Ongoing Research Initiatives

With your support, The Academy on Architecture for Health Foundation funded three research grants for the current research cycle. These studies will provide useful and pragmatic information related to ambulatory care work environments, to the integrated project delivery process, as well as international healthcare. We continue to look for opportunities to partner and fund research that will contribute to the healthcare design practice.

Research funded in 2019

  • OverviewImage Credit:
  • The Academy of Architecture for Health Foundation has awarded a $30,000 research grant to support the development and validation a research tool to measure nurses’ experience of inpatient care environments. The healthcare design community has long needed open-source, standardized measures that can be applied across firms, institutions and years. This study helps to fill that gap.This research will be led by an interdisciplinary team of researchers, clinicians and designers. Renae Rich, M.S., a research analyst at HDR, led the awarded proposal, and the core study team will include Francesqca Jimenez, M.S., a researcher at HDR, as well as a team of nurses from Methodist Hospital and Methodist Women’s Hospital in Omaha, Nebraska, led by Cheryl Bohacek, MSN, RN, OCN, oncology service leader at Methodist Hospital.“Current limitations in design research include a lack of valid measures that can provide direct feedback about the role of the built environment in producing desirable outcomes, and this work is addressing that gap in inpatient units,” Rich said.
  • “Nurses hold valuable information on the design of the environment to promote healing as well as a positive work environment,” Bohacek added.
  • “We believe that this research endeavor will not only inform our own processes in nursing practice and the delivery of healthcare services, but also contribute substantively to the field of healthcare design research,” said Teri Tipton Bruening, MSN, RN-BC, CNE, vice president and chief nursing officer at Methodist Hospital and Methodist Women’s Hospital. The study will initially draw upon data HDR has collected in several healthcare facilities over the past year and will include several subsequent phases of quantitative and qualitative data collection, analysis and refinement. Jeri Brittin, Ph.D., HDR’s director of research, noted that, “Renae has done an exceptional job of planning this work, and the resulting instrument will be published and made available for all in the industry to use. Consistent and valid measurement is critical to move the field of design research forward.” This grant would not be possible without the sponsorship of countless architects, healthcare designers, supporting firms, and industry partners. A special thanks goes to the Atreo Group and President, Harry Pliskin for their amazing support that allows these grants to be large enough to truly contribute to the advancement of the field.
  • More press on AAHFoundation Grant Awardees for Development and Validation of an Instrument to Measure Nurse Experience of the Inpatient Care Environment
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Research funded in 2018

  • AuthorsPrinciple Investigator:
    Shan Jiang, Ph.D. (West Virginia University)
    Davis Allison, FAIA, FACHA, Professor and Director (Clemson University
    Andrew Duchowski, Ph.D., Professor (Clemson University)
  • OverviewLarge hospitals are often complex and highly sophisticated environments due to their functional complexity and the way in which they evolve and grow over time. As a result, they typically present excessively institutional environments that can have negative effects on hospital occupants, such as wayfinding difficulties and spatial disorientation. As a core component of any healthcare facility, hospital circulation spaces remain neglected compared to the healthcare design and research in other domains conducted and reported to date. Visual engagement with nature, which has been proven therapeutic, has been hypothesized as playing the roles of wayfinding cues and facilitating spatial cognition in healthcare complexes. However, there is a paucity of empirical studies conducted on this topic, which has resulted in a significant knowledge gap.
    1. Hypothesis: Having visual access to nature from within hospital circulation spaces serve as identifiable and memorable landmarks and facilitate people’s spatial cognition and wayfinding performances in a diagnostic and treatment health care environment. The design of hospital circulation spaces with transparent connections and views to nature will be examined in relation to people’s spatial orientation and wayfinding performances compared to hospital corridors with no window views. People’s environmental experience of visual engagement with nature and the distribution of visual attention in hospital circulation spaces will be explored.

    This study will also examine Immersive Virtual Environment (IVE) technologies as complementary methods and tools in healthcare design research.In this exploratory, survey-embedded experimental study, 90 volunteers will complete various wayfinding tasks in fully immersive virtual hospital environments. Participants’ eye movements will be tracked and analyzed, and a series of variables will be measured to compare the time consumed to complete the tasks and the route selection. Participants’ navigation strategies will be interviewed through cognitive mapping. Participants will also take surveys to report their sense of direction.

    This study is meaningful and desirable from the greater emphasis on involving user participation in the caregiving and healing process. Study results will be translated to immediate design recommendations intended to help guide the layout of medical compartments, corridors, and courtyards in a complex hospital design, and provide alternative solutions to hospital wayfinding issues.

  • AuthorsPrinciple Investigator:
    Farhana Ferdous, PhD (Howard University)
  • OverviewThe relationship between the physical environment and prevalence of social interaction have been a core topic of inquiry in environmental gerontology. By 2050, it has been estimated that the world will number 2 billion older adults, aged ≥60 years. Among them around 25 million people worldwide have dementia, and the number of people with dementia is predicted to exceed 80 million by 2040. A growing body of literature in the areas of environment-behavior studies shows that the physical environment affects positive behavioral changes, in turn, affecting individual, group and organizational outcomes, but little research has focused on older adults especially those with cognitive impairment by examining the physical environment of care facilities.Based on previous research this study would like to explore in what level and how does the spatial configuration of the built environment in long-term care facilities (LTCF) could influence the physical activity and social interaction among the residents.  By using non-pharmacological interventions, the purpose of this study is to measure the physical environment by analyzing the spatial configuration and layout in long-term care facilities that are believed to initiate physical activities and positive social interaction among dementia residents, staff and use the findings to give evidence-based design guidelines for future research and design of memory care facilities to promote therapeutic experience for people experiencing early to moderate stage dementia. The results of this study will give evidence-based design guidelines that are generalizable regardless of geographic location of the LTCF and will provide designers about the effectiveness or the weaknesses of their design decisions. As an expected outcome, this study will be able to establish that by combining physical activity with social interaction, the environmental design could have a protective effect against dementia.
    This study will objectively measure the spatial configuration of LTCF to evaluate the provision of physical activities (among residents) and social interactions (among residents and staff) to promote a healthy living for people experiencing early to moderate stage. Use findings of the study to inform more robust, multi-level research analysis and evidence- based design guidelines by suggesting alternative spatial layout of the physical environment in LTCF and thereby aimed at improving the therapeutic experience for people experiencing early to moderate stage.