The Center for Health Design Blog

Gresham, Smith and Partners Becomes First EDAC Advocate Firm To Accredit its Healthcare Design Team

Firm Committed to Development of Innovative, Efficient and Safe Facilities

CONCORD, CA (March 11, 2010)–The Center for Health Design, a nonprofit research, education, and advocacy organization announces that Gresham, Smith and Partners, a leading multi-disciplinary design and consulting firm to the built environment, is the first firm to fulfill the EDAC (Evidence-based Design Accreditation and Certification) Advocate Firm commitment of having at least 25% of its healthcare design team EDAC accredited. The Center for Health Design (CHD), which focuses work on the use of evidence-based design, developed the EDAC program as a way to educate and assess individuals on their understanding of how to base healthcare design decisions on credible research evidence and project evaluation results.

“By achieving our goal of becoming the first EDAC Advocate Firm to accredit its team, we are furthering our dedication to providing clients with a staff that understands the importance of evidenced based design and is committed to contributing to the body of knowledge that supports efficient clinical processes,” stated Ken Priest, AIA, NCARB, LEED AP, executive vice president of Healthcare, Gresham, Smith and Partners.

GS&P has long been a proponent and practitioner of evidence-based design. The firm designed St. Joseph Hospital in West Bend, Wisconsin, which is the world’s first hospital designed specifically to reduce medical errors. Additionally, GS&P designed Clarian Arnett Hospital in Lafayette, Indiana, which is a new facility that features standardized medical/surgical patient rooms that combine components of patient safety. In an effort to gain insight on the functionality of the spaces, the team constructed detailed mock-ups of exam, medical/surgical and LDR rooms as well as basic layouts for a nurse station and operating room. Staff and community toured these full-scale models to give designers their feedback, which was then incorporated into the design.

“We applaud Gresham, Smith and Partners on completing its initial commitment to being an EDAC Advocate Firm,” commented Debra Levin, President and CEO of CHD. “We are confident that by making a long term commitment to developing the practice and knowledge of evidence-based design, the firm will help improve outcomes for its clients and be a leader in the field.”

“By becoming an EDAC Advocate Firm, we have created a culture that is accelerating the application of credible research in design to improve patient and staff well-being, and contributing new evidence, which is equally as important. We anticipate additional healthcare design staff will become EDAC accredited as we continue to apply research evidence in all of our designs to support improved outcomes,” stated Sheila Bosch, Ph.D., EDAC, LEED AP, GS&P’s director of Healthcare Research.

CHD began development of EDAC in 2005 with a grant from the Robert Wood Johnson Foundation. The program now offers study preparation resources, access to healthcare design expertise, a comprehensive accreditation exam, and continuing education. Any industry organization interested in joining in EDAC’s mission to build a community of accredited individuals may partner with CHD to become an Advocate Firm. The current list of partner organizations comprises of an Educational Partner, six Champion Firms, six Advocate Firms and one Pebble Pioneer. Since the exam launched in 2009, over 300 individuals among over have become EDAC accredited.

###

About The Center for Health Design
The Center for Health Design (CHD), formed in 1993, is a nonprofit research and advocacy organization of forward-thinking healthcare, elder care, design and construction professionals and product manufacturers who are leading the quest to improve the quality of healthcare facilities and create new environments for healthy aging. Its voluntary board of directors guides the work of paid staff that manages and directs the organization’s research, education, and advocacy efforts. For more information, visit www.healthdesign.org.

About Gresham, Smith and Partners
Gresham, Smith and Partners (GS&P) provides design and consulting solutions for the built environment that contribute to the success of national and international clients. For more than 40 years, GS&P has focused on enhancing quality of life and sustainability within communities. GS&P consists of industry-leading professionals practicing architecture and engineering design as well as scientists and highly specialized planning and strategic consultants in Water Services, Transportation, Land Planning, Aviation, Corporate and Urban Design, Environmental Compliance, Healthcare, and Industrial Design Services. GS&P consistently ranks among the top architecture and engineering firms in the United States. For more information regarding GS&P, visit www.gspnet.com.

EDAC and The Item Writing Workshop

As you know, CHD is developing an exam to assess individuals’ abilty to employ evidence-based design in their projects. On August 13 and 14, volunteers convened at our office to begin the process of writing examination questions. We were all surprised to learn about all the mechanics that are involved.

Our group was fearlessly led by psychometrician Robert Shaw of Applied Measurement Professionals (AMP). According to Rob, each test item should only measure one ability. By doing this, you have the best chance of measuring a candidate’s knowledge of one situation.

