A research primer on literature reviews

One of the most well-known literature reviews in the field of health care design is “A Review of the Research Literature on Evidence-Based Healthcare Design.” Published in 2008, its popularity stems from the summaries about design and outcomes from multiple research studies.

Literature reviews, which are their own kind of research, can take the form of a narrative review, a scoping review, a systematic review, a meta-analysis or even an umbrella review — the newest review type.

A narrative review is a common approach to create a broad, written thematic summary of research on a topic. It may not have a structured approach to find studies, but the results are valuable when exploring a topic for the first time.

A scoping review is often used for emerging topics that are not well-defined. A scoping review will map the evidence and identify gaps in knowledge. It may not include research quality appraisals, but like a narrative review, there is a descriptive summary.

The authors of the recent paper, “Impact of the physical environment on ICU patient transport: A scoping review,” point out that the most recent intensive care unit design guidelines highlight the impact of health care facility design on transports but that more research was needed. The aim of their patient transport scoping review was to identify and summarize the research while establishing gaps and research opportunities.

A systematic review is often directed to answer a specific question. As the name implies, the approach is systematic. There is a structured protocol for the search, inclusion or exclusion criteria and the evaluation of each paper. Systematic reviews have become more common in health care design as we often have enough research to support more directed questions. In a recent example, “Investigating the Impact of Healthcare Environmental Design on Staff Security: A Systematic Review,” the authors focused on Type II workplace violence. (This is an assault committed by a service recipient against a service provider.)

After finding 496 papers and reviewing their inclusion criteria, 15 studies were used to summarize the role of the physical environment in mitigating aggressive behavior. Their review consolidated the evidence into a single document, as the information lived in many different disciplinary-specific journals.

A meta-analysis combines statistical results from multiple studies — it goes beyond a narrative descriptive or thematic summary. It quantifies the evidence strength and includes an estimated effect size by combining data from multiple studies instead of just one. This type of review is rare in the field of health care design due to variability in outcomes and measures. As the field continues to evolve, this may become more feasible.

Lastly, an umbrella review is a systematic review of systematic reviews. Umbrella reviews can include either a meta-analysis of the meta-analysis from each systematic review or a narrative synthesis and comparison of findings. Umbrella reviews also are uncommon in health care design, but they may be in our future.

In summary, a literature review is a great resource to summarize what is known about health care design and related outcomes. A researcher (or team of researchers) has likely spent months distilling this information for you. As a result, reviews are invaluable to anyone who does not have time to find, read and synthesize a multitude of studies on their own.

Research used for this column

The following research citations from The Center for Health Design’s Knowledge Repository of health care design resources were used by the author when writing this column:

• Y. Jiang and A. Joseph, “Impact of the physical environment on ICU patient transport: A scoping review,” HERD: Health Environments Research & Design Journal, in press (2025).
• S. MohammadiGorji, S.J. Bosch, S. Valipoor and G. De Portu, “Investigating the impact of healthcare environmental design on staff security: A systematic review,” HERD: Health Environments Research & Design Journal, vol. 14, no. 1 (2021): pages 251–272.
• R.S. Ulrich, C. Zimring, X. Zhu, J. DuBose, H.-B. Seo, Y.-S. Choi, X. Quan and A. Joseph, “A Review of the Research Literature on Evidence-Based Healthcare Design,” HERD: Health Environments Research & Design Journal, vol. 1, no. 3 (2008): pages 61–125.

About this column

The HERD Journal is a quarterly peer-reviewed publication created through a partnership between The Center for Health Design and Sage Publications. “Heard from HERD” uses studies published in the journal as a primer to explore different topics in evidence-based design and physical environment research.

Ellen Taylor, Ph.D., EDAC, AIA, co-editor of HERD Journal and vice president for research, The Center for Health Design.