Edac Study Guide 1: An Introduction To Evidence-Based Design

Front 1

List four major stakeholders in a healthcare facility and the purpose that facility serves for each of them.

Back 1

Patients and families - healing environment
Staff - work environment
Providers of healthcare - business environment
Community and organization - cultural environment

Front 2

Define evidence-based design.

Back 2

EBD is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes.

Front 3

List the seven major trends facing healthcare today.

Back 3

1. Public focus on quality and safety
2. Reimbursement challenges
3. Aging population and caregiver shortages
4. Health information technology
5. Genomics and technology
6. Emergency room saturation and disaster preparedness
7. Sustainable healthcare

Front 4

EBD can positively influence the current trends and challenges healthcare faces by...

Back 4

- reducing medical errors and therefore cost of care
- improving satisfaction and efficiency of caregivers thus helping employee recruitment and retention
- designing a physical environment supportive of new IT and work processes
- providing innovative, adaptable designs maximizing disaster response

Front 5

HAI is a ______(a)_______ and is now more generically referred to as ______(b)______.

Back 5

a. Hospital-Acquired Infection
b. Healthcare-Associated Infection

Front 6

An HAI is defined as...

Back 6

...an infection that a patient acquires during the course of receiving treatment for another condition within a healthcare setting.

Front 7

List the two major factors that increased healthcare costs in the US ares associated with.

Back 7

1. Increased life expectancy
2. Cost of new medical technology

Front 8

List the 8 key steps in the EBD process.

Back 8

1. Define evidence-based goals and objectives
2. Find sources for relevant evidence
3. Critically interpret relevant evidence
4. Create and innovate evidence-based design concepts
5. Develop a hypothesis
6. Collect baseline performance measures
7. Monitor implementation of design and construction
8. Measure post-occupancy performance results

Front 9

Ch1Q1: Evidence-based design is the process of basing decisions about _______ on credible research to achieve the best possible outcomes.

a. patient outcomes
b. the built environment
c. nursing staff-to-patient ratios

Back 9

b. the built environment

Front 10

Ch1Q2: Which of the following clinical and safety outcomes are not typically affected by the design of the physical health environment?

a. medical errors
b. adverse reactions to drugs
c. hospital-acquired infections

Back 10

a. adverse reactions to drugs

Front 11

Ch1Q3: True or False: Employee turnover rates may be influenced by the physical design of a healthcare facility?

Back 11

True

Front 12

Ch1Q4: The goal of the business case for EBD is to determine how healthcare facility investments contribute to improvements in patient-care quality and the safety and satisfaction of both patients and staff while positively enhancing ____________.

a. the bottom line
b. the physical design
c. workforce efficiency

Back 12

a. the bottom line

Front 13

Ch1Q5: Central to making the business case for physical design innovations is the need to balance ____________ against ongoing operating savings and revenue enhancements.

a. patient outcomes
b. one-time construction costs
c. longer design and construction timelines

Back 13

b. one-time construction costs

Front 14

Ch1Q6: Staff outcomes that may not be influenced by the design of the physical healthcare environment are:

a. turnover
b. efficiency
c. personality

Back 14

c. personality

Front 15

List the three types of settings in which healthcare is provided.

Back 15

1. inpatient hospitals
2. primary and outpatient care facilities
3. long-term care facilities

Front 16

Inpatient hospitals can be classified by which categories?

Back 16

- ownership
- length of stay
- type of service
- public access
- location
- size

Front 17

Inpatient hospitals classified by ownership include the following varieties...

Back 17

- Public hospitals (government-owned)
- Federal hospitals (for federal beneficiary groups)
- Voluntary not-for-profit hospitals (privately-owned, tax exempt)
- Proprietary hospitals (investor-owned)

Front 18

Inpatient hospitals classified by length of stay include the following varieties...

Back 18

- Short-stay hospitals (stay < 30 days, treatment of acute conditions)
- Long-term-care hospitals (stay > 30 days, treatment of chronic conditions and extended medical/rehab care)

Front 19

Inpatient hospitals classified by type of service include the following varieties...

Back 19

- General acute-care hospitals (diagnostic, treatment and surgical services for a variety of medical conditions)
- Specialty hospitals (admitting only certain types/ages of patients or those with specified illnesses/conditions)

Front 20

Inpatient hospitals classified by public access include the following varieties...

