Nurse crosses her arms wearing a hair net, gloves, mask, and surgery gown while others operate in the background. Nurse crosses her arms wearing a hair net, gloves, mask, and surgery gown while others operate in the background.

Evidence Based Flooring Solutions

Achieving EBD Goals Through Flooring Selection

Flooring sets the stage for all healthcare activities, and its selection and specification can impact multiple health-related outcomes. Utilizing research from The Center for Health Design, these eight goals inform and support how performance characteristics of flooring materials can have an actionable impact on the health system’s revenue.

Source: Nanda, U., Malone, E., and Joseph, A. (2012). Achieving EBD Goals through Flooring Selection & Design. Concord, CA: The Center for Health Design.


Explore the Goals

Closeup of a person in blue pants and white shoes using a large mop on the floor. Closeup of a person in blue pants and white shoes using a large mop on the floor.

EBD Goal #1: Reduce slips, trips, and falls

Overall medical spending for fatal falls was estimated to be $754 million.


Source: https://www.ncbi.nim.nih.gov/pmc/articles/PMC6089380

Nurses in blue scrubs walk a patient in a bed down a hallway Nurses in blue scrubs walk a patient in a bed down a hallway

EBD Goal #2: Reduce patient and staff injuries associated with falls

The Centers for Medicare and Medicaid Services (CMS) no longer pay for any additional costs associated with "never events". Falls with injury are a serious reportable “never-event” and are non-reimbursable to the health system.

Source: Https://psnet.ahrq.gov
A nurse in blue scrubs and a doctor in a white coat talk in hospital hallway white other walk by A nurse in blue scrubs and a doctor in a white coat talk in hospital hallway white other walk by

EBD Goal #3: Reduce noise levels

In healthcare environments, evidence suggests that increased noise levels can have a measurable impact on both the patient and staff experience.


Source: Ulrich, R. S., Zimring, C., Zhu, X., DuBose, J., Seo, H. B., Choi, Y. S., ... & Joseph, A. (2008). A review of the research literature on evidence-based healthcare design. HERD: Health Environments Research & Design Journal, 1(3), 61-125.

 
Nurse wearing blue scrubs and hair in a ponytail holds her hand on her forehead and closes her eyes. Nurse wearing blue scrubs and hair in a ponytail holds her hand on her forehead and closes her eyes.

EBD Goal #4: Reduce staff fatigue

Nurse fatigue can have a profound impact on adverse patient outcomes such as patient mortality and medication errors, as well as individual adverse nurse outcomes including musculoskeletal injuries, emotional disorders and job burnout.


Source: Bae, S., & Fabry, D. (2014). Assessing the relationships between nurse work hours/overtime and nurse and patient outcomes: Systematic literature review. Nursing Outlook, 62(2), 138-156. Trinkoff, A. M., Johantgen, M., Storr, C. L., Gurses, A. P., Liang, Y., & Han, K. (2011). Nurses’ work schedule characteristics, nurse staffing, and patient mortality. Nursing Research, 60(1), 1-8. doi:10.1097/NNR.0b013e3181fff15d [doi]

Nurse in blue scrubs cleans a hospital bed with a rag and cleaning spray. Nurse in blue scrubs cleans a hospital bed with a rag and cleaning spray.

EBD Goal #5: Reduce surface contamination and potential risk of Healthcare-Associated Infections (HAI)

Products within the healing environment must support human health. The Advisory Board, a leading healthcare research group stated, “Suppliers who produce materials that passively fight infection without added antimicrobials have a high value.” In 2003 the CDC stated that no evidence is available to suggest that the use of products treated with antimicrobial chemicals will make patients healthier or prevent disease.
Little girl with braided hair wears a soccer uniform and sits in a hospital bed and talks to a nurse in white coat. Little girl with braided hair wears a soccer uniform and sits in a hospital bed and talks to a nurse in white coat.

EBD Goal #6: Improve Indoor Air Quality (IAQ)

Every day, patients and healthcare workers are exposed to an array of chemicals. Many of these chemicals have been shown to have a lasting negative impact on individual health and the environment.

Source: Health Care Without Harm – Healthy Flooring
A empty hospital with a bed, visitor chairs, and large windows with a city view. A empty hospital with a bed, visitor chairs, and large windows with a city view.

EBD Goal #7: Improve patient and family satisfaction

Flooring can substantially contribute to patient experience, safety and outcomes and is a critical capital investment decision for healthcare facilities.


Source: Harris, D. D., & Detke, L. A. (2013). The role of flooring as a design element affecting patient and healthcare worker safety. HERD: Health Environments Research & Design Journal, 6(3), 95-119.

Closeup of a machine cleaning a hospital floor Closeup of a machine cleaning a hospital floor

EBD Goal #8: Represent the best return on investment


It is crucial when making design decisions to evaluate a flooring material’s long-term cost-effectiveness in relation to its initial costs.

Source: Moussatche, H., & Languel, J. (2002). Life cycle costing of interior materials for Florida’s schools. Journal of Interior Design, 28(2), 37-49