{"title":"A Methodological Process for Healthcare Flooring Material Decisions Using Cost-Benefit Analysis and Sustainability Frameworks.","authors":"Xiaoyu Chen, Lisa Sundahl Platt","doi":"10.1177/19375867261429408","DOIUrl":"https://doi.org/10.1177/19375867261429408","url":null,"abstract":"<p><p>ObjectivesThis study aimed to develop a cost-benefit analysis (CBA) process to guide the evidence-based selection of healthcare flooring materials that balance safety, environmental sustainability, and economic viability.BackgroundFlooring selection in healthcare environments significantly influences patient safety and well-being, operational costs, maintainability, and environmental performance. However, tools that support material choices aligned with both sustainability goals and long-term cost efficiency remain limited, especially in the predesign and specification stages.MethodsA CBA approach was applied, integrating discounted cost analysis for economic assessment, sustainability key performance indicators for environmental and maintenance evaluation, and a benefit-cost ratio model for final decision-making. This quantitative approach compared flooring materials' \"first costs\" to long-term benefits concerning safety, environmental sustainability, and maintainability, supporting trade-off analysis in healthcare design.ResultsBased on the data used for this research, common flooring materials such as rubber and linoleum demonstrated a high balance of durability, safety, and sustainability performance. Conversely, vinyl-based options scored lower on composite criteria for long-term performance and sustainable value proposition. This examination culminated in a generalizable cost-benefit model for healthcare material decisions.ConclusionsThis study introduces a design decision-support approach that complements choice management during the environment of care predesign stage for practitioners and healthcare facility operations specialists. The parameters used in this study offer the potential to better inform environmental planning lifecycle choices by considering healthcare flooring material safety and sustainability as equally weighted criteria, without compromising operational fiscal prudence.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"19375867261429408"},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Connectedness to Nature and Professional Quality of Life Among Nurses in South Korea in the Context of COVID-19.","authors":"Hyeon Sik Chu, Young Ran Tak, Hanyi Lee","doi":"10.1177/19375867251404030","DOIUrl":"10.1177/19375867251404030","url":null,"abstract":"<p><p>BackgroundClinical nurses are consistently exposed to high levels of occupational stress, which can undermine their professional quality of life, resulting in burnout, reduced compassion satisfaction, and psychological exhaustion. In the aftermath of the COVID-19 pandemic, resilience has emerged as a critical protective factor in helping nurses manage these stressors. Moreover, connectedness to nature has gained recognition as a potential influence on enhancing nurses' professional quality of life.PurposeDrawing on Nature-Based Biopsychosocial Resilience Theory and General Systems Theory, this research investigates how connectedness to nature influences nurses' Professional Quality of Life, exploring the mediating role of psychological resilience.MethodsA cross-sectional survey was conducted among clinical nurses during the COVID-19 pandemic. Path analysis examined direct and indirect relationships among connectedness to nature, psychological resilience, and three components of professional quality of life: compassion satisfaction, burnout, and secondary traumatic stress.ResultsConnectedness to nature was significantly associated with higher compassion satisfaction and lower burnout. Psychological resilience partially mediated these relationships, indicating that while connectedness to nature may offer immediate stress-buffering benefits, it also contributes to the development of resilience, a critical long-term protective resource. No significant effects were observed for secondary traumatic stress.ConclusionsThe findings suggest that connectedness to nature serves as a potent, nature-based avenue for strengthening nurses' psychological capital and elevating critical components of their professional quality of life. This underscores the compelling rationale for integrating nature-based strategies into healthcare environments to proactively foster the emotional well-being and long-term sustainability of frontline nurses.