Sustainable design and evidence-based design are each unique design approaches significantly impacting healthcare architecture today (Shepley, Baum, Ginsberg, & Rostenberg, in press). Sustainable design promotes buildings that improve ecological health and indoor environmental quality, while evidence-based design advocates healthcare facilities which enable positive health outcomes through the application of best practice strategies informed by research and practical knowledge (Hamilton, 2003). Although each movement directly impacts current healthcare architecture (Klein, 2007), each is often implemented in isolation of the other, and some even consider these philosophies to be in conflict with one another (e.g. Harvie, 2006; Teske & Mann, 2007).

For example, how frequently do sustainable goals of reduced water consumption conflict with evidence based design goals of increasing hand washing compliance? Does the use of HEPA or laminar air flow devices (installed to improve infection control) compromise the energy-consumption efficiency of building-wide air-handling systems? Are many finishes and materials which are well suited to controlling the spread of infection, actually hazardous and toxic to the environment? And perhaps most significantly, does a building footprint that introduces natural daylight into technologically complex healthcare environments (such as surgery, radiology and procedural medicine suites) inherently increase travel distances, compromise desired clinical adjacencies and complicate opportunities for future flexibility and incremental adoption of changes in medical technology and operations?