title: The role of the architectural environment in community health: an evidence-based initiative.
abstract: This discussion reports the status of a 12-year program administered by a statewide health agency to strategically assess, redevelop, and monitor the architectural and facility management performance of its network of community-based public health care facilities. A protocol, the Strategic Facility Improvement initiative, has directly resulted in significant improvements to the major share of a network of over 100 community clinic and clinical support facilities in the State of Louisiana. The SFI initiative provides oversight with respect to the allocation of public health capital improvement infrastructural resources and has guided completion of 55 facility replacement or renovation projects to date. Its administrative mission, organizational structure, and field methodology is presented as a vehicle to significantly improve the architectural condition of clinical and clinical support environments for underrepresented patient populations. The SFI process is discussed as an evidence-based means to foster greater systemic success in capital improvement efforts within public sector health agencies in the United States and in international contexts.
authors.affiliation: School of Architecture, Department of Health Systems Management, Tulane University, New Orleans, Louisiana 70118, USA. sverder@tulane.edu
authors.forename: Stephen
authors.initials: S
authors.lastname: Verderber
authors.forename: Joseph
authors.initials: J
authors.lastname: Kimbrell
mesh_terms: D001108:Architecture; D003151:Community Health Centers / Q000458:organization & administration*; D005160:Facility Design and Construction / Q000191:economics*; D005379:Financing, Construction; D006272:Health Facility Environment; D006801:Humans; D011635:Public Health Administration; D013219:State Government; D014481:United States