From user perception to architecture.

Improving arrival and waiting spaces in primary healthcare centres

Authors

DOI:

https://doi.org/10.17411/jacces.v15i1.530

Abstract

This research paper examines primary healthcare facilities in Montenegro, focusing on outpatient spaces - arrival infrastructure, outside spaces, and inside spaces. In Montenegro, primary health centres provide 80-85% of all health care services and are designed to serve patients within the defined local community. In these facilities, the maintainer of primary care is a chosen doctor (GP), a person most familiar with the patient's conditions and social background. Despite the personal service healthcare centres provide, the architectural expressions of the built facilities do not reflect the intimate nature or personalisation of this service. By examining the user experience and doing field research, we identified several shortcomings in these facilities' exterior and interior quality. Data was gathered through a questionnaire involving users and field research, encompassing large, medium, and small-sized healthcare centres. Participants initially expressed neutral perceptions of existing elements, but when given the opportunity to choose, they became more inclined to suggest improvements. The field study identified rather negative architectural aspects, including inconsistencies in performance across the facilities. The design primarily serves the functional requirements determined by the current capacity, whereas considerations regarding aesthetics and the users' comfort are often neglected. The findings highlight the need to align architectural design with user preferences, emphasising the significance of user-centric healthcare facility design in Montenegro and similar environments.

Author Biographies

  • Žaklina Nježić, Department of Public Building Design, Faculty of Architecture, Budapest University of Technology and Economics

    Doctoral student and Teaching assistant at the Department of Public Building Design

  • Zoltán Schrammel, Department of Public Building Design, Faculty of Architecture, Budapest University of Technology and Economics

    Assistant professor, International courses leader and Doctoral supervisor at the Department of Public Building Design

  • Réka Mandoki, Department of Residential Building Design, Faculty of Architecture, Budapest University of Technology and Economics

    Assistant Research Fellow and Teaching assistant at the Department of Residential Building Design

References

Alfonsi, E., Capolongo, S., & Buffoli, M. (2014). Evidence Based Design and healthcare: an unconventional approach to hospital design. Annali Di Igiene : Medicina Preventiva e Di Comunita, 26(2), 137–143. https://doi.org/10.7416/ai.2014.1968.

Ayas, E., Eklund, J., & Ishihara, S. (2008). Affective design of waiting areas in primary healthcare. The TQM Journal, 20(4), 389–408. https://doi.org/10.1108/17542730810881366.

Budaiwi, I. M., Mohammed, M. A., & Harbi, H. A. (2022). Indoor environmental quality-based space categorization framework: the case of health-care facilities. Journal of Facilities Management. https://doi.org/10.1108/JFM-04-2022-0035.

Clinical Center of Montenegro. (2022). Direktorica KCCG: Za mjesec počinje izgradnja Klinike za mentalno zdravlje, a onda i novog objekta za još dvije klinike. https://kccg.me/vijesti/direktorica-kccg-za-mjesec-pocinje-izgradnja-klinike-za-mentalno-zdravlje-a-onda-i-novog-objekta-za-jos-dvije-klinike/

Devlin, A. S., & Arneill, A. B. (2003). Health Care Environments and Patient Outcomes. Environment and Behavior, 35(5),665–694. https://doi.org/10.1177/0013916503255102

Dilani, A. (2008). Psychosocially supportive design: A salutogenic approach to the design of the physical environment. Design and Health Scientific Review, 1(2), 47–55. https://www.brikbase.org/sites/default/files/49Alan-Dilani-WCDH-2005.pdf.

Eijkelenboom, A., & Bluyssen, P. M. (2020). Profiling outpatient staff based on their self-reported comfort and preferences of indoor environmental quality and social comfort in six hospitals. Building and Environment, 184, 107220. https://doi.org/10.1016/j.buildenv.2020.107220.

Gabbott, M., & Hogg, G. (1996). The glory of stories: Using critical incidents to understand service evaluation in the primary healthcare context. Journal of Marketing Management, 12(6), 493–503. https://doi.org/10.1080/0267257X.1996.9964431.

