The study combined quantitative and qualitative approaches, in terms of both staff perception and facility manager perspective, to evaluate the effectiveness of indoor environmental quality (IEQ) of LEED–certified facilities and relationship between IEQ and occupant comfort and productivity in healthcare settings in the USA climate zones 2 and 3. A multiple-methods approach combining a questionnaire survey and semi-structured interview was tested for effective post-occupancy evaluation. The study compared one non-LEED healthcare facility with five LEED certified healthcare buildings and examined which variable(s) had significant relationship with comfort and productivity by surveying 249 occupants and interviewing six facility managers in six healthcare settings. The results showed that five LEED–certified healthcare settings were superior to one non-LEED facility in most of building performance factors. Building design, temperature comfort, image presented to visitors, use of space, control over noise and ability to meet occupants’ needs were significant predictors for overall comfort. Lighting overall, temperature comfort and image presented to visitors had a significant positive relationship with perceived productivity. Only one non-LEED hospital was selected and some buildings had small response rate, the results should be interpreted with caution.

Objectives: This study examines the role of visibility and proximity on nurse communication patterns, perception of privacy, and efficiency in double-corridor nursing units. Background: Nurses are extremely important for the quality of healthcare. The literature suggests that visibility and proximity have a substantial impact on the delivery of care and staff experience. However, few studies have empirically examined nursing units in China. Method: Questionnaire surveys, observations, and simulations of medication administration tasks were employed. Results: Visibility and proximity influenced communication patterns, perceptions of privacy, and efficiency. The type of wall in the medication room could impact nurses’ perception of privacy and efficiency. A partial glass wall in the medication room could achieve balance between privacy and visibility. A medication room that is adjacent to and is easily accessed from the nurse station (NS) could provide efficient communication and efficient work. The partition type between the NS and the doctor’s office and the layout of the medication room could impact communication patterns. The relative position of the NS, medication room, and disposal room could influence the flow of medication administration tasks, and a geographically contiguous spatial layout could enhance work efficiency. Conclusions: The findings contribute to the body of knowledge on the impact of visibility and proximity on nurses’ communication patterns, perception of privacy, and efficiency. Recommendations to improve the design of double-corridor nursing units are also provided.

Purpose Healthcare projects face multiple obstacles in achieving sustainability. This paper aims to provide information regarding the energy consumption of healthcare facilities, to identify barriers to sustainability and to suggest methods to improve the effectiveness of these buildings. Design/methodology/approach This study investigates sustainability in healthcare buildings by examining national databases about energy use and energy savings. The authors then initiate a dialogue on this topic by interviewing experts in healthcare planning and design regarding the implications of this data, challenges to sustainability and potential solutions to these challenges. Findings An analysis of data from the Energy Information Administration revealed that healthcare facilities rank second among building types in the USA in energy use per square foot and rank fourth in total energy use. Data from the US Green Building Council showed that only 1 per cent of healthcare buildings are registered with the Leadership in Energy and Environmental Design rating system, and 0.4 per cent have achieved certification, which is low compared with other building types. Research limitations/implications Research and discussion must continue engaging all stakeholders to interpret the data and identify transformative solutions to facilitate sustainable healthcare design construction and operation. Practical implications It is important to approach sustainability in healthcare from social, economic, environmental and health-related perspectives. The authors identify five major barriers to sustainable healthcare design and construction and discuss 12 practical solutions. Originality/value Given the energy demands of healthcare buildings, facilitating their sustainability has the potential to make a significant difference in national energy use. Empirical research and evidence-based design can potentially help to accelerate sustainability by clarifying impacts and documenting the economic and operational returns on investment.

This article revealed the frequency of nurse activities; how they spent their time; how they use the clinical spaces; identified important clinical spaces, linkages, and driver of inefficiency in nursing work and nursing unit design; and finally generated recommendations for double-corridor nursing unit design in China which can be used by medical planner, hospital administrator.

A combination of quantitative and qualitative approaches was used to evaluate the effectiveness of LEED-certified healthcare settings from the perspectives of both staff and facility managers. This study surveyed 164 staff members in two healthcare settings in a case study to compare LEED and non-LEED-certified healthcare facilities and surveyed 146 staff in six LEED-certified healthcare settings for the main study. Telephone interviews with six facility managers were used to verify the survey results and further examine the facilities' performance and the effectiveness of the LEED strategies. An independent t-test was used to examine the difference between a LEED hospital and a non-LEED hospital in one healthcare system. Building performance was rated higher by staff in the LEED-certified hospital than in the non-LEED hospital. Multivariate analysis of variance (MANOVA) was conducted to compare staff ratings between the silver and gold LEED certification levels and between males and females, as well as to explore the possibility of interaction effects. Compared with the staff in silver-certified facilities, staff members in the gold-certified hospitals gave the buildings significantly higher ratings in most performance variables, including building overall, overall comfort and controllability. Males felt more comfortable than females with temperatures in healthcare facilities.