Evidence-Based Design

The Center for Health Design EBD Journal Club: Built Environment Design Interventions at the Exits of Secured Dementia Care Units

December 8, 2022 / Dochitect / Design for Geriatrics, Evidence-Based Design

Webinar

Journal Club Title: Built Environment Design Interventions at the Exits of Secured Dementia Care Units: A Review of the Empirical Literature
Journal Club Date: December 8, 2022
Moderator: Addie M Abushousheh, PhD, EDAC, Assoc AIA
Discussant: Diana Anderson, MD, M.Arch
Organization: The Center for Health Design

The EBD Journal Club

Built environment design is recognized as important in the care and management of responsive behaviors for those living with Alzheimer’s disease and other dementias in secured dementia care units (e.g., exiting attempts, agitation).

The repetitious behavior of “walking with purpose” (previously termed wandering) in those with dementia has influenced safety-related architectural design components of dementia care units that decrease exiting attempts. Empirical literature addressing design interventions to prevent exiting for those with dementia is lacking and outdated.

To advance our understanding, the presenter sought to describe design interventions in dementia care units through a topical analysis of experimental studies. The studies assessed five interior design interventions at egress doorways: implementing horizontal and vertical floor grid patterns, mirrors, murals, conditioning responses to color cues, and camouflaging door hardware or vision panels.

Click HERE for more information.

Webinars

Built Environment Design Interventions at the Exits of Secured Dementia Care Units: A Review of the Empirical Literature

October 9, 2022 / Dochitect / Design for Geriatrics, Evidence-Based Design

Peer-reviewed publication

Publication: Health Environments Research and Design
Publication Reference: 2022 Oct 9;19375867221125930. doi: 10.1177/19375867221125930.
Authors: Anderson DC, Kota SS, Yeh L, & Budson AE
Date: October 9, 2022. Online ahead of print.

Abstract

Purpose: To review evidence around design interventions that influence exiting attempts in dementia care units, informing architectural and clinical practice.

Background: Built environment design is recognized as important in the care and management of responsive behaviors for those living with Alzheimer’s disease and other dementias in secured dementia care units (e.g., exiting attempts, agitation). The repetitious behavior of “walking with purpose” (previously termed wandering) in those with dementia has influenced safety-related architectural design components of dementia care units that decrease exiting attempts. Empirical literature addressing design interventions to prevent exiting for those with dementia is lacking and outdated.

Methods: We sought to describe known design techniques through a topical analysis of experimental studies. A thorough search for empirical studies that assessed interior design interventions at exit doors within dementia care units was undertaken. The review included an extensive search for existing literature and a screening of each study identified for its relevance, quality, and applicability.

Results: The experimental studies included in the review collectively assessed five interior design interventions at egress doorways: implementing horizontal and vertical floor grid patterns, mirrors, murals, conditioning responses to color cues, and camouflaging door hardware or vision panels. Why empirical studies have not continued more recently as built environment trends have shifted toward promoting meaningful and purposeful movement through design are considered. Advances in our understanding around the pathophysiology of dementia which might affect future design interventions related to egress are also identified.

Conclusion: The built environment is an important part of dementia care, and further prospective research is needed on the role of design interventions in the context of exiting attempts within secured units and subsequent behavior outcomes.

Keywords: Alzheimer’s disease; Built environment design; architecture; dementia; long-term care; nursing home; visual barriers; wandering.

Find the full article HERE.

Peer-Reviewed Publications

Symposium on Sustainability in Healthcare – Architectural Design as a Determinant of Heath

May 25, 2021 / Dochitect / Design for Resiliency, Design for the Future of Health, Evidence-Based Design

Presentations

Event: Symposium on Sustainability in Healthcare
Title: Architectural Design as a Determinant of Heath
Date: May 25, 2021

KEYNOTE LUNCH – 11:30 AM – 1:00 PM

Keynote Presentation: “Architectural Design as a Determinant of Health”

Presenter: Diana Anderson, MD, M.Arch

Our understanding of the role the environment plays in shaping health has expanded immensely over the last few decades. A growing body of empirical data and evidence-based design research demonstrates that architecture impacts care delivery as well as health outcomes.

