan
Sharing results
Other Resources
12
How EDAC is Different Than Other Credentials
EDAC is complementary to other design industry credentials and provides
added expertise to strengthen an individual’s knowledge. It is for anyone who
is a member of a project team designing a new hospital, ambulatory center, or
renovating an existing building. The EDAC program:
•Focuses on achieving improvement and outcomes in all three areas of safety
(patient, staff and environment)
•Does not have pre-requisites or licensure requirements
•Tests your knowledge of the EBD process, not specific research
•Credential recognized across the U.S. and internationally
13
Benefits of EDAC Certification
EDAC certification is for anyone interested
in formalizing their knowledge of the EBD
process. The credential provides:
•
•
•
•
•
•
Public recognition of your EBD
expertise
Increased value with clients and/or
employers
Ability to share a common language
with project team members
Credibility when justifying
expenditures associated with design
decisions and innovations
Access to ongoing professional
learning tools and newsletters
Access to the a community of likeminded individuals
14
EDAC Certification - Students
•Set yourself apart – EDAC certification is an internationally recognized asset
on your resume.
•Put your passion to work – change the world of healthcare using evidencebased design.
•Network with top industry professionals – join a community that is
passionate about changing the face of healthcare design.
•Get 40% off EDAC Study Guides and the EDAC Exam.
•Visit www.healthdesign.org/edac and use code STU
from The Center for Health Design
15
Evidence-Based Design
History and Background
from The Center for Health Design
EBD History and Background
from The Center for Health Design
EVIDENCE-BASED DESIGN
IS THE PROCESS OF BASING
DECISIONS ABOUT THE BUILT
ENVIRONMENT ON CREDIBLE
RESEARCH TO ACHIEVE THE
BEST POSSIBLE OUTCOMES
EBD Process
Listed in SG1
Key Differences Between EBD and
Typical Project Delivery
Addresses Healthcare Trends/Challenges
• Developing design strategies targeted to improve clinical, environmental and
safety outcomes.
Research is Used
• EBD uses relevant evidence to educate the project team and guides the
development of design strategies. The integration of these strategies is linked
to achieving outcomes.
New Research is Created
• Conducting post occupancy evaluation/research to create new evidence
and report the results.
from The Center for Health Design
Other Considerations: The Environment of Care
Implementation
Physical
Environment
Concepts
EOC
Layout/
Operations
People
Systems
from The Center for Health Design
The impact of the physical
environment on organizational
culture can best be understood
by considering the components
of the Environment of Care
(EOC).
Value Proposition for CEOs
The New Reality:
Healthcare faces greater transparency around patient
and workforce safety/ quality issues
Progressive organizations can
achieve measurable improvements
and operating savings through
evidence-based design.
from The Center for Health Design
Why EBD in Healthcare? The Business Case
•
Goal – demonstrate facilities investments contribute to improvements in:
– Patient-care quality
– Safety and satisfaction of patients and staff, and
– Enhancing the bottom line
•
Create a business case by looking at the entire life cycle for the project
and consider:
– First year and multiyear costs
– Revenue and operational savings
– ROI based on a multi year payback period
– Assessment of baseline performance changes
from The Center for Health Design
The Business Case – Return on Investment
1
Source: Zofia Rybkowski, PhD Candidate, UC Berkeley, Engineering and Project Management, Dept. of
Civil and Environmental Engineering.
Can design really
affect outcomes?
BUILT
ENVIRONMENT RESEARCH
2004
650
DOES EXIST
2008
1,000+
2014
CHD Knowledge Repository – 3,000
26
Knowledge Repository
www.healthdesign.org/search/articles
Sample EDAC Exam
Questions
from The Center for Health Design
Sample Question
RECALL: Central to making the business case for new design strategies, what
will need to be balanced against ongoing operating savings and revenue
enhancements?
a. patient outcomes
b. one-time capital costs
c. longer construction timelines
d. project vision and mission
Sample Question - Answer
RECALL: Central to making the business case for new design strategies, what
will need to be balanced against ongoing operating savings and revenue
enhancements?
a. patient outcomes
b. one-time capital costs
c. longer construction timelines
d. project vision and mission
SAMPLE QUESTION
RECALL: When applying an evidenced-based design process, why MUST the
economic and social factors included in the Environment of Care (EOC) model
be considered when designing the physical environment?
a)
b)
c)
d)
They affect the development of the budget
They influence the results of the research.
They define baseline performance metrics.
They exist concurrently and influence planning.
ANSWER
RECALL: When applying an evidenced-based design process, why MUST the
economic and social factors included in the Environment of Care (EOC) model
be considered when designing the physical environment?
a)
b)
c)
d)
They affect the development of the budget
They influence the results of the research.
They define baseline performance metrics.
They exist concurrently and influence planning.
Sample Question
APPLICATION: A project team is designing a brand new children’s hospice.
Before starting the design, the team employed a researcher who conducted a
study in three of the city’s existing hospices using the following tools: surveys;
in-depth interviews; focus groups. Which of the following best describes the
research methodology used?
a. applied research
b. mixed methods
c. quantitative
d. qualitative
Sample Question - Answer
APPLICATION: A project team is designing a brand new children’s hospice.
