title: Design research and the globalization of healthcare environments.
abstract: OBJECTIVE
  Global healthcare practice has expanded in the past 20 years. At the same time the incorporation of research into the design process has gained prominence as a best practice among architects. The authors of this study investigated the status of design research in a variety of international settings. We intended to answer the question, "how pervasive is healthcare design research outside of the United States?"
  
  
  METHODS
  The authors reviewed the international literature on the design of healthcare facilities. More than 500 international studies and conference proceedings were incorporated in this literature review. A team of five research assistants searched multiple databases comparing approximately 16 keywords to geographic location. Some of those keywords included: evidence-based design, salutogenic design, design research, and healthcare environment. Additional articles were gathered by contacting prominent researchers and asking for their personal assessment of local health design research studies.
  
  
  RESULTS
  While there are design researchers in most parts of the world, the majority of studies focus on the needs of populations in developed countries and generate guidelines that have significant cost and cultural implications that prohibit their implementation in developing countries. Additionally, the body of literature discussing the role of culture in healthcare environments is extremely limited.
  
  
  CONCLUSIONS
  Design researchers must address the cultural implications of their studies. Additionally, we need to expand our research objectives to address healthcare design in countries that have not been previous considered.
authors: Mardelle McCuskey
authors: MM
authors: Shepley
authors: Yilin
authors: Y
authors: Song
mesh_terms: D054521:Cultural Competency; D000067013:Evidence-Based Facility Design; D005160:Facility Design and Construction / Q000379:methods*; D006272:Health Facility Environment / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D038622:Internationality; D008519:Medicine, Traditional; D020380:Needs Assessment; D012106:Research
keywords: Evidence-based design; healing environments; human factors; literature review; methodology