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78 Cards in this Set
- Front
- Back
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What two processes does EBD incorporate that typical healthcare design does not?
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1) using available relevant evidence to educate the EBD team and inform design
2) creating new evidence linking design interventions and outcomes to share and enhance the body of EBD knowledge |
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The project team should be assembled _________ in the project. The team should also be _____________ including administrators, professionals/users, architects/consultants/planners, researchers, etc.
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early, interdisciplinary
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The interdisciplinary team should be assembled early. The linear timing of involvement of team members should ______(a)______ followed; team members ______(b)_____ all be involved at the same early stage in the process.
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a) not be
b) should |
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Executive leadership is essential. The board of directors, CEO, CFO, CIO, and hospital and medical administrators make _____(a)______ decisions and can most strongly influence ______(b)______ change.
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a) financial
b) cultural and institutional |
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_____________________ provide expertise specific to the areas of interest and understanding of current trends and technologies.
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Specialists and consultants
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________________ provide an understanding of first-hand experience receiving healthcare.
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Patients, families and community patient advocates
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_______________ are specifically trained in the EBD process and should be involved early
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EBD researchers
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It is important to clearly identify the following expectations to the each member of the project team; ____(a)______, _______(b)_______ and ______(c)______.
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a) length of participation
b) decision-making authority c) responsibilities and deliverables |
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Expectations of the team members by the administrators should be clear. The team members should also state their expectations of the administrators. This will help maintain open __________ and _____________.
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communication, collaboration
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Ch1Q1: The interdisciplinary EBD team should include community leaders because:
a) otherwise the community might derail the project b) community leaders can help market the project c) the team can gain insights into previous medical experiences, consumer expectations, and community needs |
c) the team can gain insights into previous medical experiences, consumer expectations, and community needs
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Ch1Q2: Staff and frontline managers can contribute what to the EBD project team?
a) patient's point of view b) ideas derived from hands-on experience c) staff should not be included; their narrow perspective might derail the project |
b) ideas derived from hands-on experience
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Ch1Q3: _____________ as part of a collaborative approach to project planning and design requires the development of an organizational structure and decision-making protocol.
a) communication strategies b) bottom-up decision-making c) managing diverse perspectives |
c) managing diverse perspectives
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Ch1Q4: Concurrently addressing multiple perspectives during all phases of the project the team can establish alignment between the ______, _________, and ______ at the earliest points of the project.
a) project vision, building materials, community of users b) project vision, design interventions, budget c) project plan, vision, and implementation |
c) project plan, vision and implementation
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Ch1Q5: While establishing the operational structure, it is important to identify and stress team members' expectations, which should include:
a) how long they should expect to participate, their decision-making authority, and project-deliverable responsibilities b) who they report to, what they report on, when their reports are due c) how much they will be paid, what the consequences are of not delivering by the deadlines, and how they should communicate with one another |
a) how long they should expect to participate, their decision-making authority, and project-deliverable responsibilities
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In order to prevent the removal of the EBD process from the project later on, the vision should include the following three elements...
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- define desired outcomes and timelines and their potential to change throughout the process
- document the sponsorship and commitment of executive leaders to the EBD process - state the EBD approach |
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The _____________ is a person or small team within the project team that keeps the project on point and in alignment with the project visions and the organization's overall vision and goals.
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vision keeper
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A strategic facilities plan should be developed. This outlines the goals and objectives of the organization, the market position driving the need for change and specific projects focused on bringing the physical environment in alignment with operational goals. What else should be included in this strategic facilities plan?
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- translate project goals and objectives into research hypotheses
- evaluate current practices and establish an operational baseline - determine market positioning, including proposed service offerings - identify the context and culture within which the project will be conducted - identify research and outcome metrics - formulate a research budget and a plan to secure funding |
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If it is determined that no new evidence will be created should the team still document and share their results?
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Yes. This can contribute to the body of knowledge and add validity/support to similar studies.
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Creating and maintaining an update _____________ is important in gaining financial and executive support in an EBD project. Healthcare operations finance, architectural estimating, healthcare research, process improvement and facilities managements should be involved in this.