Back 20

- Community hospitals (serve the general community)
- Non-community hospitals (including federally-owned hospitals ex. VA, prison, college hospitals)

Front 21

Inpatient hospitals classified by location include the following varieties...

Back 21

- Urban hospitals (located in area with pop. of at least 50,000)
- Rural hospitals (located in an area with fewer than 50,000 inhabitants)

Front 22

Inpatient hospitals classified by size include the following varieties...

Back 22

- Small (fewer than 100 beds)
- Medium (100-500 beds)
- Large (more than 500 beds)

Front 23

Define "teaching or academic hospital".

Back 23

...hospitals with approved physician residency programs.

Front 24

Define "critical-access hospital".

Back 24

...rural, limited-service hospital (35 miles from any other hospital, provides 24/7 emergency care services, no more than 15 acute-care patient beds)

Front 25

List one pro and con to "doctor-ownerd specialty hospital".

Back 25

pro - new healthcare model with high-quality care
con - undercuts community hospitals by only performing most lucrative procedures/services

Front 26

Define "healthcare system".

Back 26

...owned, leased, sponsored, contract managed by a central organization

Front 27

Define "healthcare network".

Back 27

...group of hospitals, providers, physicians, insurers and/or community agencies that work together to provide a broad compliment of services to their constituents

Front 28

Define "primary care".

Back 28

...patient's first contact with the healthcare system. A patient's Primary Care Physician serves as the gatekeeper to the many components of the healthcare system.

Front 29

Define "outpatient services".

Back 29

...also defined as ambulatory care.

Front 30

Hospital-based outpatient services include 5 main types:

Back 30

clinical, surgical, emergency, home healthcare, women's health

Front 31

Freestanding facilities include:

Back 31

walk-in clinics, urgent-care centers, emerge-centers, surgicenters, mobile services (screening, diagnostic, etc.), EMTs

Front 32

True or false: Long-term care centers focus on curing the patient.

Back 32

False

Front 33

Key stakeholders in an EBD project include but are not limited to:

Back 33

Board of trustees and leadership, researchers and designers, vendors/suppliers, patients, caregivers/family/visitors, staff, community partners, community organizations, donors

Front 34

Of the key stakeholders, who has the ability to cut across departments and specialties, maintain a focus on the organization's values, and make complex decisions thus shaping the culture and process of the EBD efforts?

Back 34

the CEO

Front 35

List the six components that define EOC (Environment of Care).

Back 35

1. concepts
2. people
3. systems
4. layout/operations
5. physical environment
6. implementation

Front 36

List various ways the components of the EOC can manifest themselves to build the culture of an organization.

Back 36

Stated and unstated values, shared assumptions of its members, policies and procedures, official and informal organizational structures, observed symbols and artifacts, etc.

Front 37

Culture in an organization may be difficult to change because...

Back 37

...it is so deeply rooted in the organization and the current EOC that all involved parties are familiar with.

Front 38

Ch2Q1: Facilities that give patients a wide range of healthcare choices and attempt to meet consumer needs of convenience and cost reduction are collectively know as ___________.

a. walk-in clinics
b. surgicenters
c. freestanding facilities

Back 38

a. freestanding facilities

Front 39

Ch2Q2: _______ Refers to any personal care or assistance that a patient receives on an ongoing basis because of a disability or chronic illness that limits his or her ability to function.

a. long-term care
b. institutional care
c. home healthcare

Back 39

b. long-term care

Front 40

Ch2Q3: Hospital-based outpatient services can be broadly classified into five main types; clinical, surgical, emergency, home health, and _______ health.

a. psychiatric
b. women's
c. pediatric

Back 40

b. women's

Front 41

Ch2Q4 Outpatient services are also referred to as _________ care.

a. ambulatory
b. walk-in
c. non-institutional

Back 41

a. ambulatory

Front 42

Ch2Q5: Preliminary studies by the Weill Cornell Medical College's Physician Organization in six existing ambulatory sites found that the more attractive the environment, the _______ the perceived quality and the ____________ the anxiety.

a. higher, higher
b. lower, lower
c. higher, lower

Back 42

c. higher, lower

Front 43

Ch2Q6: Hospital boards are ultimately accountable for organizational activity, accomplishment and ___________.