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"276-290"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spatial Configuration and Staff Experience in Ambulatory Care: A Comparative Analysis of Linear and Onstage/Offstage Clinic Designs.","authors":"Miyoung Hong, Kevin Real","doi":"10.1177/19375867251406583","DOIUrl":"10.1177/19375867251406583","url":null,"abstract":"<p><p>ObjectiveThis study examined staff perceptions of design and patterns of work locations and activities across two different designs, linear design and onstage/offstage clinic design, to inform evidence-based facility design and planning decisions.BackgroundHealthcare industry trends indicate an increasing focus on outpatient facilities, which currently represent 42% of healthcare construction spending, necessitating research on optimal design approaches for staff efficiency and satisfaction.MethodThree types of data collection and analysis were employed. First, surveys were conducted with nursing, medicine, physician assistants, case managers, and medical assistants/technicians from linear design (<i>N</i> = 48) and onstage/offstage design (<i>N</i> = 50) clinics. Second, focus groups of 24 staff were employed across clinics. Third, staff shadowing utilized tablet-based applications to record patterns of work activities, participants, and locations (<i>N</i> = 6,604 observations; 150 h).ResultsSurvey results showed Onstage/Offstage clinic staff had significantly more favorable perceptions of Clinic Design Features (<i>p</i> = .000), Design Awareness (<i>p</i> = .001), and Satisfaction with Design (<i>p</i> = .001) than Linear Design staff. Open-ended survey comments provided staff preferences and issues with clinic design. Focus group analysis revealed two themes from Linear Design staff: (1) Distance, and (2) Onstage/Offstage clinic design was superior and one theme from Onstage/Offstage staff: Proximity. Shadowing data revealed distinct workflow patterns, with Onstage/Offstage clinic staff spending significantly more time in direct patient care while Linear Design staff allocated more time to paperwork and patient reception activities. <b>Conclusions:</b> Key implications for clinic designers include prioritizing centralized staff work areas, implementing acoustic privacy solutions with spatial zoning; and redesigning patient interaction points for enhanced privacy compliance.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"165-179"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improving Overcrowding in Outpatient Departments of Old Hospitals: A Case Study in Beijing.","authors":"Yi Wang, HaoYu Xiao","doi":"10.1177/19375867251404027","DOIUrl":"10.1177/19375867251404027","url":null,"abstract":"<p><p>Research ObjectiveThis study addresses the issue of excessive overcrowding in outpatient departments of old large tertiary hospitals in China and proposes a spatial optimization framework to improve patient experience and enhance hospital operational efficiency.Research BackgroundExisting research mainly focuses on emergency and inpatient departments, with limited attention to outpatient spaces. From the perspective of environmental behavior studies, this research proposes the \"Traffic-Stay Dual Adaptation Model\" to evaluate how spatial layout affects patient behavior and attempts to address overcrowding during the normal operation of outpatient departments.Research MethodsUsing Structural Equation Modeling (SEM) and Agent-Based Modeling (ABM), surveys were conducted in two hospitals in Beijing. Six behavioral dimensions were analyzed-comfort, service accessibility, safety, orientation, fluency, and accessibility. Outpatient spatial optimization strategies were proposed, and ABM simulations were conducted using AnyLogic to visualize and validate the effects of the strategies.Research ResultsThe SEM results show a significant positive correlation between traffic adaptability and stay adaptability (β = 0.91). Optimization strategies include adopting outer-corridor layouts, expanding public areas, improving patient flow, and adjusting spatial boundaries. Simulation results show that these measures effectively reduce spatial density and stress density. Hospitals with networked layouts have greater potential for optimization.Research ConclusionThe Dual Adaptation Model proposed in this study can effectively balance spatial fluidity and comfort, alleviating outpatient overcrowding. The findings offer practical guidance for outpatient space optimization, enhancing hospital efficiency and improving patient experiences.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"83-101"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daejin Kim, Cameron Campbell, Todd Wehr, Libby Funke, Amy Dagestad
{"title":"Evaluating Innovative Design Strategies in a Maternity Unit: A Post-Occupancy Evaluation Approach.","authors":"Daejin Kim, Cameron Campbell, Todd Wehr, Libby Funke, Amy Dagestad","doi":"10.1177/19375867251391363","DOIUrl":"10.1177/19375867251391363","url":null,"abstract":"<p><p>Objectives, Purpose, or AimThis study evaluates the effectiveness of three innovative design strategies implemented in a hospital-based maternity unit 3 years post-occupancy. It aims to identify areas for improvement and demonstrate how a perception-based Post-Occupancy Evaluation (POE) can yield actionable insights in the absence of baseline data.BackgroundAs maternity units strive to balance clinical efficiency with family-centered care, few long-term evaluations of design performance have been conducted. This study addresses this gap by using a perception-based POE to assess design outcomes over time.MethodsA convergent mixed-methods approach was employed, combining structured observations, ambient noise level measurements, focus group interviews, and an online staff survey. Participants were nursing staff, who have direct and ongoing engagement with the unit. Quantitative and qualitative data were analyzed separately and then integrated through triangulation to develop a comprehensive understanding of the facility's performance.ResultsDecentralized nursing stations improved