Before starting the design, the team employed a researcher who conducted a
study in three of the city’s existing hospices using the following tools: surveys;
in-depth interviews; focus groups. Which of the following best describes the
research methodology used?
a. applied research
b. mixed methods
c. quantitative
d. qualitative
SAMPLE QUESTION
APPLICATION: Historically, most health care organizations have
thought of the physical building as a sunk cost. In evidence-based
design, and as part of developing the business case, what is the
physical building viewed as?
a)A revenue center.
b)A strategic investment.
c)A capital expense.
d)A healing environment
ANSWER
APPLICATION: Historically, most health care organizations have
thought of the physical building as a sunk cost. In evidencebased design, and as part of developing the business case, what
is the physical building viewed as?
a)A revenue center.
b)A strategic investment.
c)A capital expense.
d)A healing environment
Sample Question
ANALYSIS: A summary of EBD research in an architectural magazine indicates
that carpeting is associated with a reduction in patient falls and decreased
workplace injuries; while nursing floor layout is associated with a reduction in
patient falls and increased staff satisfaction. Given a limited budget, what
should the organization do FIRST to determine where to invest its limited
resources?
a.Select the design feature that is most in line with the EBD vision.
b.Check the hospital statistics to see which of the two design features will
result in a greater reduction in operating costs.
c.Choose the design feature that is of most interest to the core design team.
d.Conduct a critical review of the existing research before making any
decisions.
Sample Question - Answer
ANALYSIS: A summary of EBD research in an architectural magazine indicates
that carpeting is associated with a reduction in patient falls and decreased
workplace injuries; while nursing floor layout is associated with a reduction in
patient falls and increased staff satisfaction. Given a limited budget, what
should the organization do FIRST to determine where to invest its limited
resources?
a.Select the design feature that is most in line with the EBD vision.
b.Check the hospital statistics to see which of the two design features will
result in a greater reduction in operating costs.
c.Choose the design feature that is of most interest to the core design team.
d.Conduct a critical review of the existing research before making any
decisions.
Sample Question
ANALYSIS: One of the members of the interdisciplinary project team, an
experienced nurse, brought in a research report from a peer-reviewed journal
that indicated that the efficiency of care provided by the nursing staff is
influenced by the layout of patient rooms. This team member argued that the
bulk of the EBD budget be spent on this design feature. The team MUST:
a.Allocate the bulk of the budget to patient room redesign, based on this
evidence.
b.Validate the research by finding hospitals that have shown an increase in staff
efficiency based upon layout of patient rooms.
c.Find evidence to support a wider range of EBD features before deciding how
the budget should be allocated.
d. Ignore the recommendation because the report lacks rigor.
Sample Question - Answer
ANALYSIS: One of the members of the interdisciplinary project team, an
experienced nurse, brought in a research report from a peer-reviewed journal
that indicated that the efficiency of care provided by the nursing staff is
influenced by the layout of patient rooms. This team member argued that the
bulk of the EBD budget be spent on this design feature. The team MUST:
a.Allocate the bulk of the budget to patient room redesign, based on this
evidence.
b.Validate the research by finding hospitals that have shown an increase in staff
efficiency based upon layout of patient rooms.
c.Find evidence to support a wider range of EBD features before deciding
how the budget should be allocated.
d. Ignore the recommendation because the report lacks rigor.
Sample Question
ANALYSIS: A hospital-based project team wants to make sure that the
observation instrument they developed has a high degree of reliability. They
should:
a) Test it in a variety of settings both within and outside the hospital.
b) Have several researchers use it within a specified timeframe and place with
the same subjects and see if similar results are achieved.
c) Ask an experienced researcher to validate that the instrument is measuring
what it is supposed to measure.
d) Collect opinions on the instrument from within the design team.
Sample Question - Answer
ANALYSIS: A hospital-based project team wants to make sure that the
observation instrument they developed has a high degree of reliability. They
should:
a) Test it in a variety of settings both within and outside the hospital.
b) Have several researchers use it within a specified timeframe and place
with the same subjects and see if similar results are achieved.
c) Ask an experienced researcher to validate that the instrument is measuring
what it is supposed to measure.
d) Collect opinions on the instrument from within the design team.
SAMPLE QUESTION
RECALL: When designing a hospital using an evidence-based
approach, it is MOST important to remember which of the
following?
a)To include users in identifying design strategies
b)To make the connection between design and outcomes
c)To consider the impact of confounding variables
d)To evaluate and collect baseline data
SAMPLE QUESTION
RECALL: When designing a hospital using an evidence-based
approach, it is MOST important to remember which of the
following?
a)To include users in identifying design strategies
b)To make the connection between design and outcomes
c)To consider the impact of confounding variables
d)To evaluate and collect baseline data
Get the EDAC Credential
1. Apply for the exam
2. Download the candidate
handbook
3. Read the study guides
4. Review the exam content
outline
5. Participate in a study session
6. Take the sample exam
Visit www.healthdesign.org/edac
for more information.
45
To Maintain Your
Certification
1. Attend conferences and
webinars that contain
information about the EvidenceBased Design process, read
the HERD Journal, etc.
2. Retain any certificates or CEU
forms for courses you attend.
3. Look out for the renewal
notification reminders that will
come from Castle Worldwide.
4. You will self-report your CEUs
on the Castle Worldwide
website – 6 CEUS required
every 2 years.
Visit www.healthdesign.org/edac for more information.
Contact The Center for Health Design for any questions: 925-521-9404
Contact Information
Catherine Ancheta
The Center for Health Design
925.521.9404, ext. 122
cancheta@healthdesign.org
47