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business case
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The business case should compare facilities costs at which stages?
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- cost to build, first cost
- cost to maintain, multiyear costs - cost over lifespan of project, lifecycle costs |
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The business case should compare business costs and revenue including:
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- operational improvements; due to reduced staff turnover, medical errors, etc.
- endowment development; potential increase in philanthropical donations - market share; increased based on volume capacity, quality of service, space amenities, etc |
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Define 'payback period'.
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The time it takes for the cash-flow line to move from a negative to a positive balance.
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In an age of rapid change the interdisciplinary team must be prepared to pull the plug on the project for the following reasons:
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- to reassess information or process based on newly acquired information
- reassess assumptions or objectives - review the plan entirely in an effort to avoid catching misunderstandings/misassumptions before anything gets built and money gets spent |
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Functional and space programming in EBD includes which elements?
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- using existing evidence to inform programming and forecast needs
- addressing EOC components - incorporating evidence-based interventions - documenting the process and carefully recording use of evidence and further formulation of hypothesis - evaluating the anticipated return-on-ivestment for design interventions |
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An operational plan must be designed concurrently with any physical design intervention planning...the following items and relationships must be considered...
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- vision for the future
- current situation and operational issues - preliminary future operating plan - hours of operation, utilization and staffing - operational support system requirements - interdepartmental adjacencies and access (work flow) - facility layout and design considerations - future trends and operational flexibility - desired patient-centered experiences |
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Design and planning of spaces and concepts must be clearly identified when they are non-negotiables to the vision, goals and EBD outcomes desired. This will help avoid....
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eliminating essential design interventions when the budget calls for value engineering.
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If a non-negotiable MUST be removed from the project, the project team needs to reevaluate whether the ROI will be maintained __________ the design intervention in question.
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without
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Ch2Q1: Existing evidence should be evaluated based on which three criteria?
a) relevance, validity, reliability b) importance, relevance, authority c) rigor, methodology, generalizability |
a) relevance, validity, reliability
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Ch2Q2: __________ is necessary to document the links between project goals, desired outcomes, and the supporting evidence.
a) a comprehensive research plan b) a shared vision c) meticulous record keeping |
c) meticulous record keeping
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Ch2Q3: Part of the development of a strategic facilities plan is to assess the current processes at a macro level and collect data on the ____________ level of performance within the organization.
a) past b) current c) anticipated |
b) current
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Ch2Q4: On a particular project, the team determined that the project budget could not support specific costs directly associated with an EBD design intervention. What is the best strategy at this point?
a) drop the EBD design intervention b) Enlist the help of consultants to find more funding c) determine if the projected return-on-investment off-sets the additional project costs |
c) determine if the projected ROI off-sets the additional project costs
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Ch2Q5: With the assistance of a researcher, the team must find and review evidence that links the design of the physical environment to ___________.
a) the project vision b) health care costs c) health care outcomes |
c) healthcare outcomes
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Ch2Q6: When existing research is not available to inform EBD goals, what can the project team do prior to finalizing the functional and space program in order to inform the program?
a) run it by the hospital administrators b) conduct their own small research study c) invite their colleagues to a focus group |
b) conduct their own small research study
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Ch2Q7: To help the executive team make informed decisions the Business Case document should evaluate:
a) staff and business costs b) facilities and business costs c) facilities and staff costs |
b) facilities and business costs
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The research plan and the vision and business case will be linked in the __________ and ____________ phases of design.
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Schematic and design
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New ideas for design intervention may arise in the early phases of design. New _____________ may come to the team's attention.
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hypotheses
There may be many hypotheses. Not all of them need be researched, however. |
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Ask the following questions to determine how well an EBD feature may align with the components of the EOC.
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Concepts - does the intervention support the stated goal or objective of the project?