a. staff satisfaction
b. patient outcomes
c. major capital investments

Back 43

c. major capital investment

Front 44

Ch2Q7: The _________ of a hospital is accountable for all of the services and behaviors of the organization.

a. chairperson of the board
b. board as a whole
c. CEO

Back 44

c. CEO

Front 45

Ch2Q8: The _______ recommends expenditures to further enable the healthcare facility to meet community needs and/or shareholder value. The ___________ approves or disapproves the recommendation.

a. board, CEO
b. CEO, board
c. CEO, government

Back 45

a. CEO, board

Front 46

Ch2Q9: ___________ strategies applied to facility design call for involving staff members in the design of effective and efficient facilities based on their day-to-day experience of what does and does not work.

a. total quality management
b. universal designs
c. participative management

Back 46

c. participative management

Front 47

Ch2Q10: A facility's Environment of Care defines its _________.

a. physical design
b. culture
c. outcomes

Back 47

b. culture

Front 48

Data that refers to the information that can be directly sensed (seen, heard, touched, tasted, and smelled) and is demonstrable to other people is ________ data.

Back 48

Empirical

Front 49

________ data can be considered empirical when they are gathered through interviews, questionnaire surveys, rating scales and other measurement tools.

Back 49

Subjective

Front 50

Four key areas of the EOC consistently are affected by EBD design characteristics. They are...

Back 50

1. reduction in staff stress and fatigue
2. improvement in patient safety
3. reduction in patient stress
4. improvement in overall healthcare quality

Front 51

Three major categories of EBD outcomes are...

Back 51

1. patient safety (infections, medical errors and falls)
2. patient outcomes (pain, sleep, stress, depression, length of stay, privacy, support, satisfaction, etc.)
3. staff outcomes (injuries, stress, effectiveness, satisfaction)

Front 52

Ch3Q1: True or false: Subjective data are never considered empirical because it represents people's opinions rather than actual fact.

Back 52

False

Front 53

Ch3Q2: Select the best answer: EBD is differentiated from traditional design in _____.

a. its involvement of staff in design decisions
b. its emphasis on using research to support design decision making and evaluation of design innovations
c. the composition of the interdisciplinary design

Back 53

b. its emphasis on using research to support design decision making and evaluation of the interdisciplinary design

Front 54

Ch3Q3: Ideally, EBD research can be used during and after the construction and occupancy phases to _______.

a. develop hypotheses about how the design decisions may impact outcomes
b. evaluate the effectiveness of design solutions
c. alter parts of the design as it becomes clear whether or not decisions were appropriate

Back 54

b. evaluate the effectiveness of design solutions

Front 55

Ch3Q4: Ideally, stakeholders should use research to understand which environmental elements are the best design options to improve outcomes in the _____ phase of the project.

a. predesign/design
b. construction
c. occupancy

Back 55

a. predesign/design

Front 56

Ch3Q5: Specific information about the built environment recorded over time and relative to patient and staff exposure during their time within that setting is needed to assert ________ relationships between features of the built environment and outcomes.

a. theoretical
b. correlational
c. causal

Back 56

c. causal

Front 57

List the 8 key steps in the EBD process.

Back 57

1. Define evidence-based goals and objectives
2. Find sources for relevant evidence
3. Critically interpret relevant evidence
4. Create and innovate evidence-based design concepts
5. Develop a hypothesis
6. Collect baseline performance measures
7. Monitor implementation of design and construction
8. Measure post-occupancy performance results

Front 58

What are the six questions to ask regarding the cost, investment in and ROI of an EBD project?

Back 58

1. Is the project urgent in order to fulfill the organization's mission?
2. Is the proposed plan appropriate compared to other alternatives?
3. Is the cost appropriate compared to other similar projects in the region?
4. Has the financial impact of increased volume, expense and revenue assumptions been analyzed?
5. Have the proper sources of funds been analyzed and is it enough to handle the growth?
6. Will EBD features be incorporated and employed in the proposed project?

Front 59

Ch4Q1: The EBD process can be incorporated into ____ stage of the building design process.

a. predesign/design
b. construction
c. any

Back 59

c. any

Front 60

Ch4Q2: The phase when the building is outfitted with everything needed to make it ready for patient-care services is called the ________.

a. programming phase
b. commissioning phase
c. occupancy phase

Back 60

b. commissioning phase