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Healthcare projects face multiple obstacles in achieving sustainability. This paper aims to provide information regarding the energy consumption of healthcare facilities, to identify barriers to sustainability and to suggest methods to improve the effectiveness of these buildings.

This study investigates sustainability in healthcare buildings by examining national databases about energy use and energy savings. The authors then initiate a dialogue on this topic by interviewing experts in healthcare planning and design regarding the implications of this data, challenges to sustainability and potential solutions to these challenges.

An analysis of data from the Energy Information Administration revealed that healthcare facilities rank second among building types in the USA in energy use per square foot and rank fourth in total energy use. Data from the US Green Building Council showed that only 1 per cent of healthcare buildings are registered with the Leadership in Energy and Environmental Design rating system, and 0.4 per cent have achieved certification, which is low compared with other building types.

Research and discussion must continue engaging all stakeholders to interpret the data and identify transformative solutions to facilitate sustainable healthcare design construction and operation.

It is important to approach sustainability in healthcare from social, economic, environmental and health-related perspectives. The authors identify five major barriers to sustainable healthcare design and construction and discuss 12 practical solutions.

Given the energy demands of healthcare buildings, facilitating their sustainability has the potential to make a significant difference in national energy use. Empirical research and evidence-based design can potentially help to accelerate sustainability by clarifying impacts and documenting the economic and operational returns on investment.

This paper explores how service design can contribute to the evolution of health service systems, moving them toward people-centered, integrated and technology-enabled care; the paper develops a research agenda to leverage service design research for healthcare transformation.

This conceptual study starts by analyzing healthcare challenges in terms of demographic trends and economic constraints, along with the problems of lack of people-centricity, dispersion of care and slowness in incorporating emerging technologies. Then, it examines the theoretical underpinnings of service design to develop a framework for exploring how a human-centered, transformative and service systems approach can contribute to addressing healthcare challenges, with illustrative cases of service design research in healthcare being given.

The proposed framework explores how a human-centered service design approach can leverage the potential of technology and advance healthcare systems toward people-centered care; how a transformative service design approach can go beyond explanatory research of healthcare phenomena to develop innovative solutions for healthcare change and wellbeing; and how a service systems perspective can address the complexity of healthcare systems, hence moving toward integrated care.

This paper systematizes and develops a framework for how service design can contribute to healthcare transformation. It identifies key healthcare application areas for future service design research and pathways for advancing service design in healthcare by using new interdisciplinary bridges, methodological developments and theoretical foundations.

This paper aims to focus on the involvement of mental healthcare professionals in a co-design process of a digital healthcare platform. Many people with severe mental disorders need constant support and monitoring, and with long waiting lists and scarce resources in mental healthcare, there is a dire need for innovative digital solutions to counteract those issues. This paper elaborates on a co-design process of a digital platform and mobile app designed for people with mental disorders. The platform primarily considers two perspectives: i) the patients and ii) the healthcare professionals.

This paper is based on canonical action research, where the co-design involvement with 13 healthcare professionals is analyzed and their interactions with three primary scenarios are focused.

The main contribution of this paper is three co-design principles: i) clarity and information accessibility regarding the patient's side, ii) efficiency and flexibility when it comes to the healthcare professional's side and iii) a notification function in the mobile application.

The theoretical contribution is the conceptualization of the three co-design principles that others can use when designing digital platforms in healthcare in general and psychiatric care in particular. The practical contributions are firstly outlined through the co-design process itself, where scenarios to guide the work are used, and secondly, the improvements made in the digital platform derived from the results of the co-design process.

The purpose of this paper is to explore and describe the perspectives and reasoning of senior development leaders in healthcare organizations, when reflecting on design as theory and practice in relation to more traditional methods and tools for improving quality and support innovation.

The paper is based on a qualitative interview design with five development and innovation leaders from separate healthcare regions in Sweden. They have, to varying degrees, applied design theory and practice for quality improvement and innovation in their organizations. The interview transcript was analysed using a content analysis together with an interpretive approach.

The major findings are to be found in the balancing act for leadership and organizations in healthcare when it comes to introducing and combining different theories and practices for improving quality and support innovation. The balance is between the change in power dynamics and pushing traditional boundaries in a complex healthcare world.

The narratives from the leaders' experience of applying design theory and practice for improving healthcare quality can help us create readiness and knowledge about how we prevent and/or facilitate planning and implementing design theories, practices, methods and tools in a healthcare context.

The study provides a unique insight when it captures and illustrates five different organizations' experiences when applying design for developing healthcare quality.

The study aims to explore how segmentation as a methodology can be adapted to the healthcare context to provide a more nuanced understanding of the served population and to facilitate the design of patient-centric services.

The study was based on a collaborative project with a national healthcare organization following the principles of action design research. The study describes the quantitative segmentation performed during the project, followed by a qualitative interview study of how segments correspond with patient behaviors in an actual healthcare setting, and service design workshops facilitated by segments. A number of design principles are outlined based on the learnings of the project.

The segmentation approach increased understanding of patient variability within the service provider organization and was considered an effective foundation for modular service design. Patient characteristics and life circumstances were related to specific patterns of health behaviors, such as avoidance or passivity, or a persistent proactivity. These patterns influenced the patients' preferred value co-creation role and what type of support patients sought from the care provider.

The proposed segmentation approach is immediately generalizable to further healthcare contexts and similar services: improved understanding of patients, vulnerable patients in particular, improves the fit and inclusivity of services.

The segmentation approach to service design was demonstrated to be effective in a large-scale context. The approach allows service providers to design service options that improve the fit with individual patients' needs for support and autonomy. The results illuminate how patient characteristics influence health and value co-creation behaviors.

