Evidence-based Design Accreditation and Certification (EDAC): Why it matters

Rooftop garden, Dublin Methodist Hospital, Dublin, OH

Rooftop garden, Dublin Methodist Hospital, Dublin, OH. Photo by Brad Feinknoph for Karlsberger

In yesterday’s blog post, I discussed my plans to pursue a PhD that would focus on access to nature and evidence-based design in the healthcare setting, and I promised to go into more depth about EBD today. For even more information and resources, please visit the TLN website’s page: www.healinglandscapes.org/resources/ebd.

A large and growing body of evidence attests to the fact that the physical environment impacts patient stress, patient and staff safety, staff effectiveness and quality of care provided in hospitals and other healthcare settings. Basing healthcare facility planning and design decisions on this evidence to achieve the best possible patient, staff and operational outcomes is what evidence-based design (EBD) is all about.
The Center for Health Design

In EBD, research generally refers to empirical research, the systematic investigation of the tangible facts aimed at gaining knowledge, making discoveries, testing and revising theories, and applying new knowledge…What differentiates EBD from the traditional design approach is the emphasis on using research to support design decision making and evaluation of design innovations.
An Introduction to Evidence-Based Design: Exploring Healthcare and Design
(EDAC Study Guide 1), p. 72.

I recently took (and passed) the Evidence-based Design Accreditation and Certification (EDAC) exam, the culmination of the Center for Health Design’s program to educate and certify individuals in using an evidence-based approach for the design and construction of healthcare facilities. I admit, when I first heard about it, I was dubious. Why should I take an exam that is so heavily geared to architects? When I registered, I had to fill in the “other” box for my profession because “landscape architect” wasn’t even one of the options. Discouraging. When I asked an architect colleague who has been involved in shaping EDAC from early on whether (and why) I should bother, he explained: First, it gives everyone who will serve on a healthcare project’s Interdisciplinary Design Team (IDT) an overview of the EBD process, which differs in key ways from the usual design process (namely the rigor of using (and developing new) research and evidence to guide the project from beginning to completion). Second, it creates a good foundation for everyone on the IDT (designers, researchers, healthcare administrators and practitioners, etc.) and helps these very different professionals speak the same language. Finally, being certified as an EBD practitioner increases the likelihood that one who wants to work on these projects will…actually get to work on these projects.

Landscape architects don’t have a chip on their shoulder about their low status on the design totem pole; we have giant chunks missing. So often – in healthcare as in other realms of design – LAs are brought in at the last minute to put a few plants around the outside of the building or, as the folks at Hitchcock Design Group say, to “put the parsley around the meatloaf.” This is a real shame. Landscape architects and designers, and especially those who are trained in healthcare garden design, have so much more to offer. In addition to creating the best possible gardens for patients, visitors, and staff, they can help with site planning considerations such as building location and orientation, utilizing existing site features, locating windows to maximize views, and siting gardens and courtyards; they can be great allies for maximizing sustainable design practices regarding site and landscape; and they know the research and requirements for specific user populations.

But rather than whining about being last picked for the team, we landscape architects and designers need to be proactive. We need to demonstrate our grasp of the process – not just our role in it, but how the system functions as a whole. Just as other healthcare design professionals and practitioners need to take us more seriously and embrace what we have to offer, we need to take evidence-based design and its practitioners seriously. I encourage landscape architects who specialize, or want to specialize, in healthcare design to consider taking the EDAC exam. It has been a humbling experience for me, learning about all of the elements that must be considered by the entire team throughout the entire design project from beginning to end. I’ve learned a lot and, I hope, put myself in a better position as a designer, researcher, writer, and educator toward creating and advocating for the best environments that promote health and well-being.

Note: I serve as a volunteer on the Center for Health Design’s Environmental Standards Council, but neither the Therapeutic Landscapes Network nor I receive monetary compensation for this or any other information related to the CHD on the TLN website or Blog.

The image above is of one of the courtyard gardens at Dublin Methodist Hospital, an evidence-based design project by Karlsberger Architects, CAMA, Inc., and MSI Design. One of the TLN’s Advisory Board members, Jerry Smith (also EDAC certified), was instrumental in the design of this and other gardens at Dublin Methodist. For more information about the gardens, see this article in City Scene Magazine: “Gardens with a View Rooftop greenery promotes healing and eco-conscious practices in Dublin.”