This talk explores built space as an important determinant of health and questions whether the built environment itself should be considered alongside other parameters of care, analogous to our medical interventions. Historical examples of the convergence of hospital architecture and medical practice exist. The design of the tuberculosis sanatorium during the early 20th century illustrates this infrequent intersection; the healthy building emphasizing contact with nature, developed to prevent the spread of contagions.

In the context of the COVID-19 global pandemic, we can revisit past models and consider new and sustainable innovations to emphasize infection prevention and control. A current focus on design equity, ensuring overall accessibility to healthcare-built space, is explored through universal design principles. It is imperative that we consider a convergence of the healthcare and design disciplines in order to promote novel solutions to augment-built environment resilience and subsequently support equitable, safe and efficient care delivery.

More information about the event is available HERE.

Keynote Presentations

Tulane School of Medicine: Architectural Design as a Determinant of Health

January 14, 2021 / Dochitect / Design for Clinical Staff, Evidence-Based Design, The Physician-Architect Model

Presentations

Event: Tulane School of Medicine- Medical Student Government + GAPSA (Graduate Professional Student Association) lecture series
Title: Architectural Design as a Determinant of Health
Date: January 14, 2021

Lecture Overview
Our understanding of the role the environment plays in shaping health has expanded immensely over the last few decades. A growing body of empirical data and evidence-based design research demonstrates that architecture impacts care delivery as well as health outcomes. This talk explores built space as an important determinant of health and questions whether the built environment itself should be considered alongside other parameters of care, analogous to our medical interventions.

Historical examples of the convergence of hospital architecture and medical practice exist. The design of the tuberculosis sanatorium during the early 20^th century illustrates this infrequent intersection; the healthy building emphasizing contact with nature, developed to prevent the spread of contagions by isolating patients and preparing them for a return to normal life. In the context of the COVID-19 global pandemic, we can revisit the sanatorium model to de-medicalize architecture, and emphasize infection prevention and control. It is imperative that we consider a convergence of the healthcare and design disciplines in order to promote innovative solutions to augment built environment resilience and subsequently support equitable, safe and efficient care delivery.

Lectures

JHD Podcast – Widening the Lens: Clinical Perspectives on Design Thinking in Public Health

August 20, 2020 / Dochitect / Design for Clinical Staff, Design for Patient Safety, Design for Resiliency, Evidence-Based Design

Presentations

Title: “Widening the Lens: Clinical Perspectives on Design Thinking in Public Health”
Podcast: The Journal of Health Design
Date: August 20, 2020

The Health Design Podcast · Benjamin Bassin, MD, EDAC

The COVID-19 pandemic has created many stressors and challenges across all levels of low to highly resourced health systems. However, it has also shown the incredible number of opportunities for innovation, ingenuity and system re-engineering. This team believe it is time to support a paradigm change and advocate for healthcare’s next big investment: intentional and embedded partnerships between clinicians, designers, and architects with dedicated resources to ensure an effective collaborative environment to help solve healthcare’s greatest challenges.

Read the full editorial article HERE.

Podcasts

Paging the Engineers and Architects, STAT: The emergence of the hybrid clinician

May 16, 2020 / Dochitect / Design for Clinical Staff, Evidence-Based Design, The Physician-Architect Model

Webinar

Webinar Title:’Paging the Engineers and Architects, STAT: The emergence of the hybrid clinician
Webinar Date: May 16, 2020
Organization: Clinician Engineer Hub Webinar Series

Overview:
The Clinician Engineer Hub is an international non-profit organisation that aims to bring together the clinical and biomedical engineering field and provide talented medical students and clinicians exposure to the world of clinical medicine, the challenges doctors face in diagnosing and treating patients and how to potentially solve these issues with cutting edge engineering solutions.

For the Clinician Engineer Hub Webinar Series, Dochitect discusses the emergence of the hybrid clinician and the importance of this model in addressing healthcare challenges and innovation.

The webinar recording is accessible HERE!

