Integrated Healthscape Strategies: An Ecological Approach to Evidence-Based Design

Aim: This paper explores some of the premises of evidence-based design (EBD) and suggests that greater attention to and differentiation of the various purposes of research are needed, along with the development of an ecological theory that reflects the complexity of the health systems studied and more varied ways to communicate with and engage practitioners. Background: Problems with the American healthcare system are well known. For the past 20 years, an intervention that has gained increasing attention has been the physical design of healthcare facilities-hospitals in particular. EBD has been advocated as one means of using research to examine the relationship between design and healthcare to improve patient safety and the quality of care. Conclusions: The concept of integrated healthscape strategies is proposed to focus not only on research "evidence" and the methods used to collect and analyze it, but also on the different purposes research serves, the role of theory, and the use of EBD research in practice.