For half the day, Rob explained to us the process of item writing. For example, we learned that when writing the “wrong” answers, called distractors, these have to be neutral and must not cue the candidate to any one choice.

By the end of day one, I think all of us had a pretty good understanding of the item writing process. However, actually developing our own items was quite a different challenge. After Rob let us each select our assignments, everyone started writing. For most, the first item we each wrote took over an hour. I started to wonder if we were going to complete the required 300 items by the end of day two!

Well, we didn’t. We finished about 70 items. However, considering how difficult the task is, I am still extremely impressed with this number. Not only did the group write all these items, but they also started to review a few of them. This turned out to be a huge process in itself.

Because the group needs to unanimously support the terminology used to express an item as well as the available multiple choice answers, reviewing one item could take up to 30 minutes. (And this is only because Rob made us stop discussing the item.) There is no doubt that our wonderful group of EDAC volunteers is dedicated to meticulously approving the right content.

In the next few weeks, volunteers will continue to write examination items. Our goal is to produce at least 300 items by Labor Day. In September, AMP and CHD volunteers will re-convene to edit and approve many of these items. Concurrently, we are working on creating study materials to ensure that we are educating candidates to appropriately prepare them for the exam. If anything, learning the item writing process has renewed my appreciation for all of the tests I’ve taken throughout the years.

July CHD CHER Update

The CHD Coalition for Health Environments Research (CHER) has been busy these past few months. Here’s an update:

Presentations
CHD CHER Committee Members Jane Rohde, AIA, IIDA, NCARB (President, JSR Associates, Inc.) and Roger Leib, AIA, ACHA (President, Leib & Leib) presented “CHER: Exploring the Evidence” at NeoCon on June 12th in Chicago, IL. Jane and Roger gave an overview of some of the CHD CHER reports, including the most recent, ” Limiting the Spread of Infection in the Health Care Environment“.

The objective of this study was to investigate the ability of upholstery, wall finishes, and floor finishes to harbor microorganisms before and after cleaning, and to evaluate the possible microbe transmission by healthcare providers. The principal investigators (Mary G. Lankford, Susan Collins, Larry Youngberg, Denise Rooney of Northwestern Memorial Hospital and John Warren and Gary Noskin of The Feinberg School of Medicine of Northwestern University) of this study suggest that manufacturers test their products with typical hospital cleaning methods.

They recommend starting this evaluation process through the Centers for Disease Control and Prevention’s Division of Healthcare Quality Promotion (DHQP). You can view a full report on “Guidelines for Environmental Infection Control in Healthcare Facilities” on the CDC website. We encourage manufacturers to collaborate with the design and research community to re-evaluate their products.

Coming Soon
The latest CHD CHER report to be produced is coming soon! Look for “The Effect of Environmental Design on Reducing Nursing & Medication Errors in Acute Care Settings” to be posted on CHD’s website. The investigators of this study (Habib Chaudhury of Simon Fraser University and Atiya Mahmood of Oregon State University) examined the issue of errors in medical-surgical units through a literature review, a nursing survey, focus groups and site visits.

To read more about other upcoming reports and activities for CHD’s CHER Members, visit our website.

A Room with a View

This evening I was looking out my office window at Mount Diablo. From time to time, it’s important to remind myself why I became interested in the work of The Center. This is important because I never want to take things for granted – especially a view of Mount Diablo.

In 2001, I worked at a children’s psychiatric treatment facility in Washington State. The living area consisted of three lounges and 16 single bed rooms. Each lounge was furnished with heavy furniture, upholstered in a coarse material. The weight of the furniture was meant to discourage the patients from lifting and throwing chairs. The lounge carpet was also coarse and difficult to sit on for long periods of time. Each lounge was built with only one window, about 15 feet hight. The color of the entire facility was beige. Needless to say, there were few positive distractions for the staff or the patients.

One afternoon, I was assigned to take a patient to Children’s Hospital in Seattle, Washington. At the psychiatric treatment center, this patient’s (a 16 – year old girl, diagnosed with schizophrenia) demeanor was consistently subdued. However, upon entering Children’s her face brightened immediately. She happily talked about her previous experiences at Children’s and excitedly spoke about her appointment that day.

As soon as we entered Children’s, it was apparent that this hospital was extraordinarily different from the treatment facility she was used to. We were both struck by the bright murals and inclusion of nature. The patient’s face reflected the same positive environment that I noticed. That moment was a dramatic demonstration of the constrasting influences the built environment can have.

I often wonder what it would have been like to work at a treatment facility where the environment reflected the hope that we had for the patients’ future. Remembering this experience reminds me how lucky I am to be part of an organization that supports this hope (and one that gives me a room with a view!!)