Hospitals that heal: Why evidence-based design matters

There is an increasing realisation that the physical health care environment in which we deliver care can influence a patient's illness, recovery and wellness for decades to come. The relatively new field of evidence-based design (EBD) seeks to evaluate this impact and to build an economic, governance and operational roadmap of specific design interventions within hospitals. This paper explores the concept of the physical health environment as a collaborator in clinical care, rather than merely a backdrop to it and examines the premise of primum non nocere or first do no harm as a basis for hospital construction. Building a healthcare facility should be seen as primarily a clinical project rather than solely as an exercise in construction and logistics. The role of clinicians in such projects is pivotal and yet has traditionally been minimal. This paper investigates when and how clinicians should inform the evolution of a hospital build—from pre-design mapping, value engineering and design evaluation to clinical commissioning. The integration of technology into design and ultimately how clinical governance must underpin all aspects of the project is considered.