People - Are considerations made for how the intervention impacts staffing and provides amenities supporting safety and satisfaction of patients, families and staff? Systems - What technology and operational systems need to be considered during the development of the EBD intervention? Layout and operations - Will the layout cause changes in the operational model, requiring modifications in processes, staffing and organizational culture? Physical environment - Does the EBD consider the added benefits of natural lighting and views, visibility and accessibility, environmental control for patients and staff, along with increased privacy and safety, different cultural preferences and sustainable design components? Implementation - Will additional interdisciplinary project team members be needed to properly apply and integrate the design interventions? Have considerations been discussed about how the design intervention will be implemented while minimizing impact on infection-control risk and operational disruption? |
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During the schematic design development and evaluation process it is important to...
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- annotate diagrams
- document assumptions - update hypotheses - test design concepts - select the best options - construct mock-ups |
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________________ are important in communicating the intent behind EBD interventions and linking them to perceived outcomes.
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annotated diagrams
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_________________ is typically in the form of a qualitative statement and does not need to be specific or quantitative.
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documenting assumptions
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The guiding principles defined at the beginning of the project were developed to...
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- set the project goals
- serve as a planning framework - guide the decisions-making process |
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The guiding principles should be used and checked when in the project?
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continuously throughout
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Other elements should be considered in deciding upon the best design options. What are these considerations?
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- complexity of implementation
- impact to operations and functional programs - long-term flexibility - project costs - operational costs - schedule timeline - EOC - outcomes |
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The time and money that are saved despite the initial cost of creating _____________ is significant.
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mock-ups
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Early on during the design phase, the project team should ensure that the _______________ clearly states the costs, benefits and executive support of/for EBD being incorporated into the project.
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Business case
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The research plan should continue to be updated with new information, assumptions and ideas during the ______________ phase.
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design
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During the construction document phase of a project list the work that supports the EBD process...
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- monitor implementation of design and construction (ensure EBD intervention's original intent has not been compromised)
- finalize the business case (ensure that ROI and business case documents have been documented and, after Construction Documents, have been delivered to executive leadership) - plan for the integration of design concepts into operations (train staff members to use the space and processes as designed, culture change facilitated by administrators and staff may be necessary) |
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Ch3Q1: The group that approves research studies involving human subjects is called the:
a) Institutional Review Board b) Institutional Research Board c) Research Review Board |
a) Institutional Review Board
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Ch3Q2: Testing each _________ against the project's guiding principles provides a consistent evaluation method that determines to what extent the planning and design concept addresses the original project goals.
a) hypothesis b) schematic design c) design concept |
b) design concept
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Ch3Q3: Whose role is it to monitor the evidence-based design features to ensure that the original intent has not been compromised?
a) project architect b) EBD project team c) EBD researchers |
a) EBD project team
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Ch3Q4: In planning for the integration of the new concepts and plans, a _____ perspective should be considered for specific departments, concurrently exploring how technology, culture, process, and space can be integrated in a way that streamlines the flow of information, improves service quality, and achieves desired outcomes.
a) user-oriented b) systems-based c) comprehensive |
b) systems-based
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Ch3Q5: An implementation strategy outlines the _________ required to construct the proposed project.
a) operational logistics b) manpower c) materials |
a) operational logistics
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When soliciting and awarding construction contracts it is important to involve those who are invested in the _______________ and its benefits.
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EBD process
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A construction manager should be brought on early in the process for what reasons?
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It can help establish participant ownership in the vision and can lead to subcontractors getting involved who also have equal investment in the project.
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During the construction process constant ______________ by the design team (and research team if applicable) will help to ensure that the EBD objectives are upheld.
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Observation/monitoring
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It is important to consider that an EBD process will change the physical environment as well as _____________ and may require a change in culture and additional staff training.
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cultural or operational changes
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The commissioning process is important in ensuring...
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that the building/design performs the way it should thus fulfilling the EBD objectives.
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When can a team begin conducting post occupancy evaluations?
