Which Values Should Guide Health Care Organizations' Retrofit Expenditures on Patient-Centered and Evidence-Based Design?

When built environments in health care result from an evidence-based design (EBD) process, they are interventions that can improve patients' health outcomes. This commentary on a case discusses which ethical values should guide organizations' capital expenditure decisions about retrofits, which might be more costly than the original budget. This discussion urges reevaluation of the common assumption that capital improvements are "sunk costs," since such improvements can promote long-term positive health outcomes for an organization's patients, thereby advancing both financial value and ethical values. This commentary also suggests that EBD offers key interventions that are clinically and ethically relevant.