Key Points

  • EBD investments are often recouped in just a year or two, with operating benefits continuing for several years.
  • Financial boosts from EBD come in the form of reduced medication errors, decreased need for medication, and reduced staff injuries.
  • AHRQ (Agency for Healthcare Research and Quality) has supported the financial benefits of EBD investments for several years.
  • Recent changes in the healthcare landscape are the foundation for a strong business case for EBD.

Evidence-based design saves money. Every day, we see more research and examples of hospitals and long-term care facilities benefiting financially from their evidence-based design (EBD) investments.

Still, EBD is really misunderstood, and that usually has to do with cost. Lots of organizations execute on huge EBD initiatives, but plenty make small adjustments to improve their design environments for their patients and staff. When they do make big changes though, they’re likely to see return in the form of not just better patient experiences and outcomes, but also financial investments that are recouped in just a year or two.

How Evidence-Based Design Brings Great ROI to Healthcare Organizations

The benefits of evidence-based design aren’t a secret. As far back as 2010, Becker’s Hospital Review acknowledged the most common perks including:

Enhanced Patient Safety

Private rooms reduce infections and improve sleep. Encouraging family participation in a patient’s care through the use of “family zones” have even been found to reduce patient falls. Sound-absorbing ceiling tiles have even been found to lower blood pressure and heart rates as well as reduce (expensive) readmission rates.

Reduced Medical Errors

Outfitting rooms with small, locked cabinets makes medication administration more accurate, faster, and more efficient. Getting away from centralized medication storage has been found to yield significant decreases in costly ICU medication errors (up to 70%).

Decreased Need for Medication

EBD changes like natural light have led to drops in patient medication consumption as high as 21% in some facilities. Outdoor views are potent distractions from pain and help encourage positive emotions, decreasing the need for pain medication. A drop in medication use can lead to shorter hospital stays and maximized reimbursement. It also helps avoid both Medicare penalties and commercial payer denials.

Reduced Staff Injuries

Simple EBD changes like ceiling lifts can help reduce staff injuries and encourage a drop in the cost of claims and work days off. Some facilities have seen staff injuries almost completely disappear after installing patient lifts (which paid for themselves within two years).

Securing Reimbursement With Meals From a Rooftop Garden

Connecticut’s New Milford Hospital has taken evidence-based design to new levels by putting a twist on hospital gardens. This design feature opens the door to better food for both patients and staff. Vegetable dishes are picked from the garden the same day and compliment a healthful menu for their patients. According to Chef Kerry Gold, “Often, patients will be discharged, and will ask if they can stay for lunch.”

In the age of HCAHPS surveys that can impact reimbursement as well as market share, making efforts to boost patient satisfaction is never a mistake.

Avoiding HIPAA Penalties

If you’ve been following our monthly Physical Security Breach Roundups, you know that this type of breach is very common…and very costly.

Penalties for HIPAA violations can run from $100 to $50,000 per violation. As standards and technology for health information storage increase, facilities will have less room to claim they “didn’t know” that their laptops, flash drives, paper records, and other PHI weren’t properly stored. Here’s a refresher on what a HIPAA violation could cost your facility,

Violation category Penalty per violation All such violations of an identical provision in a calendar year
Did Not Know $100 – $50,000 $1,500,000
Reasonable Cause $1,000 – $50,000 $1,500,000
Willful Neglect—Corrected $10,000 – $50,000 $1,500,000
Willful Neglect—Not Corrected $50,000 $1,500,000

The way things are headed now, the ROI for investments in advanced storage and security will only increase. This post will get you started understanding the standards of physical safeguards you should be maintaining at your facility.

AHRQ’s Believes in the ROI of Evidence-Based Design

AHRQ (Agency for Healthcare Research and Quality) takes a positive stance on evidence-based design. According to their report, Transforming Hospitals: Designing for Safety and Qualityfeatures that added $12 million to hospital construction costs were projected to be recovered in one year—all through operational savings and increased revenue. The agency states that,

“Although designing an updated facility using evidence-based design principles may add up-front capital costs, this investment ultimately decreases medical and financial complications that can result from a poorly designed facility.

The Business Case for Evidence-Based Design

If your organization doesn’t fully understand the financial benefits of EBD yet, a strong business case that centers on ROI might be just what they need to see. Health Design has an example available, and here are some highlights,

  • The healthcare landscape is changing: From increasing costs, facilities coming to the end of their useful lives, and a quality and safety revolution that’s moving across the country, evidence-based design is quickly becoming a logical choice for most organizations.
  • Physical environments should be connected to safety and quality improvement: Safety and quality improvement aren’t just a clinical concern. Patient and staff work environments are an essential element in reducing multiple hospital-acquired conditions. For well over 10 years, research has supported the idea that the environment in which patients receive care and caregivers work has a quantifiable and measurable impact on them.
  • One-time capital costs can be balanced with ongoing operational savings: This was first analyzed in 2004 by a team that reviewed the experiences of healthcare organizations using EBD in various portions of their construction projects. When they analyzed the operating cost savings from EBD applications, they decided that the operating benefits would continue for several years.
  • Reimbursement is changing: Hospitals and other facilities now function in a pay for performance environment where many hospitals are getting away from charging for errors. Mandated reporting for patient experiences is also becoming more common.

Evidence-based design is a fact of not just the hospital of the future, but today. To learn about the basics of EBD in healthcare, check out our introduction to evidence-based design here.