The aim of this study was to develop built environment (BE) design knowledge to support resilient healthcare by systematically reviewing the evidence-based design (EBD) literature.
Background:
Although the EBD literature is vast, it has not made explicit its contribution to resilient healthcare, which is a key component of the highly complex health service.
Method:
This review followed the steps recommended by the Preferred Reporting Items for Systematic reviews and Meta-Analyses method. After applying the inclusion and exclusion criteria, 43 journal papers were selected. The papers were analyzed in light of five guidelines for coping with complexity, allowing for the development of BE design knowledge that supports resilient healthcare.
Results:
The design knowledge compiled by the review was structured according to four levels of abstraction: five design-meta principles, corresponding to the five complexity guidelines, seven design principles, 21 design prescriptions, and 58 practical examples. The design knowledge emphasizes the interactions between the BE as physical infrastructure and the functions that it supports.
Conclusions:
The design knowledge is expected to be useful not only to architects but also to those involved in the functional design of health services as they interact with the BE. Furthermore, our proposal provides a knowledge template that can be continuously updated based on the experience of practitioners and academic research.
AaltoL.SirolaP.Kalliomäki-LevantoT.LahtinenM.RuohomäkiV.SalonenH.ReijulaK. (2019). User-centric work environments in modular healthcare facilities. Engineering, Construction and Architectural Management, ECAM-04-2018-0169.
2.
AchourN.PriceA. D. (2010). Resilience strategies of healthcare facilities: Present and future. International Journal of Disaster Resilience in the Built Environment1(3), 264–276.
3.
AppleM. (2014). A comparative evaluation of Swedish intensive care patient rooms. Health Environments Research & Design Journal, 7(3), 78–93.
4.
AttiaS.LevinsonR.NdongoE.HolzerP.KazanciO. B.HomaeiS.ZhangC.OlesenB. W.QiD.HamdyMHeiselbergP. (2021). Resilient cooling of buildings to protect against heat waves and power outages: Key concepts and definition. Energy and Buildings, 239, 110869.
5.
BaldaufJ. P.FormosoC. T.TzortzopoulosP. (2021). Method for managing requirements in healthcare projects using building information modelling. Engineering, Construction and Architectural Management, 28(8), 2090–2118.
6.
BattistoD.PakR.Vander WoodM. A.PilcherJ. J. (2009). Using a task analysis to describe nursing work in acute care patient environments. The Journal of Nursing Administration, 39(12), 537–547.
7.
BaumgartA.DenzC.BenderH. J.SchleppersA. (2009). How work context affects operating room processes: Using data mining and computer simulation to analyze facility and process design. Quality Management in Healthcare, 18(4), 305–314.
8.
BergS. H.AkerjordetK.EkstedtM.AaseK. (2018). Methodological strategies in resilient health care studies: An integrative review. Safety Science, 110, 300–312.
9.
BlennerhassettJ. M.BorschmannK. N.Lipson-SmithR. A.BernhardtJ. (2018). Behavioral mapping of patient activity to explore the built environment during rehabilitation. Health Environments Research & Design Journal, 11(3), 109–123.
10.
BorsciS.UchegbuI.BuckleP.NiZ.WalneS.HannaG. B. (2018). Designing medical technology for resilience: Integrating health economics and human factors approaches. Expert Review of Medical Devices, 15(1), 15–26.
11.
BrainardJ.HunterP. R. (2016). Do complexity-informed health interventions work? A scoping review. Implementation Theory, 11(1), 127.
12.
BraithwaiteJ.ChurrucaK.LongJ. C.EllisL. A.HerkesJ. (2018). When complexity science meets implementation science: A theoretical and empirical analysis of systems change. BMC Med, 16(1), 63.
13.
BraithwaiteJ. (2018). Changing how we think about healthcare improvement. BMJ, 361361, k2014.
14.
BrambillaA.SunT. Z.ElshazlyW.GhazyA.BarachP.LindahlG.CapolongoS. (2021). Flexibility during the COVID-19 pandemic response: Healthcare facility assessment tools for resilient evaluation. International Journal of Environmental Research and Public Health, 18(21), 11478.
15.
BrewerC. S.KovnerC. T.GreeneW.Tukov-ShuserM.DjukicM. (2012). Predictors of actual turnover in a national sample of newly licensed registered nurses employed in hospitals. Journal of Advanced Nursing, 68(3), 521–538.
16.
BrownC. E.EcoffL. (2011). A systematic approach to the inclusion of evidence in healthcare design. Health Environments Research & Design Journal, 4(2), 7–16.
17.