This chapter integrates organization design and sustainability concepts to describe an accelerated transformational change at the Fairview Medical Group (United States).

A case study of the transformation at Fairview Medical Group’s primary care clinics was developed from interviews and first-person accounts of the change. Objective data regarding outcomes was used to evaluate the effectiveness of the redesign process.

The Fairview Medical Group developed an innovation and change capability to transform 35 primary care clinics in six months. All of the clinics were certified by the state of Minnesota as complying with their healthcare standards. Clinical outcomes, costs, and employee and physician engagement also increased. All of the improved measures are sustained.

Healthcare reform in the United States struggles because the organization design challenges are great and the change difficulties even greater. Fairview’s experience provides important evidence and lessons that can help advance our understanding of effective healthcare and create more sustainable healthcare systems. This chapter provides healthcare system administrators evidence and alternatives in the pursuit of implementation.

The purpose of this paper is to introduce and discuss potential applications of emerging Building Information Model (BIM) and related technologies as applied to healthcare facilities. The paper presents example of applications of digital tools enabled by BIM that support more integrated outcomes for complex healthcare projects.

Paper formulation by a transdisciplinary author group with ideas and approaches developed through discussions and writing to explore future research directions. Initial ideas are supplemented by a literature review with examples introduced where relevant.

BIM as a front-end construction engineering tool is quite mature. Application of BIM and related tools to support complex healthcare at the precinct scale, for facilities management (FM), including improved user experience (UX) has been limited but shows great promise to support complex healthcare projects.

The research presented is limited and exploratory as it represents the first step by this group to investigate an integrated approach to digital healthcare design and FM.

The paper introduces the considerable benefits of BIM models, and related tools for FM and/or UX (both staff and patients) to save time, money and improves efficiency and accuracy in healthcare facilities.

The transdisciplinary author group brought broad perspectives to the potential benefits of combining accurate data-rich legacy building models with other digital tools for increased integration and co-ordination at all life stages of a healthcare precinct.

The study aims to examine how features that foster a sense of control, create positive distractions and provide access to social support influence patients’ well-being and, subsequently, their likelihood to choose hotel-like hospital rooms and their willingness to pay higher out-of-pocket expenses for such rooms. While there is increasing evidence to suggest the importance of the provision of hospitality in healthcare settings, research on these developments remains under-represented, particularly in the hospitality literature. In response, the present study builds on Ulrich’s (1991) theory of supportive design to examine patient responses to hotel-like features in a hospital room.

Using data from a survey of 406 patients, the authors used structural equation modeling to test the model.

Consistent with supportive design principles, the infusion of hotel-like features that foster a sense of control for patients, create positive distractions and provide access to social support was found to positively impact patients’ physical and mental well-being, which, in turn, increased their likelihood to choose a hospital room with hotel-like features and their willingness to pay for such rooms.

Findings attest to the need for healthcare providers to make the necessary investment in hotel-like features and to leverage the communicative power of these environmental cues. Social support in the form of hospitality-trained and certified healthcare staff was found to be the most important hotel-like feature, which also presents significant commercial opportunities for hospitality companies and professionals.

The study represents one of the first attempts to empirically develop a structured model to examine the infusion of hospitality into healthcare. It provides researchers with a theoretically supported framework for future inquiry into the domain. It also makes a significant contribution to advancing the research on patient well-being in healthcare settings and demonstrates the importance of hospitality to such endeavors.

The purpose of this study is to create a knowledge base for decision-making in healthcare design by seeking, analyzing and discussing the preferences of facility managers of healthcare facilities regarding floor finishes and their selection criteria. The goal is to enable a simplified and holistic selection of floor finishes based on multiple criteria. The authors studied floor finish selection in three healthcare units: emergency, surgery and in-patient units.

The authors completed a literature review to identify types of floor finishes currently used in healthcare facilities and the criteria applied for their selection. Using the literature survey results, a questionnaire was designed and administered to healthcare facility managers. The descriptive statistical analysis and the Friedman and Wilcoxon signed-ranks tests were used for reporting and analyzing the survey data.

The top five floor finishes used in the healthcare sector were identified as vinyl flooring, vinyl composite tile (VCT), rubber, linoleum and ceramic flooring. The top five selection criteria for floor finishes were durability, infection control, ease of maintenance, maintenance cost and user safety. The non-parametric test results show that the floor finish rankings and selection criteria were similar in the three healthcare units under study.

The most significant contribution of this research is to the design decision-making process of healthcare facilities. These results offer an understanding of what floor finishes are preferred by healthcare facility managers and why. This knowledge is crucial for designers and facility managers to make informed choices and floor finish manufacturers to keep their product line relevant to the industry.

This paper proposes a method for managing client requirements with the use of Building Information Modelling (BIM). The development of healthcare projects demands a large amount of requirements information, in order to deal with a diversity of clients and frequents changes in healthcare services. The proposed method supports healthcare design by adopting a process-based approach for client requirements management, with the aim of improving value generation.

Design Science Research was the methodological approach adopted in this investigation. The main outcome of this study emerged from an empirical study carried out in a healthcare project in Brazil.

The proposed method involves three stages: (1) capturing and processing requirements; (2) product and requirements modelling, which involves the connection between requirements and the BIM 3-D model and (3) supporting design solution refinement, through the communication of requirements and the assessment of design in relation to updated client requirements information.

This study explores client requirements management from a process perspective, proposing activities and their interdependences and possible sources of data, including healthcare services information. The main theoretical contributions are related to the understanding of the nature and complexity of the information involved in client requirements management, and how this can be modelled.