Garcés, H. O., Durán, C., Espinosa, E., Jerez, A., Palominos, F., Hinojosa, M., & Carrasco, R. (2022). Monitoring of Thermal Comfort and Air Quality for Sustainable Energy Management inside Hospitals Based on Online Analytical Processing and the Internet of Things. International Journal of Environmental Research and Public Health, 19(19), 12207. https://doi.org/10.3390/ijerph191912207.

Ghazali, R., & Abbas, M. Y. (2012). Quality Physical Environment in Paediatric Wards: Designer’s Creation Versus Users’ Satisfaction. Procedia - Social and Behavioral Sciences, 35, 221–229. https://doi.org/10.1016/j.sbspro.2012.02.082.

Government of Montenegro. (2022a). Organisation of health care. Ministry of Health. https://www.gov.me/en/article/organisation-of-health-care.

Government of Montenegro. (2022b). Počinje gradnja Klinike za infektivne bolesti i dermatovenerologiju u Podgorici. https://www.gov.me/clanak/pocinje-gradnja-klinike-za-infektivne-bolesti-i-dermatovenerologiju-u-podgorici.

Government of Montenegro. (2022c). Saopštenje: Počinje gradnja Klinike za mentalno zdravlje u Podgorici. https://www.gov.me/clanak/saopstenje-pocinje-gradnja-klinike-za-mentalno-zdravlje-u-podgorici.

Hadjri, K., & Crozier, C. (2009). Post‐occupancy evaluation: purpose, benefits and barriers. Facilities, 27(1/2), 21–33. https://doi.org/10.1108/02632770910923063.

Huisman, E. R. C. M., Morales, E., van Hoof, J., & Kort, H. S. M. (2012). Healing environment: A review of the impact of physical environmental factors on users. Building and Environment, 58, 70–80. https://doi.org/10.1016/j.buildenv.2012.06.016.

Hutton, J. D., & Richardson, L. D. (1995). Healthscapes: The role of the facility and physical environment on consumer attitudes, satisfaction, quality assessments, and behaviors. Health Care Management Review, 20(2), 48–61. https://doi.org/10.1097/00004010-199502020-00008.

Joseph, A., Quan, X., Keller, A. B., Taylor, E., Nanda, U., & Hua, Y. (2014). Building a knowledge base for evidence-based healthcare facility design through a post-occupancy evaluation toolkit. Intelligent Buildings International, 6(3), 155–169. https://doi.org/10.1080/17508975.2014.903163.

Jovanović, N., Miglietta, E., Podlesek, A., Malekzadeh, A., Lasalvia, A., Campbell, J., & Priebe, S. (2022). Impact of the hospital built environment on treatment satisfaction of psychiatric in-patients. Psychological Medicine, 52(10), 1969–1980. https://doi.org/10.1017/S0033291720003815.

Kearns, R. A., Neuwelt, P. M., & Eggleton, K. (2020). Permeable boundaries? Patient perspectives on space and time in general practice waiting rooms. Health & Place, 63, 102347. https://doi.org/10.1016/j.healthplace.2020.102347.

Krist, A. H., Nease, D. E., Kreps, G. L., Overholser, L., & McKenzie, M. (2016). Engaging Patients in Primary and Specialty Care. In Oncology Informatics (pp. 55–79). Elsevier. https://doi.org/10.1016/B978-0-12-802115-6.00004-5.

Lawson, B. (2010). Healing architecture. Arts & Health, 2(2), 95–108. https://doi.org/10.1080/17533010903488517.

Lyon, C. (2017). Humanist principles, sustainable design and salutogenics: A new form of healthcare architecture. Architectural Design, 87(2). https://api.semanticscholar.org/CorpusID:114510036.

Mechanic, D. (2004). In my chosen doctor I trust. BMJ, 329(7480), 1418–1419. https://doi.org/10.1136/BMJ.329.7480.1418.

Ministry of Ecology, S. P. and U. (2023). Competition for the Conceptual Architectural Design of the Primary Health Care Centre in City kvart in Podgorica. https://www.architecturalcompetitions.me/en/detaljno/competition-for-the-conceptual-architectural-design-of-the-primary-health-care-centre-in-city-kvart-in-podgorica.

Montenegro Ministry of Health. (2015). Master plan of the development of health system in Montenegro 2015-2020. https://extranet.who.int/countryplanningcycles/sites/default/files/public_file_rep/MNE_Montenegro_Master-Plan-of-the-Development-of-Health-System_2015-2020.pdf.

