An Introduction to Evidence-based Design Accreditation and Certification - EDAC

1. An Introduction to Evidence-based Design Accreditation and Certification - EDAC

2. EVIDENCE-BASED DESIGN IS THE PROCESS OF BASING DECISIONS ABOUT THE BUILT ENVIRONMENT ON CREDIBLE RESEARCH TO ACHIEVE THE BEST POSSIBLE OUTCOMES

3. Evidence-based Design (EBD) History and Background

4. EBD Process Listed in SG1, pg. 27-28

5. Can design really affect outcomes?

6. Key Differences Between EBD and Typical Project Delivery Addresses Healthcare Trends/Challenges • Develops design strategies targeted at improving clinical, environmental and safety outcomes. SG1, pg. 7-22, 29, 76-77 Research is Used • EBD uses relevant evidence to educate the project team and guide the development of design strategies. The integration of these strategies is linked to achieving outcomes. New Research is Created • Conducting post-occupancy evaluation research to create new evidence and report the results.

7. The Two Bottom Lines for CEOs First Time Capital Costs Operating Costs

8. The Business Case – Return on Investment 1 Source: Zofia Rybkowski, PhD Candidate, UC Berkeley, Engineering and Project Management, Dept. of Civil and Environmental Engineering.

9. Over 1,200 studies demonstrate the importance of evidence-based design

10. About EDAC & The Exam

11. EDAC Mission and Vision Mission: To develop a community of certified industry professionals through education and assessment of an evidence-based design process. Vision: A world where all healthcare environments are created using an evidence-based design process. EDAC was created to: • Provide a definition of EBD and define a standard process for implementing EBD • Establish expectations for individuals who are or will be using an EBD process • Institutionalize EBD as an accepted and credible approach to improving healthcare outcomes

12. Exam Structure All 110-items on the exam are built using stems, keys, and distracters. • Stems: This is the statement or questions to which a candidate responds. This must be read very carefully to avoid answer choices based on a misread stem. • Keys: This is the most appropriate choice of all the possible responses. • Distracters: These are the additional three responses available to a candidate. They do not need to be entirely incorrect to make them the wrong choices. However, they are NOT the most appropriate choice.

13. Types of Exam Questions APPLICATION ANALYSIS RECALL • causes candidates to interpret, classify, translate, or recognize relationships • has correct answers that vary based upon the situation • characteristics: questions or statements have more than one variable and require careful reading and correlation of the answers with the variables in the question or statement. • requires information synthesis, problem solving, and selection of the best response • has correct answers that vary based upon the situation • candidates act on a problem and identify clues in the question or statement • characteristics: the longest question/statement. Asks candidates to select the best answer. Requires careful reading to establish the relationship between variables in the question and the answer. • requires candidates to draw from memorized facts, so the correct response was previously learned • does not have correct answers that vary with the situation • characteristics: the question or statement is short with one variable.

14. Exam Outline Test questions were developed based upon the exam content outline. The examination was developed by a group of volunteers with the facilitation and guidance of psychometricians. The outline provides: • The framework and outline for the three study guides • Summary of everything that could possibly be on the exam • The exam content outline can be downloaded from www.healthdesign.org/edac

15. Exam Outline • Five Focus Areas: • EBD for Healthcare • Research • Pre-Design • Design • Construction & Occupancy

16. Preparing for the Exam Read all three study guides to: • Gain an overview about the healthcare industry • Understand the trends and challenges that impact healthcare construction • Learn information about conducting research • Contextualize the environment in which evidence-based design is practiced

17. Other Resources

18. Benefits of EDAC Certification EDAC certification is for anyone interested in formalizing their knowledge of the EBD process. The credential provides: • Public recognition of your EBD expertise • Increased value with employers and clients • Ability to share a common language with project team members • Credibility when justifying expenditures associated with design decisions and innovations • Access to ongoing professional learning tools and newsletters • Access to the a community of like-minded individuals

19. How EDAC is Different Than Other Credentials EDAC is complementary to other design industry credentials and provides added expertise to strengthen an individual’s knowledge. It is for anyone who is a member of a project team designing a new hospital, ambulatory center, or renovating an existing building. The EDAC program: Focuses on achieving improvement and outcomes in all three areas of safety (patient, staff and environment) Does not have pre-requisites or licensure requirements Tests your knowledge of the EBD process, not specific research Credential recognized across the U.S. and internationally

20. Sample EDAC Exam Questions

21. Sample Question RECALL: Central to making the business case for physical design innovations, what will need to be balanced against ongoing operating savings and revenue enhancements? a. patient outcomes b. one-time construction costs c. longer design and construction timelines d. project vision and mission

22. Sample Question - Answer RECALL: Central to making the business case for physical design innovations, what will need to be balanced against ongoing operating savings and revenue enhancements? a. patient outcomes b. one-time construction costs c. longer design and construction timelines d. project vision and mission

