The idea that environmental design research can impact staff efficiency, financial performance and patient welfare has been evolving for nearly 30 years. Now, a growing body of evidence attests to the fact that health care design impacts patient stress, patient and staff safety, staff effectiveness and the quality of care.
As evidence-based design (EBD) becomes more widespread, health care organizations are understanding its importance and want to build their facilities with the guidance of EBD practitioners. However, no standards for it have existed until now.
Accreditation and certification
Rolled out this year by the Center for Health Design (CHD), a nonprofit organization dedicated to health care design research, education and advocacy, the Evidence-based Design Accreditation and Certification (EDAC) program is transforming the field of health care design by providing nationally recognized accreditation to promote the use of an evidence-based design process in health care building projects. The goal of the program is to institutionalize EBD as an accepted and credible approach to improve health care outcomes. Anyone in the health care industry interested in becoming more knowledgeable about the EBD process—from novices to veterans—can take the EDAC exam.
The current EDAC program is made up of the following components:
- An educational process, which involves taking continuing education courses and participating in webinars, plus using study guides and other materials; and
- Accreditation of individuals, which involves test-taking.
The EDAC accreditation is designed to help health care organizations identify qualified experts who understand the implementation of evidence-based design in new and existing health care environments. It is meant to complement the American College of Healthcare Architects (ACHA) certification and align with the Environment of Care section of the 2006 Guidelines for Design and Construction of Health Care Facilities by the Facility Guidelines Institute and the American Institute of Architects.
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A patient room at Firelands Regional Medical Center, Sandusky, Ohio, demonstrates the principle that providing family space assists a patient's recovery. |
The program is also meant to teach about the research process, such as identifying, hypothesizing, implementing, gathering and reporting credible data associated with a health care project. EDAC accreditation will ensure health care organizations are getting value-added expertise and confirmation that the professionals they are dealing with are knowledgeable and qualified. EDAC accreditation also can provide professional advancement through learning and education.
As the practice of evidence-based design moves forward, the body of knowledge will grow and health care design as a whole will benefit from the latest research, ideas and methodologies so all accredited individuals and the projects they work on can achieve the best outcomes.
Toward a common goal
CHD has been working to improve medical facilities through design interventions for the past 20 years. Most recently, the center's focus has been on the creative use of EBD to incorporate research into each step of the design process. As awareness of EBD has grown, more and more people have sought to build hospitals with the guidance of EBD practitioners. However, the industry lacked a clear definition or a clear way to determine the actual practice of evidence-based design.
"Like the early days of green design, many health care designers claim that they know how to do evidence-based design, but clients have had no way to qualify those claims," says Debra Levin, president and CEO of The Center for Health Design. "And, there is lots of information and theories about evidence-based design, but no one has defined the EBD context or process."
The center began development of EDAC several years ago with a grant from the Robert Wood Johnson Foundation. Since its inception, the approach to establishing the EDAC accreditation has been a multidisciplinary effort.
More than 100 individuals with representation across the health care industry, including architects, hospital executives, strategic planners, clinicians, researchers and interior designers, volunteered their time to support the project. These volunteers identified essential, base knowledge that is needed by an individual in order to implement EBD into a health care building project.
EDAC champions consisting of six national design firms contributed to the production of the study materials and/or the examination. Additionally, 40 percent or more of each's health care team completed the EDAC examination during its BETA launch in February 2009. The participating firms included such industry names as Harley Ellis Devereaux, OWP/P, Cama Inc., American Art Resources, Kahler Slater and Salvatore Associates.
For the future, the CHD plans to establish Phase II of EDAC as well as develop a certification program for health care buildings.
About the exam
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Decentralized nursing observation can increase nurse-to-patient contact time. |
The EDAC examination consists of 110 multiple-choice questions (100 scored and 10 pretest). Pretest items are not scored and are included to gather statistics for their use on future exams. Applicants will have two hours to complete the exam, which covers the following basic sections:
- Evidence-based design for health care;Research;
- Predesign;
- Design; and
- Construction and occupancy.
Getting started
Applicants can find the exam application in the official candidate handbook, which is available online at www.healthdesign.org/edac. Only paper applications will be accepted through mail or fax. Once the application is complete, applicants will receive notification that they can schedule their exam either online or by phone. There are no prerequisites to sit for the examination.
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A hospital lobby provides access to natural daylight, which has been shown to reduce patient stress, depression and length of stay. |
A guide called the "Detailed Content Outline" (DCO) covers everything that will be on the exam. This outline is the best place to start to evaluate preparedness. Click here to access the guide.
Moreover, study guides are available to provide EBD background and application information while also offering a history of EBD in health care. They go on to define a process to implement EBD. Click here for a complimentary copy of the guide.
Applicants in the United States can take the exam at Applied Measurement Professionals (AMP) Assessment Centers. AMP Centers are typically located in H&R Block offices. To find a nearby testing location, applicants can log on to www.goamp.com. International applicants have a select number of locations from which to choose that may only be available on a limited basis. AMP can provide more information on the options for international applications.
Taking the exam
Once the examination has been completed at an approved testing center, applicants are instructed to report to the examination proctor to receive their score reports. An applicant's score report will indicate a "pass" or "fail," which is determined by the applicant's raw score. A raw score is the number of questions the applicant answered correctly. Additional detail is provided in the form of raw scores by major content categories.
If the applicant passes, he or she will become an EDAC Accredited Individual and, within six weeks, will receive an information packet that will include information on accessing tools and resources from CHD. The applicant will also be able to use the appellation EDAC after his or her name and will be recognized on the EDAC Web site as an EDAC accredited individual.
The cost to sit for the examination is $285 in the United States and $311 internationally, including exams taken in Canada. If applicants do not pass the examination on the first attempt, they are eligible to retake it immediately. However, a new, complete application and second-time fee of $205 is required to reapply. Those interested should visit the AMP Web site to learn more about retaking the examination.
Finally, attaining accreditation is an indication of a well-defined body of knowledge. Renewal of the accreditation is required every year to maintain accredited status. EDAC accredited individuals are required to participate in three approved continuing education hours to maintain this status. Additionally, a fee of $60 is due to CHD every two years.
The center's Web site, located at www.healthdesign.org, can provide updated information about continuing education courses and requirements.
Growing rapidly
The EBD movement is growing rapidly and the need to understand how design can positively contribute to patient care and staff well-being has never been greater. The EDAC accreditation will allow the health care design industry to produce more practitioners who possess the knowledge necessary to inform their designs with credible research.
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The Evidence-based Design Accreditation and Certification (EDAC) Web site features a directory of resources at www.healthdesign.org/edac/resources.php that were selected to aid in studying for the examination and understanding the state of the health care industry. They include the following:
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C. Richard Hall AIA, ACHA, EDAC, is principal-in-charge and director of health care design services for Harley Ellis Devereaux, an EDAC champion firm. He can be contacted via e-mail at crhall@hedev.com |
This article first appeared in the July 2009 issue of HFM.
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