staff responsiveness and patient proximity but reduced informal peer communication. Integrated Labor-Delivery-Recovery-Postpartum/Neonatal Intensive Care Unit rooms supported care continuity and family involvement, though some ergonomic challenges in staff workspaces were reported. Lighting design fostered a calming, residential atmosphere. Acoustic outcomes were mixed-overall noise levels decreased, but localized disturbances remained.ConclusionsThe maternity unit met key design goals in lighting, spatial efficiency, and family-centered care. Yet, improvements in communication, workspace ergonomics, and supply accessibility are needed. This study highlights the value of POE methods rooted in perception and triangulation to inform future evidence-based design improvements in healthcare environments.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"31-47"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cross-Cultural Insights into Hospital Design: Chinese Perspectives on Australian Hospitals.","authors":"Se Yan, Shiran Geng, Hing-Wah Chau, Wenyu Zhang, Elmira Jamei, Chunyang Zhang","doi":"10.1177/19375867251391364","DOIUrl":"10.1177/19375867251391364","url":null,"abstract":"<p><p>ObjectiveThis study explores how experienced Chinese healthcare design professionals perceive Australian hospital environments to shed light on hospital design perspectives across cultural contexts.BackgroundWhile hospital design significantly influences patient outcomes and staff performance, limited research addresses how hospital environments are perceived across cultural and national contexts. This study fills that gap by examining Australian hospitals through the lens of Chinese professionals with extensive experience in healthcare design.MethodsUsing a mixed-methods approach, post-visit surveys were administered to twenty-three Chinese healthcare design professionals after guided tours of five large Australian tertiary hospitals. The survey captured demographic data, ranked key design priorities, and collected qualitative feedback on spatial experience and design performance.ResultsParticipants identified strengths in Australian hospitals, including child-friendly features, spatial comfort, biophilic integration, and service efficiency. However, they also point to challenges related to wayfinding clarity and public amenity distribution. Contrasts were drawn with Chinese hospitals, where design priorities emphasise functionality, administrative control, and throughput under systemic and governance constraints.ConclusionsFindings reflect differing design values shaped by cultural and institutional factors. While Australian hospitals are seen as therapeutic and inclusive, Chinese counterparts prioritise operational efficiency. The study highlights opportunities for knowledge exchange and culturally sensitive adaptation, offering practitioner-informed insights that can inform future comparative and empirical research on hospital design. (1.3).</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"16-30"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From Yard to Healing Garden: The Role of Participatory Design in Shaping Therapeutic Landscapes.","authors":"Rodrigo Quiroz Saavedra, Antonia Cruz Covarrubias","doi":"10.1177/19375867251406541","DOIUrl":"10.1177/19375867251406541","url":null,"abstract":"<p><p>ObjectiveThis study aims to understand how the participatory design process of healing gardens unfolds in practice, and its relationship with the uses and benefits they provide to users in hospital and residential care home settings.BackgroundHealing gardens are increasingly recognized for their potential to support psychological, emotional, social, and therapeutic well-being. Yet, little is known about how participatory design processes influence their long-term usability and effectiveness, especially in institutional contexts with diverse user needs.MethodsThis study examines two contrasting case studies of healing garden projects-one in a hospital for individuals with neurological impairments, the other in a residential home for children who have experienced trauma. Using an exploratory sequential mixed methods design and an extreme case approach, the study analyzes how the structure and inclusiveness of the participatory design process shaped the perceived benefits, actual uses, and symbolic meaning of each space.ResultsFindings show that inclusive participation, especially by direct beneficiaries, fosters stronger alignment between user needs and design features, leading to increased use, greater perceived therapeutic value, and a deeper sense of space ownership. In contrast, designs dominated by institutional or staff perspectives failed to meet users' needs, resulting in underutilization, misappropriation of space, or limited therapeutic outcomes.ConclusionsThe results emphasize the necessity of embedding context-sensitive, bottom-up participatory strategies throughout the diagnostic and design phases to ensure therapeutic outcomes in landscape architecture. The study offers actionable insights for landscape architects, healthcare administrators, and policy-makers seeking to implement evidence-based, equitable therapeutic environments in care settings.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"180-200"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}