23. Sample Question APPLICATION: A project team is designing a brand new children’s hospice. Before starting the design, the team employed a researcher who conducted a study in three of the city’s existing hospices using the following tools: surveys; in-depth interviews; focus groups. Which of the following best describes the research methodology used? a. applied research b. mixed methods c. quantitative d. qualitative

24. Sample Question - Answer APPLICATION: A project team is designing a brand new children’s hospice. Before starting the design, the team employed a researcher who conducted a study in three of the city’s existing hospices using the following tools: surveys; in-depth interviews; focus groups. Which of the following best describes the research methodology used? a. applied research b. mixed methods c. quantitative d. qualitative

25. Sample Question ANALYSIS: A summary of EBD research in an architectural magazine indicates that carpeting is associated with a reduction in patient falls and decreased workplace injuries; while nursing floor layout is associated with a reduction in patient falls and increased staff satisfaction. Given a limited budget, what should the organization do FIRST to determine where to invest its limited resources? Select the design feature that is most in line with the EBD vision. Check the hospital statistics to see which of the two design features will result in a greater reduction in operating costs. Choose the design feature that is of most interest to the core design team. Conduct a critical review of the existing research before making any decisions.

26. Sample Question - Answer ANALYSIS: A summary of EBD research in an architectural magazine indicates that carpeting is associated with a reduction in patient falls and decreased workplace injuries; while nursing floor layout is associated with a reduction in patient falls and increased staff satisfaction. Given a limited budget, what should the organization do FIRST to determine where to invest its limited resources? Select the design feature that is most in line with the EBD vision. Check the hospital statistics to see which of the two design features will result in a greater reduction in operating costs. Choose the design feature that is of most interest to the core design team. Conduct a critical review of the existing research before making any decisions.

27. Sample Question ANALYSIS: One of the members of the interdisciplinary project team, an experienced nurse, brought in a research report from a peer-reviewed journal that indicated that the efficiency of care provided by the nursing staff is influenced by the layout of patient rooms. This team member argued that the bulk of the EBD budget be spent on this design feature. The team MUST: Allocate the bulk of the budget to patient room redesign, based on this evidence. Validate the research by finding hospitals that have shown an increase in staff efficiency based upon layout of patient rooms. Find evidence to support a wider range of EBD features before deciding how the budget should be allocated. Ignore the recommendation because the report lacks rigor.

28. Sample Question - Answer ANALYSIS: One of the members of the interdisciplinary project team, an experienced nurse, brought in a research report from a peer-reviewed journal that indicated that the efficiency of care provided by the nursing staff is influenced by the layout of patient rooms. This team member argued that the bulk of the EBD budget be spent on this design feature. The team MUST: Allocate the bulk of the budget to patient room redesign, based on this evidence. Validate the research by finding hospitals that have shown an increase in staff efficiency based upon layout of patient rooms. Find evidence to support a wider range of EBD features before deciding how the budget should be allocated. Ignore the recommendation because the report lacks rigor.

29. Sample Question ANALYSIS: A hospital-based project team wants to make sure that the observation instrument they developed has a high degree of reliability. They should: Test it in a variety of settings both within and outside the hospital. Have several researchers use it within a specified timeframe and place with the same subjects and see if similar results are achieved. Ask an experienced researcher to validate that the instrument is measuring what itis supposed to measure. d) Collect opinions on the instrument from within the design team.

30. Sample Question - Answer ANALYSIS: A hospital-based project team wants to make sure that the observation instrument they developed has a high degree of reliability. They should: Test it in a variety of settings both within and outside the hospital. Have several researchers use it within a specified timeframe and place with the same subjects and see if similar results are achieved. Ask an experienced researcher to validate that the instrument is measuring what itis supposed to measure. Collect opinions on the instrument from within the design team.

31. Sample Question ANALYSIS: A research study on the impact of nature views on gallbladder surgery patients showed that nature had the restorative effect that was hypothesized. The study was conducted in a hospital, and designed so that patients were randomly assigned to a room with a “view of nature” or “no view of nature,” and all possible confounding variables were controlled. The study design was: Experimental Quasi-experimental Correlational Case Study

32. Sample Question - Answer ANALYSIS: A research study on the impact of nature views on gallbladder surgery patients showed that nature had the restorative effect that was hypothesized. The study was conducted in a hospital, and designed so that patients were randomly assigned to a room with a “view of nature” or “no view of nature,” and all possible confounding variables were controlled. The study design was: Experimental Quasi-experimental Correlational Case Study

33. Get the EDAC Credential Apply for the exam Download the candidate handbook Read the study guides Review the exam content outline Participate in a study session Take the sample exam Visit www.healthdesign.org/edac for more information.

34. Contact Information Catherine Ancheta The Center for Health Design 925.521.9404, ext. 122 cancheta@healthdesign.org