Morgan, S., Pullon, S., McKinlay, E., Garrett, S., Kennedy, J., & Watson, B. (2021). Collaborative Care in Primary Care: The Influence of Practice Interior Architecture on Informal Face-to-Face Communication—An Observational Study. HERD: Health Environments Research & Design Journal, 14(1), 190–209. https://doi.org/10.1177/1937586720939665.

Mosca, I., Terzic, N., & Tille, F. (2022). Health systems in action: Montenegro. https://eurohealthobservatory.who.int/publications/i/health-systems-in-action-montenegro-2022.

Oandasan, I. F., Gotlib Conn, L., Lingard, L., Karim, A., Jakubovicz, D., Whitehead, C., Miller, K.-L., Kennie, N., & Reeves, S. (2009). The impact of space and time on interprofessional teamwork in Canadian primary health care settings: implications for health care reform. Primary Health Care Research & Development, 10(02), 151. https://api.semanticscholar.org/CorpusID:70569580

Palaneeswaran, E., Kumaraswamy, M., & Ng, T. (2003). Targeting optimum value in public sector projects through “best value”‐focused contractor selection. Engineering, Construction and Architectural Management, 10(6), 418–431. https://doi.org/10.1108/09699980310509390.

Pati, D., Harvey, T. E., Willis, D. A., & Pati, S. (2015). Identifying Elements of the Health Care Environment That Contribute to Wayfinding. HERD: Health Environments Research & Design Journal, 8(3), 44–67. https://doi.org/10.1177/1937586714568864.

Phiri, M. (2014). Health Building Note 00-01 General design guidance for healthcare buildings. https://www.england.nhs.uk/wp-content/uploads/2021/05/HBN_00-01-2.pdf.

Preiser, W. F. E., Verderber, S., & Battisto, D. (2009). ASSESSMENT OF HEALTH CENTER PERFORMANCE: TOWARD THE DEVELOPMENT OF DESIGN GUIDELINES. Archnet-IJAR, 3(3), 21–44. https://www.archnet.org/publications/5292.

Preiser, W. F. E., White, E., & Rabinowitz, H. (2015). Post-Occupancy Evaluation (Routledge Revivals). Routledge. https://doi.org/10.4324/9781315713519.

Samah, Z. A., Ibrahim, N., & Amir, J. S. (2013). Translating Quality Care Factors to Quality Space: Design Criteria for Outpatient Facility. Procedia - Social and Behavioral Sciences, 105, 265–272. https://doi.org/10.1016/j.sbspro.2013.11.028.

Službeni list Crne Gore. (2008). Službeni list Crne Gore. Službeni List Crne Gore, 10. http://sluzbenilist.me/.

Verderber, S., Jiang, S., Hughes, G., & Xiao, Y. (2014). The evolving role of evidence-based research in healthcare facility design competitions. Frontiers of Architectural Research, 3(3), 238–249. https://doi.org/10.1016/j.foar.2013.12.001.

Vischer, J. (2002). Post-Occupancy Evaluation: A Multifaceted Tool for Building Improvement. In Learning from Our Buildings (p. 23). National Academies Press. https://doi.org/10.17226/10288

Watson, K. J., Evans, J., Karvonen, A., & Whitley, T. (2016). Re-conceiving building design quality: A review of building users in their social context. Indoor and Built Environment, 25(3), 509–523. https://doi.org/10.1177/1420326X14557550.

World Health Organization. (2020). European Programme of Work 2020-2025: United Action for Better Health. https://iris.who.int/bitstream/handle/10665/339209/WHO-EURO-2021-1919-41670-56993-eng.pdf.

Zborowsky, T., & Bunker-Hellmich, L. (2010). Integrating Healthcare Design Research into Practice: Setting a New Standard of Practice. HERD: Health Environments Research & Design Journal, 4(1), 115-130. https://doi.org/10.1177/193758671000400108.

Image of the first page of the article. The name of the article, the authors, and the abstract are displayed.

Downloads

Published

2025-05-11

How to Cite

From user perception to architecture.: Improving arrival and waiting spaces in primary healthcare centres. (2025). Journal of Accessibility and Design for All, 15(1), 38-60. https://doi.org/10.17411/jacces.v15i1.530