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6 months after building occupation
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Ch4Q1: During an EBD construction phase, the project team not only periodically monitors construction, but also finalizes the ___________ (which includes the implementation for post-occupancy research), gains approval, and applies for funding.
a) design documents b) construction documents c) research plan |
c) research plan
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Ch4Q2: What is(are) the advantage(s) of early consultation with the construction manager?
a) identify alternative approaches that can achieve the research objectives with lower cost and shorter schedules b) ensure that adequate funding and technical requirements are included in the construction plan to assure success c) a and b |
c) a and b
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Ch4Q3: During the commissioning phase of the EBD project, the project team
a) verifies that the building complies with the intent of the research plan, design interventions, and business case b) verifies that the installation and performance of systems is in line with design c) develops and uses a commissioning plan to evaluate requirements in construction documents |
a) verifies that the building complies with the intent of the research plan, design interventions and business case.
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Ch4Q4: Oftentimes EBD interventions require a shift in __________ based on changes in space.
a) attitudes b) work processes c) culture |
b) work processes
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Ch4Q5: Creating ideal patient experiences, and the behavioral expectations for staff associated with that goal, can be said to represent what kind of change?
a) culture b) attitude c) work processes |
a) culture
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Waiting at least _________ months after occupancy is important in order for users to learn to use the space effectively and consistently. It may take some time to get used to the new design and an early POE may not accurately depict the long-term use of the space.
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6
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In a traditional project, POE implies there is limited observation and interviews. POE in EBD implies what else?
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POE in EBD often requires studies, research as well as the more traditional evaluation to determine the success of and new questions arising from an EBD process.
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In beginning a POE the research plan is revisited. There probably are multiple hypotheses. First, one hypothesis must be chosen and the following questions can help in this decision.
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Relevance? does it tie to the organization's vision?
Distinctive? is this question unique? Significant? will this study fill a gap in the existing knowledge base? Rigorous? does this hypothesis lend itself to high-quality research and results? Feasible? is this study going to be successful considering time, money and resource availability? |
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Members of the research team ideally include a trained researcher but also may include members of _________________.
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the original project team
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The research plan should include the information needed to conduct a study but if it does not then the research team should fill in the gaps of the following list throughly...
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-statement of the research topic
- background information - hypotheses or research questions - methodology - research design - variables and measurements - data collection procedures - logistics - roles, budget and timeline - references |
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The research team must evaluate and document the logistics of implementing the plan. This includes considering...
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- cooperation of the hospital
- management of resources - ethics - IRB approval |
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If no pilot study is needed and the following four conditions are met then a research study can commence.
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1) IRB approval has been obtained
2) users have occupied the space for at least 6 months 3) necessary resources, equipment, data and tools are available 4) there is guaranteed minimal impact on daily operations |
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Who guides the data analysis process?
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a researcher
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Even if an EBD process or study turns out to be inadequate or simply a failure should the data and report be shared?
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Yes. The overall goal of EBD should always be the furthering of healthcare design and others can learn from successes and failures equally. All data and research should be reported and shared in the larger body of knowledge.
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The research report needs to include:
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- title page, abstract, intro, background, methodology and methods, results, discussion, conclusion and recommendations for future research, references, appendices
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Ch5Q1: Typically, the challenges to conducting a formal POE include cost, the lack of consistent and reliable methodologies, lack of formal policies within the architectural firm for using POE, information to improve subsequent projects and;
a) the lack of researchers trained in this approach b) the lack of knowledge about how to collect POE results c) the potential for bias when such a study is conducted by the firm that designed the building |
c) the potential for bias when such a study is conducted by the firm that designed the building
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Ch5Q2: At what point in time after occupancy is it appropriate to conduct an initial POE study?
a) immediately b) three months c) six months |
c) six months
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Ch5Q3: Using a professional independent researcher to conduct post-occupancy research ensures that the study is conducted using a credible research methodology and eliminates any ____ in collecting data or analyzing results.
a) errors b) bias c) misunderstandings |
b) bias
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Ch5Q4: The first step to conducting research during the post-occupancy phase is to determine ____________.
a) who to talk to b) what the outcomes should be c) what should be measured |
c) what should be measured
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Ch5Q5: The choice of data analysis tools depends on the ____________ and the research design.
a) research methodology b) funds available c) preferences of the researcher |
a) research methodology
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