Indoor Environmental Quality of Public Space in Healthcare: Developing a Framework for Post Assessment

Zoohee Choi, Purdue University


Environmental quality in healthcare buildings influences patients’ well-being as well as staff’s productivity and satisfaction. Particularly, public spaces in a healthcare facility, such as a lobby and waiting areas, create the first impression and shape the experience of healthcare. Improving indoor environmental quality in the public spaces of healthcare facilities can reduce stress and fear in the patients and visitors and positively affect their psychological well-being. Even though several healthcare evaluation systems (e.g., Achieving Excellence Design Evaluation Toolkit) have been developed to assess indoor environmental quality of major areas of healthcare facilities, no framework has specifically assessed the indoor environmental quality of public spaces in those facilities. To promote healthcare users’ well-being, it is essential to create an indoor environmental quality assessment tool (IEQ) for evaluating public healthcare spaces. The purpose of this study was to develop such tool based on a review of related literature, current certification programs, healthcare organizational standards, and reviews of the developed assessment tool from healthcare design professionals. To verify the validity of the IEQ, the study used Delphi technique. Three Delphi panel groups (researchers, designers, and practitioners) reviewed and provided feedback on the elements of the assessment tool. The researchers revised the IEQ according to the Delphi panels' feedback. Subsequently, the researchers and two healthcare professional volunteers designed case studies to test the usability, viability, and reliability of the newly developed IEQ. The tool assesses three sub-categories, including the visual environment (daylighting, artificial lighting, quality of view, visual stimuli ornaments, architectural structure, color coordination, and natural environment), the auditory environment (noise level, environmental surfaces, environmental intervention, and background music), and indoor air quality (thermal comfort, CO2 level, and odor). The developed assessment tool includes detailed knowledge, design strategies, back-up calculations and questions in technical language. The IEQ is separated into three parts: (1) measurement, (2) observation, and (3) rubric. The measure can be used to compare the ideal and actual healthcare environments. The findings demonstrated the importance of the indoor environmental quality in the healthcare facilities and result in the finalized assessment tool. By evaluating an indoor environmental quality of healthcare facilities located in the U.S., this research study could provide a systematic approach to identifying weaknesses and strengths of indoor environmental quality in healthcare. Healthcare professionals can use IEQ measure to identify and solve environmental quality problems in the healthcare settings. This study could provide actual numeric values of indoor environmental quality, which managers and healthcare industry stakeholders can use as a marketing tool or benchmarking process. The IEQ could be used to gather the data that would allow healthcare professionals to make future design decisions. Moreover, the study can provide information that could improve the well-being and healing environment of patients and visitors in a healthcare building. Increasing visitors’ satisfaction with the environment, their satisfaction would enhance their overall hospital experiences with the healthcare service, measured by the national standard survey instrument Hospital Consumer Assessment of Healthcare Provider and System (HCAHPS).




El Debs, Purdue University.

Subject Area

Environmental Health

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