The Canadian Standards Association, or CSA, is a not-for-profit organization that develops standards for a wide variety of sectors including Business & Quality Management, Mechanical & Industrial Equipment, and Environment & Carbon Management.
In September 2011, CSA published the first Canadian Standard for Health Care Facilities, known as CSA Z8000. This standard is being applied in the Stanton Renewal Initiative.
The following excerpts from the introductory sections of the Z8000 manual explain the purpose and intended use of the standard.
This Standard provides requirements and guidance for the planning, design, and construction of Canadian healthcare facilities. It is intended to be used by all facilities providing health care services regardless of type, size, location, or range of services. This Standard was developed for use by architects, engineers, planning and project managers, contractors and builders, commissioning teams, facility managers, maintenance managers, infection prevention and control personel, and other health care professionals.
The goal of this Standard is to ensure that the outcomes of those under the care of [a Health Care Facility] are improved where design and construction can assist with these outcomes. To achieve this requires a focus not only on safety and efficiency, but also on the impacts of the physical environment and atmosphere on the care outcome. Using the available knowledge in evidence-based design as outlined in this Standard, [Health Care Facilities] can create a physical environment that promotes positive health outcomes, quicker recovery, a reduction in medical errors, and the recruitment and retention of valued caregivers.
The Standard was developed (and will be periodically updated) based on current best practices. It focuses on safety, efficiency, quality care, inclusivity and accessibility, and the creation of a healing environment.
The first scientific research supporting the theory that the physical envirnoment influences healing is credited to Roger Ulrich. In 1984, Science Journal published Ulrich's study comparing the recovery of two groups of similar surgical patients. One group looked out their window at a view of trees; the other group looked at a brick wall. The tree-view patients took fewer and weaker pain medications, had fewer complications, and were discharged from hospital sooner.
Two decades later, Ulrich (in collaboration with Craig Zimring, Xiaobo Quan, Anjali Joseph, and Ruchi Choudhary) reviewed thousands of scientific articles and identified more than 600 quality studies showing that hospital design does impact clinical outcomes. The studies looked at a wide range of issues including single-roms versus multi-bed rooms, noise, lighting, ventilation, and layout, with results of reducing medical errors, reducing stress, improving patient sleep, reducing patient pain and the need for medications, as well as other improved outcomes.
As a result of th work of Ulrich and many others, "evidence based design" has become common in hospital planning - not only in areas such as efficiency and infection control, but also in terms of creating a healing physical environment. As one example, Section 6.2.15 of the Z8000 Standard states: The design of the [Health Care Facility] shall provide patients, staff, and the public with external views wherever possible.
Watch for more articles in the coming weeks about Z8000 and evidence based design.
