title: A review of the research literature on evidence-based healthcare design.
abstract: OBJECTIVE
  This report surveys and evaluates the scientific research on evidence-based healthcare design and extracts its implications for designing better and safer hospitals.
  
  
  BACKGROUND
  It builds on a literature review conducted by researchers in 2004.
  
  
  METHODS
  Research teams conducted a new and more exhaustive search for rigorous empirical studies that link the design of hospital physical environments with healthcare outcomes. The review followed a two-step process, including an extensive search for existing literature and a screening of each identified study for the relevance and quality of evidence.
  
  
  RESULTS
  This review found a growing body of rigorous studies to guide healthcare design, especially with respect to reducing the frequency of hospital-acquired infections. Results are organized according to three general types of outcomes: patient safety, other patient outcomes, and staff outcomes. The findings further support the importance of improving outcomes for a range of design characteristics or interventions, including single-bed rooms rather than multibed rooms, effective ventilation systems, a good acoustic environment, nature distractions and daylight, appropriate lighting, better ergonomic design, acuity-adaptable rooms, and improved floor layouts and work settings. Directions for future research are also identified.
  
  
  CONCLUSIONS
  The state of knowledge of evidence-based healthcare design has grown rapidly in recent years. The evidence indicates that well-designed physical settings play an important role in making hospitals safer and more healing for patients, and better places for staff to work.
authors.affiliation: College of Architecture, Texas A&M University, College station, TX 77843-3137, USA. rulrich@tamu.edu
authors.forename: Roger S
authors.initials: RS
authors.lastname: Ulrich
authors.forename: Craig
authors.initials: C
authors.lastname: Zimring
authors.forename: Xuemei
authors.initials: X
authors.lastname: Zhu
authors.forename: Jennifer
authors.initials: J
authors.lastname: DuBose
authors.forename: Hyun-Bo
authors.initials: HB
authors.lastname: Seo
authors.forename: Young-Seon
authors.initials: YS
authors.lastname: Choi
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Quan
authors.forename: Anjali
authors.initials: A
authors.lastname: Joseph
mesh_terms: D004780:Environment, Controlled; D055317:Evidence-Based Practice; D005160:Facility Design and Construction; D006272:Health Facility Environment; D006801:Humans; D017053:Infection Control; D009784:Occupational Diseases / Q000517:prevention & control; D061214:Patient Safety; D011787:Quality of Health Care