BuenoW. P.SaurinT. A.WachsP.KuchenbeckerR.BraithwaiteJ. (2019). Coping with complexity in intensive care units: A systematic literature review of improvement interventions. Safety Science. 118, 814–825.
18.
CapolongoS.GolaM.BrambillaA.MorgantiA.MoscaE. I.BarachP. (2020). COVID-19 and healthcare facilities: A decalogue of design strategies for resilient hospitals. Acta Biomedica, 91, 50–60.
19.
CarayonP.WetterneckT. B.Rivera-RodriguezA. J.HundtA. S.HoonakkerP.HoldenR.GursesA. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied Ergonomics, 45(1), 14–25.
20.
CartheyJ.ChowV.JungY. M.MillsS. (2011). Flexibility: Beyond the Buzzword—Practical findings from a systematic literature beview. Health Environments Research & Design Journal, 4(4), 89–108.
21.
ChoiY. S.BoschS. J. (2013). Environmental affordances: Designing for family presence and involvement in patient care. Health Environments Research & Design Journal, 6(4), 53–75.
22.
ChurrucaK.PomareC.EllisL. A.LongJ. C.BraithwaiteJ. (2019). The influence of complexity: A bibliometric analysis of complexity science in healthcare. BMJ Open, 9(3), e027308.
23.
CleggC., (2000). Socio-technical principles for system design. Applied Ergonomics31, 463–477.
24.
ColmanN.EdmondM. B.DalpiazA.WalterS.MillerD. C.HebbarK. (2020). Designing for patient safety and efficiency: Simulation-based hospital design testing. Health Environments Research & Design Journal, 13(4), 68–80.
25.
CopelandD.ChambersM. (2017). Effects of unit design on acute care nurses’ walking distances, energy expenditure, and job satisfaction: A pre–post relocation study. Health Environments Research & Design Journal, 10(4), 22–36.
26.
DeheB.BamfordD. (2017). Quality function deployment and operational design decisions–a healthcare infrastructure development case study. Production Planning & Control, 28(14), 1177–1192.
27.
FayL.Carll-WhiteA.HarrellJ. (2017). Coming full cycle: Linking POE findings to design application. Health Environments Research & Design Journal, 10(3), 83–98.
FranceD.ThroopP.JoersB.AllenL.ParekhA.RickardD.DeshpandeJ. (2009). Adapting to family-centered hospital design: Changes in providers’ attitudes over a two-year period. Health Environments Research & Design Journal, 3(1), 79–96.
30.
GalsworthG. D. (2017). Visual workplace visual thinking: Creating enterprise excellence through the technologies of the visual workplace. Taylor & Francis.
31.
GörasC.OlinK.UnbeckM.Pukk-HärenstamK.EhrenbergA.TessmaM. K.NilssonU.EkstedtM. (2019). Tasks, multitasking and interruptions among the surgical team in an operating room: A prospective observational study. BMJ Open, 9(5), e026410.
32.
GreerV.JohnsonE.HsuJ. (2021). Variables and outcomes in patient room design: A study of design hypotheses. Health Environments Research & Design Journal, 14(2), 219–233.
33.
HarteJ. D.SheehanA.StewartS. C.FoureurM. (2016). Childbirth supporters’ experiences in a built hospital birth environment: Exploring inhibiting and facilitating factors in negotiating the supporter role. Health Environments Research & Design Journal, 9(3), 135–161.
HollnagelE. (2014). Resilience engineering and the built environment. Building Research & Information, 42(2), 221–228.
36.
HollnagelE., (2017). Safety-II in practice: Developing the resilience potentials. Routledge.
37.
HollnagelE.BraithwaiteJ.WearsR. (2013). Resilient health care. Ashgate.
38.
HollnagelE.PariesJ. D.WoodsD.WreathallJ. (2011). Resilience engineering in practice: A guidebook. Ashgate.
39.
HolmdahlT.LanbeckP. (2013). Design for the post-antibiotic era: Experiences from a new building for infectious diseases in Malmö, Sweden. Health Environments Research & Design Journal, 6(4), 27–52.
40.
JellemaP.AnnemansM.HeylighenA. (2020). The roles of cancer care facilities in users’ well-being. Building Research & Information, 48(3), 254–268.
41.
KamaraJ. M.HeidrichO.TafaroV. E.MalteseS.DejacoM. C.Re CecconiF. (2020). Change factors and the adaptability of buildings. Sustainability, 12(16), 6585.
42.
KarvonenS.NordbackI.EloJ.HavulinnaJ.LaineH. J. (2017). The elimination of transfer distances is an important part of hospital design. Health Environments Research & Design Journal, 10(3), 142–151.
