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Healthcare organization performance is a function of many variables. This study measured relationships among culture, the built environment, and outcome variables in a healthcare provider organization. A culture survey composed of existing scales and custom scales was used as the principal measurement instrument. Results supported culture strength’s links with higher performance levels and identified the built environment’s role as a moderating variable that can lead to improved processes and outcomes. Job satisfaction and patient satisfaction were found to be significantly and positively correlated with culture strength and with ratings of the built environment.

This paper aims to identify costs related to dementia care provision and explore how purpose-built environment investments can help control these costs and improve quality of life and clinical outcomes.

This research adopts a multi-method approach where the findings of a literature review drove the analysis of data obtained from the 115 pilot projects funded by the Department of Health England’s National Dementia Capital Investment Programme.

Under the UK Government’s new productivity challenge, it is fundamental to identify actions that provide value for money to prioritise policy and practice. This paper identifies healthcare spaces (e.g. bathroom) where the impact of the built environment on healthcare costs are most evident and building elements (e.g. lighting) to which these costs can be directly associated. The paper advocates the development of evidence and decision support tools capable of: linking built environment interventions to the healthcare costs; and helping the healthcare and social care sectors to develop effective and efficient capital investment strategies.

Further work needs to develop more systematic ways of rationalising proactive and timely built environment interventions capable of mitigating dementia (and older people) care cost escalation.

This research takes an innovative view on capital investment for care environments and suggests that appropriate built environment interventions can have a profound impact on costs associated with dementia care provision.

The ageing of rural Chinese populations is challenging health and social policy, driving growth in rural nursing homes. Living environment plays a role in enhancing elderly quality of life (QoL), however, the impact of the built environment and care services are under-studied. The purpose of this paper is to investigate the influence of the built environment and care services on the QoL of elderly people within rural nursing homes in China.

A total of 242 residents of nursing home were surveyed, of which 76 percent were male and 24 percent were female. In total, 25.6 percent were aged between 60 and 69, 40.1 percent between 70 and 79, 31 percent between 80 and 89, and 3.3 percent were 90 or above. Quantitative data were analyzed through factor analysis, reliability test and multiple regression modeling.

The authors identified six built environment factors (room distance, space, barrier-free design, indoor environment, fire safety, and support facilities) and three services factors (i.e. daily care services, cleaning services, and healthcare services). QoL was measured over four dimensions: QoL, physical health, psychological health, and social relationships. Elderly QoL could be accurately predicted from room distance, space, barrier-free design, indoor environment, daily care services, and cleaning services.

Interventions in design of the built environment and the provision of care services are proposed, including dimensions of living space, heating, and provisions for qualified care providers.

This paper provides a clear picture about elderly special requirements on their built environment and healthcare services, helping architects, engineers and facilities managers understand elderly needs and improve built environment during design and operation stages.

A substantial amount of research argues that built environmental interventions can improve the outcomes of patients and other users of healthcare facilities, supporting the concept of evidence-based design (EBD). However, the sources of such evidence and its flow into healthcare design are less well understood. This paper aims to provide insights to both the sources and flow of EBD used in three healthcare projects, to reveal practicalities of use and the relationships between them in practice.

Three healthcare case study projects provided empirical data on the design of a number of different elements. Inductive thematic analysis was used to identify the source and flow of evidence used in this design, which was subsequently quantised to reveal the dominant patterns therein.

Healthcare design teams use evidence from various sources, the knowledge and experience of the members of the design team being the most common due to both ease of access and thus flow. Practice-based research and peer-reviewed published research flow both directly and indirectly into the design process, whilst collaborations with researchers and research institutions nurture the credibility of the latter.

The findings can be used to enhance activities that aim to design, conduct and disseminate future EBD research to improve their flow to healthcare designers.

This research contributes to understandings of EBD by exploring the flow of research from various sources in conflation and within real-life environments.

The re-use of good design solutions is a key source of evidence and knowledge in the design of healthcare buildings. However, due to the unique nature of healthcare built environments, the critical application of this evidence is of paramount importance. The purpose of this paper is to investigate the features of such critical application and identify the aspects that need to be considered during the re-use of good designs.

Data from three case studies of hospital designs in the UK were used to explore the processes behind the adaption and re-use of design solutions during the design of healthcare buildings. Data were thematically analysed to distinguish the aspects that should be carefully compared and contrasted during design re-use.

Existing designs of healthcare buildings should be captured and evaluated along with: patient demographics, care models of the hospital, other local departmental needs and facility operational aspects in order to ensure the effectiveness of re-use. In addition, properly introducing the design to the users is also a part of successful design re-use.

