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

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An Introduction to Evidence-based Design
Accreditation and Certification - EDAC
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EVIDENCE-BASED DESIGN
BEST POSSIBLE OUTCOMES
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Evidence-based Design (EBD) History and Background
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EBD Process

• Listed in SG1, pg. 27-28

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Can design really affect outcomes?
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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.

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The Two Bottom Lines for CEOs

1. First Time Capital Costs
2. Operating Costs

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The Business Case Return on Investment
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Source Zofia Rybkowski, PhD Candidate, UC
Berkeley, Engineering and Project Management,
Dept. of Civil and Environmental Engineering.
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Over 1,200 studies demonstrate the importance
of evidence-based
design
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About EDAC The Exam
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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

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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.

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Types of Exam Questions
ANALYSIS
RECALL

• 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.

• 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.

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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

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Exam Outline

• Five Focus Areas
• EBD for Healthcare
• Research
• Pre-Design
• Design
• Construction Occupancy

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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

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Other Resources
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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

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How EDAC is Different Than Other Credentials

• EDAC is complementary to other design industry
  credentials and provides added expertise to
  strengthen an individuals 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

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Sample EDAC Exam Questions
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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

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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

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Sample Question

• APPLICATION A project team is designing a brand
  new childrens hospice. Before starting the
  design, the team employed a researcher who
  conducted a study in three of the citys 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

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Sample Question - Answer

• APPLICATION A project team is designing a brand
  new childrens hospice. Before starting the
  design, the team employed a researcher who
  conducted a study in three of the citys 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

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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.

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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.

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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.

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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.

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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 it is supposed
  to measure.
• d) Collect opinions on the instrument from
  within the design team.

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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 it is supposed
  to measure.
• Collect opinions on the instrument from within
  the design team.

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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

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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

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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.

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Contact Information

• Catherine Ancheta
• The Center for Health Design
• 925.521.9404, ext. 122
• cancheta_at_healthdesign.org