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KI In The News

KI's Deborah Breunig and Evidenced-Based Design

OfficeInsight | September 2013

Deborah Breunig is the Vice President of Healthcare at KI. She is a registered nurse with a MBA and is EDAC certified. EDAC (Evidence-based design accreditation and certification) is a certification for professionals in the healthcare industry achieved through an appropriate examination. The certification is done through the combined efforts of The Center For Health Design and Castle Worldwide, an independent third-party, which administers the test (
Much to our embarrassment, our review of healthcare products at NeoCon 2011 did not include KI, which has been a long-time prominent player in this area. Perhaps our attention was inappropriately taken by the new, as is so often the case, when we all know that often what has been available for many years sometimes provides the best solutions for the latest circumstances. This is not to suggest that KI is not neck-and-neck with developments in this area. It is as aggressively forward looking as any of the players. 

All of this is to say that we welcomed the opportunity to get additional insight from Ms. Breunig about KI's perspective on the healthcare field, which appears to be leading the interior design profession into a new day in which designers will be required have a very good handle on the outcomes that can be expected from their efforts and their client's investments. 

OI: What is your take on evidenced-based design?
DB:  Let's begin with defining Evidence-Based Design (EBD). EBD is the process of basing decisions about the built environment on credible research with the objective of achieving the best outcomes, given the state of current knowledge. 

Currently, there are about 1000 professionals with EDAC certification. Healthcare has unique evironments, terminology and experiences that have resulted in some well-developed practices, including evidence-based medicine and evidence-based nursing. The process of evidence-based design follows in their path. 

Evidence-based design has been an evolving process, supported by The Center for Health Design ("CHD"), which has been providing information and research for about 20 years. As such, it is a great resource for publications and research supporting evidence-based design. 

For KI healthcare, one of our deliverables to the A&D community and our clients is our supporting contributions to the development of research and resources. 

OI: It appears, then, that the Enlightenment has come to some areas of the interior design profession.
DB:  Very much so, and this approach is evolving rapidly, precisely because there are many years of experience to build on. One of the reasons why healthcare design is on the cutting edge of this approach is because healthcare clients are scientifically minded and expect and support research-based approaches to design. 

There are many forms of "so-called" research in the interiors field, including focus groups, surveys and the like, but science-based practitioners, whether physicians, nurses or other healthcare professionals, expect recommendations to be supported by quantifiable results and hard data. 

For example, if one were to recommend placing a sleepover product in a patient room, the C-Suite, the staff will want to justify this expense and real estate allocation and will require designers and other vendors to provide data supporting a positive outcome for this outlay. As our evidence-based results database grows, we are able to show the outcome for various types of actions, which may include shortened length of stay, increased patient satisfaction, improved family experience and so forth. 

OI: Given the fairly recent adoption of the evidence-based approach, solid precedents must be relatively meager. This suggests that much what you are doing is somewhat experimental in order to establish what works and what doesn't.
DB:  Correct. And if you look at the steps of an evidence-based design process and its four different levels, the first is to keep abreast of the literature and shape and guide your design with those findings. At the other end of the spectrum, the database of predictive studies is continuously expanding. However, as with all exploration, we apply existing learning to new but related situations, followed by the gathering of new performance measures post occupancy and we learn what works and what doesn't. 

As you can see, evidence-based practice is a continuous multi-pronged approach that many firms have embraced for years. At the recent Healthcare Design Conference, there was an opportunity to hear firsthand the current practices supporting evidence-based design and how the industry can continue to build upon it and implement it in our practices. 

OI: Can you give me a feel for how widely accepted Evidenced-based Design is among healthcare designers?
DB:  Very widely accepted. We have a number of opportunities to collaborate with major healthcare design firms on research related to the environment and the impact furnishings have on that  experience. A design firm developing a specification for a client may integrate findings from research that they found desirable and applicable to their client's needs into the specification. We as a manufacturer welcome that input and we are very capable of responding with appropriate solutions. All of this represents various forms of progress - some small, some very significant - based upon experience. 

OI: What is KI's contribution to evidence-based design and healthcare?
DB:  KI has been committed to the healthcare market for many years. At KI, our mission is to continue to support the overall healthcare experience. Although furniture may be a small aspect of this overall experience, it has several important touch-points that contribute to overall satisfaction and performance with everyone within a facility: staff, patients and family. 

We have an equal foothold in the areas that affect all of those populations. As we move forward in the design and development of new furniture collections, we take into account the perspective of each user group. We have a designated development team for healthcare products, as well as existing healthcare products. The team ensures that the practices and recommendations necessary to support evidencebased design principles are integrated into our product offerings. The end users and designers demand this, and often require that we review with them our understanding and demonstrate our support in evidence-based design. 

OI: I believe our readers are generally familiar with KI products and its position in the various markets, but what is KI doing to support Evidencebased Design and how does that fit into your going to market and your product and how you do business?
DB:  Through our existing and new product development, we ensure that all aspects of product design support positive outcomes and support the current research. Examples include patient safety, ease of ingress and egress, staff safety in assisting patients to reduce the risk of injury and ease of mobility. In addition, our products support family members who must stay in the patient room by providing sleepover solutions and infection control requirements. There are many factors that research and studies indicate must be taken into account within the healthcare setting. 

A general consideration is "How do we support the safety and efficiency of a healthcare environment" and support the facility in receiving positive outcomes. 

The important factor is that we don't design in a vacuum. We bring in the voice of the customer, the architect and the designer, as well as the patient and their family. We want to ensure that all users have a voice in determining the final products. 

OI: How does KI work with The Center for Health Design?
DB:  We support the CHD as a Corporate Member. Through that relationship we look for opportunities to collaborate with other members on related topics to continue to grow the body of research. As this market evolves, we will continue to grow those relationships and collaborative ventures. 

OI: What particular areas or concerns would you want the name of KI to naturally come to mind as a possible resource or provider of unique solutions for healthcare?
DB:  One of our top differentiators is KI's ability to deliver customized products and solutions. With a great deal of vertical integration in its manufacturing, KI is unusually capable of producing customized products, particularly in the healthcare market. That goes handin-hand with the desire of healthcare facilities to develop their unique brands and differentiate themselves from others in the same market. Designers can ask KI to customize a standard product and know that we will be able to deliver. Sleepover products are one example (products that patient families use for rest during overnight stays). Patient rooms are divided into a patient zone, the staff zone and then the family zone. Because of these variables, KI's comprehensive healthcare product portfolio can provide the desired sleepover product based on the floor plan, the footprint and other factors. 

OI: How do you use your Genius wall into the healthcare setting?
DB:  Probably our best example of how we've integrated Genius wall successfully in a healthcare environment is at the University of Miami. They understand the benefits of this product and the value in eliminating the need for dry wall and the reduced disruption to clinical practices during installation. 

OI: Where is the Evidenced-based Design movement on its eventual growth curve?
DB:  It's very much in its infancy. By no means is there enough data available to make an informed decision on every topic. Funding obviously is one of the variables, but many design firms are embracing Evidence-based Design and working to develop archives of peer-reviewed research. We are moving to the next step and there will be more industry awareness and higher expectations as clients become aware of the potential impact on their bottom line. 

With more collaboration among the end user, the architect, the designers and manufacturers, a number of issues facing the healthcare industry will be addressed. Much remains to be done, but that will always be the case based on the ever-changing nature of these environments. 

As a result, we as a manufacturer need to work closely with design firms and end-users to find new areas for collaboration and for support of research. 

To learn how KI healthcare furniture creates a visual signature from the reception area to the patient room and everywhere in between, visit:

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