The findings of this research were integrated into a framework to support healthcare designers on the effective re-use of good designs. This data-driven framework could be validated further with design practitioners. Further, this research relied on memory recall of the interviewees and the accuracy and completeness of documentary records.

This research provides details of how healthcare built environment designs are embedded in project-unique circumstances. The results could therefore be used to develop meaningful and informative evaluation mechanisms for new and re-used healthcare building design features.

This research extends the understanding of the critical application of healthcare design evidence, by explaining how healthcare design solutions should be evaluated during the design process.

Several healthcare quality assessment tools measure the processes and outcomes of the care system. The actual physical infrastructure (buildings and organizational) aspects are, however, rarely considered. The purpose of this paper is to describe the process of validation and weighting of an evidence-informed framework for the quality assessment of hospital facilities from social, environmental and organizational perspectives to complement other assessments.

Sustainable High-quality Healthcare version 2 (SustHealth v2) is the updated version of an existing framework composed of three domains (social, environmental and organizational quality). To validate and establish a relevant weighting, interviews were conducted with 15 professionals within the field of healthcare planning, design, research and management. The study has been conducted through semi-structured interviews and the application of the Simon Roy Figueras (SRF) procedure for the elicitation of weights criteria. The data collected have been processed through the DecSpace web platform.

Among the three domains, the organizational qualities appear to be the most important (W = 49%), followed by the environmental (W = 29%) and social aspects (W = 22%). Relevant indicators such as future-proofing, wayfinding and users’ space control emerged as the most important within each macro-area. Those results are confirmed by the outcome of the interviews that highlight user/patient-centeredness, wayfinding strategies and space functionality as the most important concepts to foster in existing healthcare facilities improvement.

The study highlights important structural and organizational aspects that hospital managers and planners can consider when dealing with healthcare facilities’ quality improvement.

The use of the SRF multicriteria method is novel in this context when used to weight an assessment tool with a focus on hospital built environment.

The purpose of this paper is to present a conceptual framework that categorises the features and characteristics of the built environment that impact on health outcomes.

An extensive literature review was carried out. A total of 1,163 abstracts were assessed, leading to 92 papers being reviewed.

There is a considerable amount of evidence linking healthcare environments to patients' health outcomes, despite the lack of clarity in relation to cause‐effect relationships.

The paper proposes a theoretical framework linking different built environment characteristics to health outcomes. This framework provides a structure to group causal effects according to their relation with design features, materials and ambient properties, art and aesthetic aspects and use of the built environment.

The research outlined in this paper highlights the importance of certain factors related to primary health care buildings’ physical environment, such as the facility size, the functional efficiency, and the health planning of public areas in the health centers to improve the architectural space of health facilities.

This study was performed using a mixed method. Data collection was carried out through observational research and descriptive analysis in six primary health care facilities in Salvador and Lauro de Freitas, Brazil.

Based on this study’s results, facility capacity, functional efficiency and space accessibility have been considered the facilities’ main problems in the investigated context. The impact of the users’ perspective on healthcare facilities was assessed for each of these three criteria to verify the results obtained. Furthermore, most of the parameters were not satisfied, as the buildings analyzed had defects in their physical environment. Therefore, it is necessary to review and pay more attention to the architecture of these cities’ primary health care units.

The present study addresses the architectural environment design in Brazil’s healthcare facilities, which still have gaps. Improving the physical space of a health center ensures that the approach used in this research also applies to other health centers in similar contexts. The awareness that space’s activities and configurations will change according to each territory examined will open up so many investigation worlds.

This study aimed at the identification of perceptional environment properties in hospital public spaces that can affect salutogenic components and patients' overall satisfaction and suggested a conceptual framework.

A systematic review focused on specific steps to clarify the impact of public spaces' environmental quality on patients' satisfaction through the salutogenic approach. Searches were conducted in five databases and four scientific journals.

Five perceptional environment components of hospital public spaces: physical–psychological comfort, visibility, accessibility, legibility and relationability can be related to three indicators of salutogenic approach: manageability, perception and meaning and can be evaluated in patients' overall satisfaction: desire to use hospital again, to recommend the hospital to others, to prefer hospital to other healthcare environments and to trust in the hospital.

Despite studies on healthcare environments, there is a lack of research on the salutogenic approach in hospital public spaces. Therefore, this paper focuses on the environmental quality in public spaces as an influence on patients' satisfaction with the salutogenic perspective to create a health-promoting environment.