Interstitial Building Space and its Relationship to Evidence Based Design
Healthcare facilities are dynamic, long-term investments that must be able to respond to change in order to avoid obsolescence. Flexibility is a response used in healthcare facility design and construction to counter uncertainties, such as changing medical technologies, medical science and regulations. Flexible infrastructure design offers healthcare facilities the opportunity to combat obsolescence stemming from uncertainties.
Interstitial Building Space (IBS) is one of many flexible infrastructure design options that assists with both mid-range and long-term flexibility. IBS is an unfinished and unoccupied horizontal space between a building's floors, fully accessible to people for the purpose of service and maintenance.
The advent of Evidence Based Design (EBD) introduced a new dimension to the already dynamic healthcare facility. "EBD represents a body of science that links elements of the built environment with patient, staff and resource outcomes" (Malone et al. 2007 p.5). The incorporation of EBD increases the complexity for the design and construction of healthcare facilities.
A framework was developed that articulates the dependent relationships between flexibility, IBS and EBD. The framework is comprised of three key elements: 1) a comprehensive "IBS Spectrum of Benefits" matrix resulting from a systematic literature review 2) a "Flexibility-EBD Conceptual Model" illustrating the relationship between flexibility and EBD, while identifying a continuum of flexibility enabled by this relationship; and 3) a "IBS-EBD Component Mapping Framework" articulating direct matches between the "IBS Spectrum of Benefits" and EBD components.
The framework and the key elements within provide a foundational resource for stakeholders and researchers alike, navigating the interrelated intricacies associated with flexibility, EBD and IBS.