NCIDQ News: Changing a Culture of Mine to a Culture of Ours

March 27, 2009
The A&D industry should take cues from the medical community if it is to realize the full benefits of design that is evidence-based.

At first glance, the concept of Evidence-Based Design (EBD) seemed foreign to me. However, after reading the Center for Health Design’s definition (“Evidence-Based Design is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes”), I realized that the idea of EBD is something I’ve known for 23 years.

I am building director for one of the largest cities in Alabama, and my work—both as a building professional and as a board member for the International Code Council (ICC)—focuses on public safety in the built environment. The majority of building codes have been established for the same reason as EBD: to achieve the best possible outcomes for protecting human life. In the world of codes, we call this “performance-based,” rather than “evidence-based.” Yet, both EBD and performance-based codes and standards are used to create sound design solutions.

Sadly, many life safety codes are regulations developed by anecdote: collapsed walkways, offgassing of toxic fumes from suspect materials or impaired egress paths—each resulting in either physical harm or worse yet, lost lives. These human tragedies become the impetus for new fire and building codes or revisions to existing codes. As much as code officials endeavor to be visionary in creating safety features to protect the public, the prospect of commercial aircraft being used as weapons of mass destruction to bring down high-rise buildings is one that few would have contemplated as a serious building-safety issue. Still, with the recent completion of the 2009 code development process by the ICC, several security, safety and structural changes have been made to protect people in tall structures.

Whether designing commercial or residential space through EBD, or through the use of performance-based codes, a more thoughtful and effective human-centered design can be the result. A recommended resource for further research and consideration is the ICC Performance Code for Buildings and Facilities©, as well as a number of publications from the Society of Fire Protection Engineers. These sources more thoroughly explore the many aspects of human behavior and physiological condition as it relates to building occupancy and use.

Of course, performance-based codes and evidence-based design are grounded in the original concept of evidence-based medicine. The medical professions have recognized the benefit of evidence-based decision-making for years and are now using technology in ways that will advance their efforts to even higher levels. A New York Times article published at the end of 2008 highlighted the use of computerized patient records at the Marshfield Clinic in Wisconsin. (Lohr, December 27, 2008). An alternative to a passive paper record, a digital patient record is “a vibrant tool that reminds and advises doctors. It can be summoned with a mouse click, not hidden in a file drawer in a remote location and thus useless in medical emergencies.”

Reading about Marshfield’s success stories—in fewer than four years the percentage of patients with blood cholesterol at or below the recommended level increased 21 percent and the percentage of patients with satisfactory blood pressure increased 20 percent—made me wonder what would happen if those involved in building design and construction kept similar electronic databases that were widely shared among design professionals. Would we be able to track health improvements in people who inhabit sustainably designed and safely designed buildings? What wisdom and patterns would emerge that might cause us to design differently or propose different life safety codes?

The founders of InformeDesign had a similar idea when they created their database of research summaries from juried journals of design, architecture, and yes—medicine. The mission of InformeDesign is to facilitate designers’ use of current, research-based information as a decision-making tool in the design process, thereby integrating research and practice.

InformeDesign wants interior designers, architects, landscape architects, urban planners, and other design practitioners to become consumers of research. They want to coordinate the efforts of researchers and practitioners so that the outcomes of design solutions can be systematically examined. Practitioners generate raw data necessary to develop the Body of Knowledge. Researchers analyze the data, educators use the findings to teach new knowledge to future designers and, finally, design practitioners refer to documented research when planning new spaces. This seems like a clear and well articulated mission, yet some practitioners have been reluctant to share project information with InformeDesign.

The difficulty in getting designers to share data and become analysts of this data may lie in the perception that these tasks are not creative or the feeling that the time used toward such activities is not billable. My former NCIDQ board colleague, Ernest Rhoads, an interior designer at MultiCare Health System, told me, “Interior designers are not trained to appreciate the benefits of work done by other designers. The fear of sharing one’s own innovations, and possibly losing one’s market-edge, takes precedence over the perceived benefits of not having to reinvent the wheel. The time to document and capture data about projects is another roadblock. The common notion is that billable hours need to be spent generating creative output and tangibles the client can see and directly benefit from in the short term. Who in the end will pay for the time it takes to comprehensively capture research-based information?”

Rhoads believes that the healthcare industry has achieved cooperation and collaboration among peers with electronic health record implementation because of the sophisticated platforms used for the collection and distribution of data. Many years and millions of dollars have been poured into automated systems that share best practices and can slice-and-dice data into useful reports. No such platform exists for the interior design environment. Rhoads suggests that there could be an industry-wide agreement that establishes templates to collect research and outcomes in a consistent manner.

Our challenge as building and construction professionals is to restructure our thinking by promoting a culture that believes in widely sharing design data, and training practitioners to analyze that data. The adoption of InformeDesign and other research-based tools as a requirement in design work may be a step in the right direction. But the profession needs an agreement, as my colleague suggested, that design professionals will take the time, and perceived risk, to share outcomes and post-occupancy evaluations in a controlled, systematic and measurable manner.

James L. Brothers is building director for the city of Decatur, AL. In addition to serving as the public member on the NCIDQ board, he is a member of the board of directors of the International Code Council. Brothers also serves on the state of Alabama Residential Energy Code Board and the U.S. Fire Administration’s Public/Private Fire Safety Council. More information about NCIDQ is available at www.ncidq.org.

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