The Case for Evidence-Based Design
By Mark Goldman, M.Arch., Dita Peatross, Ph.D.Arch. (03/05/2009)

Goldman

Peatross

Evidence-based design, a relatively new trend in the field of planning and design, first surfaced in the healthcare industry when practitioners and researchers began studying the impact of design on clinical outcomes.

The principle holds that the physical environment impacts human behavior, both beneficially and negatively. The process, which seeks to optimize the role of building design in achieving improved outcomes, relies on analysis of hard data from research studies and the collective experience-based opinions of researchers and practitioners in the field.

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The organization’s key values and goals must be analyzed, along with how the physical environment can enable those goals. The objective is to allow evidence from research and practice to guide planning and design decisions, assist in paradigm busting, and reduce or justify construction and operating costs.

Research Findings

A Center for Health Design review of 1,000 studies pointed to the remarkable impact of various design decisions and improved outcomes primarily in the healthcare and mental health fields. Data strongly suggests the implementation of certain design and operational features was associated with reductions in skyrocketing medical errors, improved staff recruitment and retention and a higher return on investment.

Although, design decisions that fit the healthcare field are not easily tailored directly to the corrections market, given that an ever-increasing proportion of the inmate population has mental health and physical health issues, it would seem useful to draw reasoned inferences between outcomes in the former and potential applicability in the latter. 

The incentive is all the greater when one considers factors such as the enormous cost of building and operating correctional facilities amid an environment of increasing financial pressures and budgetary constraints. Difficulties in realizing improved behaviors, reduced costs or lower recidivism rates should also incentivize exploration of EBD.

Cells vs. Dormitories

Existing EBD research on medical and mental healthcare settings makes a solid case for single, and sometimes double rooms, suggesting large dormitories can be damaging to physical and mental health.

The National Commission on Correctional Health Care states that mentally and physically ill or challenged inmates should not be housed in large dormitories and dormitories should not feel crowded. The NCCHC also suggests that where multi-occupancy rooms are unavoidable, each sleeping area should be surrounded with low walls.

Single-occupancy rooms can promote lower sound levels, which improve communications, decrease staff errors, help control blood pressure, and decrease staff exhaustion and burnout, according to a 2007 study for the Center for Health Design.

Single occupancy, also helps minimize intimidations and assaults, resulting in lower levels of stress that promote physical and mental health healing. Single and other nondormitory-style rooms enhance privacy and autonomy, and encourage participation in treatment activities, thereby enhancing well-being and recovery.

Comprehensive studies of crowding suggest that inmates in two-person cells feel more stressed than those in one-person cells, and inmates in dormitories are most stressed. Sharing cells and sleeping rooms results in more unexpected and unwanted interactions. Increasing the number of inmates per room generally worsens perceptions of crowding and lack of control, stress, sick calls, suicide attempts and reported incidents. These conclusions hold true for all security levels, lengths of stay and ethnic groups. 

However, the negative consequences of dormitories can be mitigated by sizable partitions that create some personal space, according to a 2002 study of the psychological effects of prison architecture.

There are also significant factors that support dormitories, including lower construction costs and better staff visibility. Another argument is that multi-occupancy rooms can be built using smaller floor plates that decrease the amount of walking for staff, reducing stress and fatigue.
Open dormitories may also facilitate staff teamwork, since more visibility is possible.

Environment and Behavior

Research literature is abundant on what constitutes therapeutic environments that improve the health, well-being and behaviors of the physically and mentally ill. Again, many of these findings can be readily applied to inmate settings. Studies suggest the most supportive settings are:

Direct supervision in correctional and detention housing units has led to a reduction in assaults and other serious incidents, according to recent studies.

The research attributes the results to improved communications and management that accrue from the lack of physical barriers between staff and inmates. A recent review of more than 30 years of anecdotal reports and research studies indicated that direct supervision was consistently superior in reducing tensions, incidents and assaults among inmates and between inmates and staff. 

Improved inmate behavior in direct supervision housing units has also been attributed to environmental factors, such as abundant natural lighting, outside views, darkness at night and relative quiet.

Staff presence within the unit adds to inmates’ perception of safety. Darkness and quiet, and feelings of safety, are especially important for sleep. Undisturbed sleep can reduce irritability, which can in turn reduce violence, lengthen attention spans and foster improved performance on problem-solving tasks, according to research studies.

Staff Performance, Retention

As might be expected, many of the previously noted design attributes that promote improved inmate behaviors are also beneficial for staff well-being, morale and job performance.

In addition to overall noise reduction through sound-absorbent finishes, the installation of softer floors, ergonomic work areas and proper ventilation can reduce staff fatigue and work-related injuries.

Poorly designed facilities reduce staff effectiveness and productivity, decrease operational efficiency and increase operational costs.

More pleasant and attractive environments with good visual access between inmates and staff, and smaller units that bring staff and inmates closer together reduce walk time and fatigue, and increase time spent performing tasks and staff-inmate communications. Increasing the types of spaces for flexible and interactive teamwork and visual connections also improves staff communication and effectiveness.

In contrast, low light levels, inadequate and inappropriate workstations, and noisy, chaotic environments with no respite from frequent distractions and interruptions, can dramatically reduce staff satisfaction and morale. Providing places of respite where staff can recharge helps recruitment and retention.

Means to an End

To achieve the full benefits of EBD, one must be conscious of how the physical environment that we live and work in everyday can help or hinder our behaviors.

EBD calls for project teams to identify desired outcomes from the outset of the process and then to explore how the built environment can work with technology, policies and procedures, activities, business processes and culture to effect optimal change.

Once goals are clarified, evidence from various environments should be collected, documented, interpreted and applied. Documentation or publication of findings spreads the word, which potentially can positively impact scores of other facilities.

Adoption of EBD often requires a culture change and the re-evaluation of entrenched values and set operational practices. It requires that those involved think outside the box to the future and how to apply available knowledge from and beyond corrections to new correctional facilities.

Mark Goldman is principal at Atlanta-based criminal justice planning services and facility evaluation firm Mark Goldman & Associates. Dita Peatross is a senior planner in the Atlanta office of Gleeds, an international management, design and construction consultant.

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