Evidence-Based Design in Healthcare

Evidence-Based Design Principles Transform Healthcare Spaces at the General Leonard Wood Army Community Hospital



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With six Evidence-Based Design Accredited and Certified (EDAC) professionals on staff, RLF is committed to designing healthcare spaces based on proven research that contributes to healing environments. One such project is the General Leonard Wood Army Community Hospital at Fort Leonard Wood, Missouri. Located on 56 acres, the replacement hospital is a three-story, 44-bed, 256,397-square-foot hospital and 188,935-square-foot outpatient clinic designed using the Evidence-Based Design (EBD) process and incorporating EBD principles to create a healing environment that reduces patient stress, increases safety, helps staff work more efficiently, and provides an overall better quality of care. The project is currently under construction.

One of the most significant design elements, rooted in EBD principles, involves creating an intuitive wayfinding masterplan incorporating unique icons, graphic images, accent colors, landmarks, nodes, lighting, and built-in architectural cues. The overall design scheme draws inspiration from the Ozark region landscape, with each hospital level associated with a specific color and icon: purple/wildflowers, green/forest, blue/lakes, and copper/prairies. This design approach extends across signage, elevator directories, graphics, and furnishings.

To enhance the concept, the interiors team introduced an accent graphic in the Emergency Department (ED) exam rooms that mirrors the first-floor green/forest theme, seamlessly integrated into the wall protection systems.

The design also introduced a logical four-digit sequential room numbering system. This system signifies the floor level, building zone (stacked vertically), and room number. This combination establishes a straightforward addressing system, facilitating easy navigation for staff and patients. The comprehensive wayfinding master plan, coupled with an efficient room numbering system, enables patients and visitors to navigate the environment quickly, ultimately reducing stress and fostering a sense of control over their surroundings.

The successful collaboration between the design team and client to create a functional and efficient signage and wayfinding system based on EBD principles led the Defense Health Agency (DHA) to draft new Wayfinding Guidelines and Signage Standards for all MHS Healthcare Facilities.

Additional EBD elements incorporated in the design include:

• Single patient rooms include a family care provider zone with a sleeping sofa or recliner for overnight visitors, storage space to eliminate clutter, configured headwall for ease of care, and direct access to views of nature.

• Sound absorptive materials such as carpet, rubber flooring, acoustical ceiling tiles, STC walls, and sound isolation pads are incorporated into loud equipment rooms to reduce noise in patient areas.

• Public circulation areas, patient rooms, behavioral health departments, and key staff areas have large windows with views of nature. Nature photography is provided in areas where direct access to the outside can't be provided.

• A healing garden comforts those approaching the hospital and clinic. The garden is also visible within the hospital, connecting to the outdoors in the main circulation areas, some waiting areas, the dining area, and the chapel.

• Comfortable, supportive furniture is arranged in flexible groups to provide intimacy and encourage conversation. The design also includes partial-height walls with bar-height counters and chairs in the clinic mall to break up large seating areas.

• The design achieves enhanced indoor air quality using low toxicity and low-emitting materials.

• Centralized and decentralized nurse stations incorporate modular furniture and mobile computer workstations.

• Ergonomic equipment and furniture, including accessible entry/exit waiting seating, chairs with contoured arms, specialty patient seating, and fully adjustable task seating, are provided.

• Safe, durable, sound-absorbing, and contemporary materials are provided, such as carpet in waiting spaces to reduce ambient noise, reduce slips and falls, and offer hospitality areas of respite; porcelain tile in restrooms for quality and easy clean-up; and rubber flooring throughout patient care and back-of-house spaces to reduce noise, provide comfortable footing, and minimize cleaning and maintenance.

• For infection prevention, handwash sinks for inpatient areas are constructed of solid-surface materials with an integral bowl, backsplash, and apron. Seating in public and patient areas includes solid-surface materials or urethane arm caps, providing a non-porous, easy-to-clean surface.