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									                      HERD VolumE 2, NumbER 3, pp 3-5 CopyRigHt ©2009 VENDomE gRoup, llC   Editor’s Column

Balancing Three Essential
Components of Evidence
Jaynelle F. Stichler, DNSc, RN, FACHE, FAAN

           espite widespread belief                                    to add that evidence-based practice
           that healthcare design                                      must consider patient values. With
           should be evidence-based,                                   this new consideration, evidence-
clarity regarding the concept of evi-                                  based practice in any discipline in-
dence is still elusive. Rosenberg, Muir                                cludes the interplay of three essential
Gray, Haynes, and Richardson’s                                         elements: (1) individual expertise;
(1996) classic definition of evidence-                                 (2) best available evidence; and (3)
based medicine is one of the most                                      the customer’s values. In this con-
widely quoted:                                                         text, customer could be defined as
     Evidence-based medicine is the                                    the patient in medicine or nursing,
                                           Jaynelle F. Stichler, DNSc,
     conscientious, explicit, and judi-        RN, FACHE, FAAN         but it could also be other stakehold-
     cious use of current best evidence in mak- ers in different disciplines, such as the owner, the
     ing decisions about the care of individual healthcare executive team, or the board of direc-
     patients. The practice of evidence-based tors in a healthcare design project.
     medicine means integrating individual clini-
     cal expertise with the best available external Although randomized controlled trials (RCTs),
     evidence from systematic research” (p. 71).           systematic reviews, and meta-analyses are the
                                                           gold standards of research evidence in design
This definition of evidence-based medicine has practice, the use of these audacious gold stan-
become the foundation for nearly all disciplines, dards is difficult to accomplish without years of
each making slight modifications to the word- rigorous research. Of course, when we do have
ing to individualize it to their specific discipline such evidence, we can translate these findings
and practice. Evidence-based design in health- into standards, protocols, practice guidelines,
care is no exception. What is less recognized is and other such policy to guide the practice of
that Sackett, Straus, Richardson, Rosenberg, and healthcare design. Evidence-based design is an
Haynes (2000) modified the original definition emerging science that is constantly building new

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