title: Shared decision making in designing new healthcare environments-time to begin improving quality.
abstract: BACKGROUND
  Successful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments.
  
  
  CONCLUSIONS
  This paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed. We suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users' perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments.
authors.affiliation: School of Education, Health and Social Studies, Dalarna University, Falun, Sweden. mel@du.se.
authors.forename: Marie
authors.initials: M
authors.lastname: Elf
authors.affiliation: Department of Architecture, Chalmers University of Technology, Göteborg, Sweden. peter.frost@chalmers.se.
authors.forename: Peter
authors.initials: P
authors.lastname: Fröst
authors.affiliation: Department of Civil and Environmental Engineering, Chalmers University of Technology, Göteborg, Sweden. goran.lindahl@chalmers.se.
authors.forename: Göran
authors.initials: G
authors.lastname: Lindahl
authors.affiliation: Sahlgrenska Academy, Health and Caring Sciences, University of Gothenburg, Göteborg, Sweden. helle.wijk@fhs.gu.se.
authors.forename: Helle
authors.initials: H
authors.lastname: Wijk
mesh_terms: D003299:Cooperative Behavior; D003657:Decision Making; D003695:Delivery of Health Care; D006272:Health Facility Environment; D006801:Humans; D007374:Interior Design and Furnishings; D018802:Patient-Centered Care; D058996:Quality Improvement; D011787:Quality of Health Care / Q000592:standards; D012648:Self Care