working model to help designers implement EBD decision-making. The primary goal is providing a healing environment; positive outcomes depend on three investments: Designed infrastructure, including the built environment and technology Re-engineered clinical and administrative practices to maximize infrastructure investment Leadership to maximize human and infrastructure investments All three investments depend on existing research. Strategies A white paper from the Center for Health Design identifies ten strategies to aid EBD decision-making: Start with problems. Identify the problems the project is trying to solve and for which the facility design plays an important role (for example, adding or upgrading technology, expanding services to meet growing market demand, replacing aging infrastructure) Use an integrated multidisciplinary approach with consistent senior involvement, ensuring that everyone with problem-solving tools is included. It is essential to stimulate synergy between different community to maximize efforts, outcomes and interchanges. Maintain a patient- and family-centered approach; patient and family experiences are key to defining aims and assessing outcomes. Focus on financial operations past the first-cost impact, exploring the cost-effectiveness of design options over time and considering multi-year investment returns. Apply disciplined participation and criteria management. These processes use decision-making tools such as SWOT analysis, analytic hierarchy processes and decision trees which may also be used in design (particularly of technical aspects such as structure, fire safety or energy use). Establish incentive-linked criteria to increase design-team motivation and involve end users with checklists, surveys and simulations. Use strategic partnerships to create new products with hospital-staff expertise and influence. Encourage simulation and testing, assuming the patient's perspective when making lighting and energy models and computer visualizations. Use a lifecycle perspective (30–50 years) from planning to product, exploring the lifecycle return on investment of design strategies for safety and workforce outcomes. Overcommunicate. Positive outcomes are connected with the involvement of clinical staff and community members with meetings, newsletters, webcams and other tools. Tools Evidence-based design has been applied to efficacy measurements of a building's design, and is usually done at the post-construction stage as a part of a post-occupancy evaluation (POE). The POE assesses strengths and weaknesses of design decisions in relation to human behaviour in a built environment. Issues include acoustics, odor control, vibration, lighting and user-friendliness, and are binary-choice (acceptable or unacceptable). Other research techniques, such as observation, photography, checklists, interviews, surveys and focus groups, supplement traditional design-research methods. Assessment tools have been developed by The Center for Health Design and