A review of the research literature on evidence-based healthcare design. Academic Article uri icon


  • OBJECTIVE: This report surveys and evaluates the scientific research on evidence-based healthcare design and extracts its implications for designing better and safer hospitals. BACKGROUND: It builds on a literature review conducted by researchers in 2004. METHODS: Research teams conducted a new and more exhaustive search for rigorous empirical studies that link the design of hospital physical environments with healthcare outcomes. The review followed a two-step process, including an extensive search for existing literature and a screening of each identified study for the relevance and quality of evidence. RESULTS: This review found a growing body of rigorous studies to guide healthcare design, especially with respect to reducing the frequency of hospital-acquired infections. Results are organized according to three general types of outcomes: patient safety, other patient outcomes, and staff outcomes. The findings further support the importance of improving outcomes for a range of design characteristics or interventions, including single-bed rooms rather than multibed rooms, effective ventilation systems, a good acoustic environment, nature distractions and daylight, appropriate lighting, better ergonomic design, acuity-adaptable rooms, and improved floor layouts and work settings. Directions for future research are also identified. CONCLUSIONS: The state of knowledge of evidence-based healthcare design has grown rapidly in recent years. The evidence indicates that well-designed physical settings play an important role in making hospitals safer and more healing for patients, and better places for staff to work.

published proceedings

  • HERD

altmetric score

  • 100.14

author list (cited authors)

  • Ulrich, R. S., Zimring, C., Zhu, X., DuBose, J., Seo, H., Choi, Y., Quan, X., & Joseph, A.

citation count

  • 832

complete list of authors

  • Ulrich, Roger S||Zimring, Craig||Zhu, Xuemei||DuBose, Jennifer||Seo, Hyun-Bo||Choi, Young-Seon||Quan, Xiaobo||Joseph, Anjali

publication date

  • April 2008