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

Presented by: Zoohee Choi, Hyun Joo Kwon

Indoor environmental quality in healthcare influences patients’ well-being, and staff’s productivity and satisfaction. Several studies have revealed that patients have positive experiences in a quality healthcare environment with sufficient daylighting, pleasant views, elements of nature, calming colors, various stimuli, restful sounds, and a sense of aesthetic (e.g., Rubin, Owens & Golden, 1998). In particular, public spaces in a healthcare facility such as a lobby and waiting areas create the first impression and shape the experience of healthcare. Quality of public space design contributes as a vital player in the healthcare experience by creating a positive and memorable experience even when the hospital climate is characterized by fear, anxiety, stress and uncertainty (Dijkstra, 2009). Evidence indicates that improving indoor environmental quality in the public spaces of healthcare facilities reduces stress and fear in the patients and visitors and positively affects their psychological well-being (e.g., Cortvriend, 2005). Moreover, public space in healthcare is important in enhancing the hospital’s image and is thus a front-page marketing tool. Even though there are several healthcare evaluating systems (e.g., Achieving Excellence Design Evaluation Toolkit) that evaluate indoor environmental quality of major areas of healthcare facilities, no framework has assessed the indoor environmental quality of public spaces in those facilities. In order to promote healthcare users’ well-being, it is essential to create an indoor environmental quality assessment tool for healthcare public spaces. The purpose of this study is to develop an assessment tool that evaluates indoor environmental quality of a public space in healthcare based on a review of related literature, current certification programs and healthcare organization standards, and reviews of the assessment tool from three healthcare design professionals. The tool has three 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, odor). The tool includes detailed knowledge, design strategies, back-up calculations and questions in technical language. The framework of the tool is separated into three parts: (1) measurement, (2) observation, and (3) rubric. Each part consists of three categories. This research focuses on the users’ journey from the entrance of a hospital. In terms of environment in healthcare facilities, the research is restricted to main routes and general spaces: (1) entrance, (2) lobby area, (3) reception, (4) elevator lobby, (5) waiting area and (6) cafeteria. The tool bridges a gap between ideal and current healthcare environments; it also is valuable in bringing together healthcare professionals, stakeholders, design firms, local government and others to discuss indoor environmental quality. In addition, healthcare professionals will be able to see the shortcomings of the healthcare environment’s indoor environmental quality. It also can demonstrate how indoor environmental quality can improve the healthcare environment and therefore contribute to the health and wellbeing of patients, staff and visitors. This presentation will share two case studies of indoor environmental quality of healthcare public space evaluation results using the assessment tool.


  • Cortvriend, P. (2005). The effect of the healthcare environment on patients and staff. European Health Management Association.
  • Dijkstra, K. (2009). Understanding healing environments: Effects of physical environmental stimuli on patients' health and well-being. University of Twente.
  • Rubin, H. R., Owens, A. J., & Golden, G. (1998). Status report: An investigation to determine whether the built environment affects patients' medical outcomes. Martinez, CA: The Center for Health Design.