43.
KeenanJ. M. (2020). COVID, resilience, and the built environment. Environment Systems & Decisions, 40, 216–221.
44.
KumarS. (2011). Developing an experienced-based design review application for healthcare facilities using a 3d game engine. Journal of Information Technology in Construction (ITcon), 16, 85–104.
45.
LinF. F.FosterM.ChaboyerW.MarshallA. (2016). Relocating an intensive care unit: An exploratory qualitative study. Australian Critical Care, 29(2), 55–60.
46.
MahmoudZ.SarkiesM.Clay-WilliamsR.SaurinT. A.BraithwaiteJ. (2021). Managing complexity and manifestations of resilience in operating theatres: Sensemaking and purposive muddling among scheduling nurses. In BraithwaiteJ.HollnagelE.HunteG. (eds). Resilient health care (pp. 19–30). CRC Press.
47.
MoherD.LiberatiA.TetzlaffJ.AltmanD. G., the PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLOS Med. 6, 1–6.
48.
NaccarellaL.RaggattM.RedleyB. (2019). The influence of spatial design on team communication in hospital emergency departments. Health Environments Research & Design Journal, 12(2), 100–115.
49.
NohriaN.GulatiR., (1996). Is slack good or bad for innovation?Academic Managing Journal, 39 (5), 1245–1264.
50.
OchiS.LeppoldC.KatoS. (2020). Impacts of the 2011 Fukushima nuclear disaster on healthcare facilities: A systematic literature review. International Journal of Disaster Risk Reduction, 42, 101350.
51.
OgrincG.DaviesL.GoodmanD.BataldenP.DavidoffF.StevensD., (2015). SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process. American Journal of Medical Quality, 30(6), 543–549.
52.
PageS. (2010). On diversity and complexity (pp. 16–53). Princeton University Press.
53.
PatiD.EvansJ.HarveyT. E.JrBazuinD. (2012). Factors impeding flexible inpatient unit design. Health Environments Research & Design Journal, 6(1), 83–103.
54.
PatiD.HarveyT.CasonC. (2008). Inpatient unit flexibility: Design characteristics of a successful flexible unit. Environment and Behavior, 40(2), 205–232.
55.
PatiD.PatiS.HarveyT. E.Jr. (2016). Security implications of physical design attributes in the emergency department. Health Environments Research & Design Journal, 9(4), 50–63.
56.
PerrowC. (1984). Normal accidents: Living with high-risk technologies. Princeton University Press.
57.
PickupL.AtkinsonS.HollnagelE.BowieP.GrayS.RawlinsonS.ForresterK. (2017). Blood sampling-two sides to the story. Applied Ergonomics, 59, 234–242.
58.
PlattL. S.BoschS. J.KimD. (2017). Toward a framework for designing person-centered mental health interiors for Veterans. Journal of Interior Design, 42(2), 27–48.
59.
PloughA.Polzin-RosenbergD.GalvinG.ShaoA.SullivanB.HenrichN.ShahN. T. (2019). Assessing the feasibility of measuring variation in facility design among American childbirth facilities. Health Environments Research & Design Journal, 12(2), 30–43.
60.
PlsekP. E.GreenhalghT. (2001). The challenge of complexity in health care. BMJ, 323(7313), 625–628.
PouyanA. E.GhanbaranA.ShakibamaneshA. (2021). Impact of circulation complexity on hospital wayfinding behavior (Case study: Milad 1000-bed hospital, Tehran, Iran). Journal of Building Engineering, 44, 102931.
63.
PrugsiganontS.JensenP. A. (2019). Identification of space management problems in public hospitals: The case of Maharaj Chiang Mai hospital. Facilities, 37(7/8), 435–454.
64.
RansolinN.MarczykC. E. S.GeringR. P.SaurinT. A.FormosoC. T.GrøtanT. O. (2021). The built environment´s influence on resilience of healthcare services: Lessons learnt from the COVID-19 pandemic [Conference session]. Proc. 29th Annual Conference of the International Group for Lean Construction (IGLC29) (pp. 613–622), Lima, Peru.
65.
RansolinN.SaurinT. A.FormosoC. T. (2020). Integrated modelling of built environment and functional requirements: Implications for resilience. Applied Ergonomics, 88, 103154.
66.
RapportF.Francis-AutonE.CartmillJ.RyderT.BraithwaiteJ.Clay-WilliamsR. (2020). A mobile methods pilot study of surgical spaces: “Fit for purpose? Organisational productivity and workforce wellbeing in workspaces in hospital” (FLOURISH). BMC Health Services Research, 20(1), 1–15.
67.
