title: Evaluating Intention and Effect: The Impact of Healthcare Facility Design on Patient and Staff Well-Being.
abstract: OBJECTIVE
  This post occupancy evaluation (POE) assessed the impact of architectural design on psychosocial well-being among patients and staff in the context of a new complex continuing care and rehabilitation facility.
  
  
  BACKGROUND
  Departing from typical POEs, the hospital design intentions formed the theoretical basis to assess outcomes. Intentions included creating an environment of wellness; enhancing connection to the community, the city, and nature; enhancing opportunities for social interaction; and inspiring activity.
  
  
  METHODS
  A pretest-posttest quasi experiment, including quantitative surveys, assessed the impact of the building design on well-being outcomes across three facilities-the new hospital, the former hospital, and a comparison facility with a similar population.
  
  
  RESULTS
  With the exception of connection to neighborhood (for patients) and opportunities to visit with others (for staff) and wayfinding (for patients and staff), impressions of the new hospital mirrored the design intentions relative to the former hospital and the comparison facility among patients and staff. Perceptions of improvement in mental health, self-efficacy in mobility, satisfaction, and interprofessional interactions were enhanced at the new hospital relative to the former hospital, whereas optimism, depressive symptoms, general well-being, burnout, and intention to quit did not vary. Interestingly, patients and staff with favorable impressions of the building design fared better on most well-being-related outcomes relative to those with less favorable impressions.
  
  
  CONCLUSIONS
  Beyond the value of assessing the impact of the design intentions on outcomes, the approach used in this study would benefit evaluation strategies across a diversity of health and other public and large-scale buildings.
authors.affiliation: CARE, Toronto, Ontario, Canada Department of Architectural Science, Ryerson University, Toronto, Ontario, Canada celeste@careconsulting.ca.
authors.forename: Celeste
authors.initials: C
authors.lastname: Alvaro
authors.affiliation: Bridgepoint Collaboratory for Research and Innovation, Toronto, Ontario, Canada.
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Wilkinson
authors.affiliation: Bridgepoint Collaboratory for Research and Innovation, Toronto, Ontario, Canada Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
authors.forename: Sara N
authors.initials: SN
authors.lastname: Gallant
authors.affiliation: Communications Strategist, Strongbow Strategies, Toronto, Ontario, Canada.
authors.forename: Deyan
authors.initials: D
authors.lastname: Kostovski
authors.affiliation: Bridgepoint Collaboratory for Research and Innovation, Toronto, Ontario, Canada Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada.
authors.forename: Paula
authors.initials: P
authors.lastname: Gardner
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005160:Facility Design and Construction; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010564:Personnel, Hospital / Q000523:psychology*; D012047:Rehabilitation Centers; D011795:Surveys and Questionnaires
keywords: architecture and health; evidence-based design; healthcare facility design; post occupancy evaluation; the built environment and well-being