Webinars

The Intersection of Architecture/Medicine/Quality and the Clinical Nurse Specialist: Designing for the Prevention of Delirium

December 2, 2019 / Dochitect / Design for Geriatrics, Design for Patient Safety, Evidence-Based Design

Peer-reviewed publication

Publication: Clinical Nurse Specialist (The International Journal for Advanced Nursing Practice)
Publication Reference: 34(1):5-7, January/February 2020
Author: Anderson, Diana C.; Jacoby, Sonya R.; Scruth, Elizabeth Ann

Excerpt:

“We call it the delirium room,” my colleagues would say about a hospital room where, anecdotally, it was noticed that more patients tended to become delirious. I went to visit it—the door squeaked with each swing, there was minimal daylight with the window view being a neighboring wall, and the room faced the constantly noisy nursing station.What insights can architectural design provide toward our understanding of delirium and models of care?

What if “the delirium room” did not incite delirium but instead prevented and even treated it?

Read more about Delirium and Design HERE.

Peer-Reviewed Publications

Healthcare Interior Design 2.0 Podcast

November 11, 2019 / Dochitect / Design for Clinical Staff, Evidence-Based Design, Health Design & Ethics, The Physician-Architect Model

Presentations

Podcast: Healthcare Interior Design 2.0
Date: November 11, 2019

Dochitect is featured on the Healthcare Interior Design 2.0 Podcast!
Listen to @dochitect discuss the idea of what is the moral imperative of the architect to communicate research to clients and discuss potential benefits and harms of design. “Architects are sometimes torn between thinking about the state of healthcare outside of their individual project to a client,” Diana shares. “And I think we often have reservations about measuring design quality.” This and more on the changing face of the healthcare design from a “dochitect’s” perspective.

Click HERE to listen to the full podcast!

Podcasts

GeriPal Podcast: Architecture and Medicine

October 17, 2019 / Dochitect / Evidence-Based Design, The Physician-Architect Model

Presentations

Podcast: GeriPal Podcast
Title: Architecture and Medicine Podcast with Diana Anderson and Emi Kiyota
Date: October 17, 2019

Dochitect is featured on the Geripal Podcast!

Alex: What do you get when you mix a doctor and an architect?

Eric: An Archidoc?

Alex: No a Dochitect. What do you get when you mix a gerontologist with an architect?

Eric: A gerontolitect?

Alex: No an environmental gerontologist.

Re-designed spaces also have the potential to improve outcomes for older adults and people with serious illness. Further, redesigned spaces can improve quality of life for healthcare providers, and those benefits may be passed on to our patients.

Listen to the podcast with Dochitect Diana Anderson, MD, M. Arch (UCSF geriatrics fellow) and Emi Kiyota, PhD, environmental gerontologist.

Click HERE to listen to the full podcast!

Podcasts

The Journal of Health Design Podcast – Dochitect

September 4, 2019 / Dochitect / Evidence-Based Design, The Physician-Architect Model

Presentations

Podcast: The Journal of Health Design
Title: Diana Anderson: “Dochitect” who combines medicine and architecture
Date: September 4, 2019

Dochitect is featured on The Journal of Health Design Podcast!

The Health Design Podcast · Diana Anderson, “dochitect”, combines medicine and architecture.

Diana Anderson, MD, M.Arch, is a healthcare architect and a board-certified internist. She completed her medical residency training at New York-Presbyterian Hospital, Columbia University Medical Center in the United States. As a “dochitect,” Dr. Anderson combines educational and professional experience in both medicine and architecture. She has worked on hospital design projects globally and is widely published in both architectural and medical journals, books and the popular press. She speaks frequently about the impacts of healthcare design on patient outcomes, staff satisfaction and related topics. She is co-founder of the Clinicians for Design Group, an international network of leaders that seeks to inspire and accelerate the design of environments and systems. Dr. Anderson was recognized for her contributions to the field by the American Institute of Architects’ Academy of Architecture for Health U40 List of Healthcare Design’s Best under 40. As an immediate past Fellow at the Harvard Medical School Center for Bioethics, she explores space design and ethics. She is currently a geriatric medicine fellow at the University of California, San Francisco.

“Listen to @dochitect, who says every room in the #healthcare space deserves equal attention, including corridors. #architecture and #medicine work together to create better spaces and #Health outcomes. #PatientExperience #PatientCare#DesignThinking”

Podcasts

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