Research Methods for Design Practitioners to Evaluate Facilities

Because of the breadth of the topic of evaluation research methods, this discussion focuses on practitioner-focused facility evaluation (PFE). Evaluating the success of facilities is the most common type of study conducted by practitioners in the fi eld of health design research. Th ere are a variety of reasons for this: fi rst, evaluation is inherent in the culture and education of designers and healthcare providers; second, most evaluations are a form of applied research that can readily inform the design process; and third, conducting evaluations promotes additional client interaction.Types of StudiesTh e methods for conducting facility evaluations are as diverse as the universe of all research methods, because the assessment of an environment can be achieved in a variety of ways. Some of the more common techniques include surveys, interviews, and behavior mapping. Th e frequency with which these techniques are used is likely a result of their perceived user-friendliness, a critical issue because many evaluations are done by nonresearcher design practitioners. In actuality, the development of a good survey tool, interview structure, or behavior mapping protocol requires a vast repertoire of experience. Other common techniques such as physiological measures, medical record analysis (e.g., length of stay), and physical environmental calibrations (e.g., light levels and noise) are very useful as well. Th ese techniques are logistically more challenging because of their invasiveness, the need to collaborate with medical personnel on site, and the need for specialized equipment, respectively.Apart from the specifi c methodology associated with a study, evaluations can be divided into several types, including* Triangulated studies, which involve multiple methodologies addressing shared hypotheses;* Large survey studies, which involve in-depth study of a particular project;* Multiple site studies, which compare two or more projects using the same tools; and* Pre/post-evaluation studies, which are conducted in the facility in which the client currently resides and are followed by an evaluation after the new building is constructed (Shepley, 2011).Most studies are hybrids of these approaches. For example, a study involving the use of survey and interview techniques could be conducted prior to and after construction and therefore could be both a triangulated and a pre/post evaluation.I am unable to estimate the distribution of studies using these methodologies, or to project the frequency of the building types with which they are associated, because only a small percentage of evaluations is presented or published. Th e preponderance of published healthcare facility evaluations that appear in print fall into one of four categories: (1) facilities for seniors (Bakos, 1980; Heath & Giff ord, 2001; Preiser, Rabinowitz, & White, 1988); (2) gardens (Cooper-Marcus & Barnes, 1995; Heath & Giff ord, 2001; Sherman, Varni, Ulrich, & Malcarne, 2005; Whitehouse et al., 2001); (3) pediatric hospitals (Brown, Wright, & Brown, 1997; Canter, 1972. Shepley, 1995; Sherman et al., 2005; Whitehouse et al., 2001); and (4) intensive care (Shepley, 2002; Shepley & Boerger, 2006). Other topics include the evaluation of clinics (Kantrowitz, 1993; Verderber & Refuerzo, 1999); AIDS/palliative care (Shepley, 1999; Shepley & Davies, 2003; Stevenson & Humphries, 2009); women's facilities (Shepley, Bryant, & Frohman, 1995); patient room design (Wang & Kou, 2009); and facilities for the developmentally challenged (Zimring, Weitzer, & Knight, 1982).IRB IssuesAs with all types of research, it is necessary to get institutional review board (IRB) approval before beginning an evaluation study. Although PFEs are sometimes considered to be exempt from this requirement, this must be determined by specifi c hospital IRBs. Evaluations involving staff response, in particular, are more often exempt, because they do not involve a vulnerable or frail subject population (such as patients, pregnant women, the mentally disabled, and children), and because they do not involve personal questions (such as frequency of drug use). …