Linking wellness to design: Creating a tool for evaluating user’s wellness experience at the main lobby of healthcare environments

Presented by: Yongyeon Cho, Jihyun Song

Issue: The design of a healthcare facility’s main entry lobby holds a great potential for user’s health and well-being. The main lobby provides the first impression on the facility to the patients and visitors because it sets expectations for the quality of clinical care (Malkin, 1991). Research findings suggest that healthcare facility design has psychological, physiological and behavioral effects on users’ life satisfaction (Ulrich, 1991; Ananth, 2008). Others presented a wellness-focused model of care as an important consideration in the planning and design of healthcare environments with the evolving concepts of community-centered care, and preventive care rather than treatment (Silvis, 2014; Kraus & Renner, 2016). However, little research has focused on evaluating user’s experience of the main lobby that is evidence-based and associated with a wellness concept in healthcare environments. Therefore, the objectives of this study are: 1) to create user-centered wellness design evaluation criteria to evaluate design of the existing facilities for which future renovation or construction is planned, 2) to examine the importance of design features that are supportive of the physical, emotional, and social experience of users, and 3) to develop and validate design guidelines and a checklist for a main entry lobby that can support design-related decision making by designers and facility managers. Process and method: A mixed method of both qualitative and quantitative was used to create a valid set of wellness design evaluation criteria. First, content analysis was conducted to investigate existing evaluation standard and design guidelines (Appendix A). Based on the newly developed design goals, detailed criteria for the 20 wellness design features were identified (Appendix B). Second, an online survey and statistical analysis were used to examine how users might perceive the 20 wellness design features. A total of 275 human subjects were participated in the survey; participants had visited a healthcare facility at least once during the past 12 months in Iowa. The data was analyzed to identify which design features and wellness goals are important, and how the features affected the physical, emotional and social wellness of the participants. Results: To measure users’ wellness design experience, the mean values of the impact on the three types of wellness were used as criteria for assessing whether or not the user’s experience of the main entry lobby was fulfilled with regard to physical, emotional and social interactions of wellness aspects. Survey results indicate that enhancement of safety and security was the most important aspect of designing a healthcare facility’s main entry lobby. Optimal positive distractions were also noted as a key to enhance users’ perception of and experience in the main lobby. Various visiting patterns and demographics differences had a minor impact on the survey results. Based on analysis of the results, a wellness design evaluation tool (Appendix C) was developed, containing a combination of a design checklist and diagrams to integrate and communicate the evidence-based criteria for designers (Appendix D). The tool was tested at the three different healthcare facilities to identify the errors and difficulties in using the evaluation criteria to assess users’ wellness experience (Appendix E). Importance of the Topic: This research introduces evidence-based design evaluation criteria for a healthcare facility’s main entry lobby that will support the wellness experience of patients, family members, and staff. Although the survey was conducted with a limited geographical and demographic variation, the study provides a framework for creating and validating a wellness design evaluation tool for a future research. New insights from this work suggest research possibilities and application of the tool in the field among architects, interior designers, and managers of healthcare facilities.


  • Ananth, S. (2008). Healing Environments: the next natural step. Explore,4(4), 274.
  • Kraus, S & Renner, K. (2016) How architecture can help progress population health. Retrieved October 13, 2016, from
  • Malkin, J. (1991). Hospital interior architecture creating healing environments for special patent population, John Wiley & Sons, INC, 59-72.
  • Silvis, J. K. (2014). Designing Healthcare Buildings That Support Patient Wellness. Retrieved October 13, 2016, from
  • Ulrich, R. S., (1991) Effects of interior design on wellness: Theory and recent scientific research, Journal of health care interior design, Proceedings from the annual national symposium on health care interior design, 97-109.
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