Evidence shows that changes in the architecture, design, and decor of health care facilities can improve patient care and in the long run reduce expenses. These essays detail the state of the research, look inside two hospitals that put some of these innovations into practice, and consider how design fits into the moral mission ofhealth care.

While 90 percent of participants in a 2005 Gallup poll indicated that they would donate an organ if asked, only 40 percent of Americans have registered to do so, according to 2012 data from Donate Life America; likely even fewer have shared their donation wishes with loved ones. Undoubtedly, the single biggest reason for the discrepancy between the number of potential transplants and the number actually performed is our failure to talk with loved ones about our wishes regarding organ donation. (...) Although many resources already exist to hold these conversations, we can do more, and the emergence of social media provides an intriguing new opportunity. Two years ago, Organize.org set out to create the first nationwide organ donation registry in the United States. (shrink)

Fifty years ago this summer, the Uniform Anatomical Gift Act was adopted by the National Conference of Commissioners on Uniform State Laws and approved by the American Bar Association. The UAGA has provided a sound and stable legal platform on which to base an effective nationwide organ donation system. The cardinal principles of altruism, autonomy, and public trust are still important. At a time when confidence and trust in our government and many private institutions has declined, maintaining trust and confidence (...) in our health care system and its commitment to “first, do no harm” has never been more important. Any policies that override these core ethical principles could cause irreparable damage to the public's faith in our transplant system. While progress has been made to increase organ registration and the number of organs transplanted, much more must be done to realize the potential of life‐saving therapy without jeopardizing ethical principles. (shrink)

Ten years ago, when I was president and chief executive officer of Rady Children's Hospital in San Diego, if you had asked me about our commitment to environmental sustainability or about the hospital's carbon footprint, I would have given you a blank look. The issues were simply not on my radar screen. And that was true of most health care leaders.The good news? Environmental sustainability is becoming a health care priority, and exciting progress is occurring. In Greening Health Care: How (...) Hospitals Can Heal the Planet, Kathy Gerwig eloquently relates how one leading large health care system, Kaiser Permanente, achieved remarkable results in responding to the environmental health challenge over the past several years. (shrink)