Re CecconiF.MorettiN.MalteseS.DejacoM. C.KamaraJ. M.HeidrichO. (2018). A rating system for building resilience. TECHNE, Journal of Technology for Architecture and Environment, https://doi.org/10.13128/Techne-22119
68.
RealK.BardachS. H.BardachD. R. (2017). The role of the built environment: How decentralized nurse stations shape communication, patient care processes, and patient outcomes. Health Communication, 32(12), 1557–1570.
69.
RichC. R.DayT. D. (2008). Integrating electronic health records in the physical environment: A systems approach. Health Environments Research & Design Journal, 2(1), 48–65.
70.
RighiA. W.SaurinT. A. (2015). Complex socio-technical systems: Characterization and management guidelines. Applied Ergonomics, 50, 19–30.
71.
RippinA. S.ZimringC.SamuelsO.DenhamM. E. (2015). Finding a middle ground: Exploring the impact of patient-and family-centered design on nurse–family interactions in the neuro ICU. Health Environments Research & Design Journal, 9(1), 80–98.
72.
RookeJ.MolloyE.SinclairM.KoskelaL.SiriwardenaM.KagioglouM.SiemieniuchS. (2008). Models and metaphors: Complexity theory and through-life management in the built environment. Architectural Engineering and Design Management, 4, 47–57.
73.
RossoC. B.SaurinT. A. (2018). The joint use of resilience engineering and lean production for work system design: A study in healthcare. Applied Ergonomics, 71, 45–56.
74.
SadekA. H.ShepleyM. M. (2016). Space syntax analysis: Tools for augmenting the precision of healthcare facility spatial analysis. Health Environments Research & Design Journal, 10(1), 114–129.
75.
SafayeniF.PurdyL., (1991). A behavioral case study of just-in-time implementation. Journal of Operations Management, 10(2), 213–228.
76.
SaurinT. A. (2021). A complexity thinking account of the COVID-19 pandemic: Implications for systems-oriented safety management. Safety Science, 134, 105087.
77.
SaurinT. A.RookeA. J.KoskelaL., (2013). A complex systems theory perspective of lean production. International Journal of Production Research, 51 (19), 5824–5838.
78.
SchaumannD.PilosofN. P.Gath-MoradM.KalayY. E. (2020). Simulating the impact of facility design on operations: A study in an internal medicine ward. Facilities, 38(7-8), 501–522.
79.
ShortC. A.NoakesC. J.GilkesonC. A.FairA. (2014). Functional recovery of a resilient hospital type. Building Research & Information, 42(6), 657–684.
80.
ShumakerS. A.PequegnatW. (1989). Hospital design, health providers, and the delivery of effective health care. Advance in Environment, Behavior, and Design161–199.
81.
SundbergFFridhILindahlBKåreholtI (2020a). Associations between healthcare environment design and adverse events in intensive care unit. Nursing in Critical Care, 1–8.
82.
SundbergF.FridhI.LindahlB.KåreholtI. (2020b). Visitor’s experiences of an evidence-based designed healthcare environment in an intensive care unit. Health Environments Research & Design Journal, 14(2), 178–191.
83.
TolfS.MestertonJ.SöderbergD.Amer-WåhlinI.MazzocatoP. (2020). How can technology support quality improvement? Lessons learned from the adoption of an analytics tool for advanced performance measurement in a hospital unit. BMC Health Services Research, 20(1), 1–12.
84.
UlrichR. S. (1984). View through a window may influence recovery from surgery. Science, 224(4647), 420–421.
85.
UlrichR. S.ZimringC.ZhuX. M.DuBoseJ.SeoH. B.ChoiY. SQuanXJosephA. (2008). A review of the research literature on evidence-based healthcare design. Health Environments Research & Design Journal, 1(3), 61–125.
86.
Van HeuvelenJ. S. (2019). Isolation or interaction: Healthcare provider experience of design change. Sociology of Health & Illness, 41(4), 692–708.
87.
Van HoofJ.RuttenP. G. S.StruckC.HuismanE. R. C. M.KortH. S. M. (2015). The integrated and evidence-based design of healthcare environments. Architectural Engineering and Design Management, 11(4), 243–263.
88.
WaggenerL.PatiD.RaneA. P.Montenegro-MontenegroE.AngeloE. (2021). Lessons learned from decentralization of an elective surgery medical-surgical unit. Health Environments Research & Design Journal, 14(3), 182–201.
89.
ZhangY.TzortzopoulosP.KagioglouM. (2019). Healing built-environment effects on health outcomes: Environment–occupant–health framework. Building Research & Information, 47(6), 747–766.
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