Lead articles by Leonard L. Berry, Derek Parker; Russell C. Coile, Jr.; D, Kirk Hamilton; David D. O'Neill; and Blair L. Sadler

Available as an e-book only

(Taken from Audrey Kaufman's Editorial)

As we all know, the American healthcare industry is in the midst of a construction boom. With the precarious financial environment healthcare is facing, who would think this could be happening now? But there are some very good reasons for this building surge, the most important of which is, it is greatly needed. Most healthcare facilities were constructed many decades ago, and the current buildings are old and inadequate for delivering healthcare in the twenty-first century. They cannot handle new technology, they are overcrowded, and they have proven to be inefficient. The old model of provider-centered care, for which most of these facilities were designed, does not lend itself to the newer, more efficient model of patient-centered care.

So the decision to renovate or build, although financially daunting, is not a difficult one to make. The more difficult decision may be how to design this new facility. Of all the possible design features, which ones make sense for your particular facility? What will continue to be right five or ten years down the line? These design features will have a major impact on the patient, the caregiver, the institution's ability to accommodate new technology, and even the safety of the care provided.

For some insights, the editors of Frontiers turned to a group of healthcare leaders who share a passion for evidence-based design, or "better" buildings. They include a professor of marketing, whose focus has been on service excellence; two architects; two CEOs of hospitals; and a futurist. In this article, they draw on various research projects and studies to identify the design elements of better buildings and make the business case for such designs. In particular, the authors focus on the Pebble Project led by the Center for Health Design. This is a three-year research project with various healthcare organizations to evaluate their new progressive buildings. Many of the design elements used in these buildings are considered upgrades and fall intro three categories: stress reduction, safety, and ecological health. The purpose of the study is to determine if in fact these design upgrades (which of course cost more to include) have the intended positive impact and whether they make good business sense. The question that the study seeks to answer, then, is Will these design enhancements improve care and result in a positive return on investment?