Hospital planning and design projects are known for their complexity, partly attributed to the many stakeholders involved. This study aims to understand how a Dutch hospital project, with transformative change goals for its future healthcare delivery, dealt with their stakeholder engagement in the project’s planning and design phase. This study addresses heterogeneity in stakeholder relationships, an underexplored aspect within stakeholder engagement literature. A qualitative study was conducted on the stakeholder engagement during 10 years of hospital planning and design. We used an abductive approach by reviewing project documentation and transcripts of interviews with project stakeholders (n = 22) to reconstruct how the project leadership dealt with the challenges of heterogeneity in the project’s specific context. This study explores dynamism and pluralism within the relationships with seven distinctive stakeholder groups from the hospital’s multi-stakeholder setting, uncovering engagement strategies based on unique combinations of actor and process-specific characteristics. Wider transformative change goals added to the challenges faced in ownership and alignment of goals. Findings highlight the strategies and competencies the project’s owner (and leadership) deployed, such as adapting the project organisation’s structure, investing in an in-house community of practice with a dedicated stakeholder engagement role and fostering enduring collegial relations and commitment.

Background: The COVID-19 pandemic placed healthcare design at the heart of the crisis. Hospitals faced challenges such as rapidly increasing their intensive care unit capacity, enabling physical distancing measures, quickly converting to telehealth and telework practices, and above all, keeping patients and staff safe. Improving flexibility in hospital facility design and adaptability of hospital operations to function in “crisis mode” can be seen as ways of future-proofing for pandemics. In a design brief, flexibility is typically mentioned as an important target. Meanwhile, robustness of technical infrastructure is called for, and standardization at unit level with single-occupancy inpatient accommodation may be considered a way to enhance flexibility and adaptability in dealing with a surge in infectious patients. Aim: To future-proof facility design with pandemic preparedness and resilience in mind, this study evaluated what kinds of interventions were taken in Dutch hospital facilities and what perspectives need to be considered when hospitals operate in crisis mode. Methods: We have collected data from facility and estate professionals from 30 Dutch hospitals. Using a practice-based approach, in-depth interviewing helped uncover and compare successful operational strategies and design elements that provided the flexibility needed in the early stages of the recent crisis. Results: As we looked at existing facilities and alterations made to allow hospitals to operate during the COVID-19 pandemic, we discovered that staff availability and adaptability were deemed crucial. Conclusion: We add the perspective of staff as an essential factor to be considered when future-proofing hospital facility desigr crisis mode operation.

A significant majority of the literature on natural environments and urban green spaces justifies the preferences that people have for natural environments using four predictors defined by Kaplan’s preference matrix theory, namely coherence, legibility, complexity, and mystery. However, there are no studies implicitly focusing on the visual attributes assigned to each of these four predictors. Thus, the aim of this study was to explore the influence of nine visual attributes derived from the four predictors of Kaplan’s matrix on people’s preferences in the context of urban parks. A discrete choice experiment was used to obtain responses from a sample of 396 students of Golestan University. Students randomly evaluated their preferences towards a set of potential scenarios with urban park images. The results of a random parameter logit analysis showed that all of the attributes of complexity (variety of elements, number of colors, and organization of elements) and one attribute each of coherence (uniformity), mystery (visual access), and legibility (distinctive elements) affect students’ choices for urban parks, while one attribute each of mystery (physical access) and legibility (wayfinding) did not affect the choices. Furthermore, the results indicated a preference for heterogeneity of the attributes. The findings of this study can provide instructions for designing parks.

With the need to increase total revenues, airports have begun to use commercial retail. A well-designed airport may provide great service to clients and consumers and increase their satisfaction and in turn their spending behaviours. Since there is suggestive evidence that there might be cultural associations of white, purple or black with different emotional loadings to these colours across cultures, the present study investigated passengers’ preferences for architectural design characteristics of an airport in a new cultural setting. Discrete choice modelling was used to measure the passengers’ preferences for 10 interior design characteristics of the passenger terminal using 3D renderings. Data on 435 passengers were collected at Mehrabad International Airport, which also included passengers’ emotions. Passengers in the terminal hall preferred a curved and transparent ceiling, material in warm colours, cool lighting, with low width and low height, greenery and without any decorations. When compared to other studies, it may well be that passenger preferences for lighting and certain colour schemes reflect geographical or cultural differences. For other interior design characteristics, preferences relating to the shape of the ceiling and the amount of daylight, as well as the presence of greenery, may well be reflections of passengers’ restorative needs.

Purpose: Decarbonising the housing stock is one of the largest challenges in the built environment today, which is getting the attention not only from policymakers but also from social housing corporations, financial organisations and users. In line with the international Paris-Climate-Change-Conference 2015, Dutch cities and housing associations have embraced this challenge with the ambitions to become carbon neutral in 2050. To reach such goals, both the rate and depth of renovation need to increase. Several technical solutions to eliminate the energy demand in dwelling have been developed and tested. Nevertheless, the intake rate of deep retrofitting is low. Despite recent developments, there are still significant barriers related to financing, lack of information and user acceptance. To address those barriers, the purpose of this paper is to investigate the relationship between energy efficiency upgrades and the cost of living. Design/methodology/approach: Focusing on walk-up apartments in the Netherlands, a framework of refurbishment measures that affect the energy efficiency was identified, and their performance was calculated. Furthermore, the rental price adjustment was estimated, taking into account the refurbishment investment and the exploitation cost of the renovated dwellings. Findings: The comparison of the energy use and rental price for the different options demonstrated how the different renovation measures affect the energy cost, the energy use, rent and cost of living. The tenants are more likely to accept the solutions that take into account the total cost of living and sustainability benefits. The study gives a holistic standpoint to the issue of energy upgrades, by quantifying the effect of the potential measures for the whole exploitation period. It has shown the potential of the different interventions to improve the performance and living conditions, without necessarily increasing the total cost of living. Practical implications: Such results aim at supporting the decision making between the stakeholders, primarily housing associations and tenants. Originality/value: The importance of the study is that it gives a holistic standpoint to the issue of energy upgrades, by quantifying the effect of the potential measures for the whole exploitation period. The cost, as a key, if not the more most decisive, issue, is put into perspective in relation to the benefit, in order to give a direction to the renovation design and arguments for the stakeholders’ dialogue. The approach of the study goes beyond cost-optimality of measures and investigated the relation between energy upgrades and cost, as a way to evaluate design variation and address the lack of information barrier in renovations. Moreover, it also proves that deep renovation is feasible without increasing in the total cost of living, which is a principal argument to promote renovations.

Informal face-to-face communication and chance encounters encourage knowledge sharing. This Post-Occupancy Evaluation (POE) examines how well a new building of a Dutch University Institute (DI) supported interaction and perceived privacy among faculty members. The study is designed as a qualitative research project with in-depth interviews among faculty members before and after relocation into the new building. The transparent and centrally organized floor plan supported face-to-face communication but generated a lack of privacy for faculty members. Not all perceived affordances of the design were planned. Lack of visual privacy and the sense of being controlled by others were related to the hierarchical position of teachers in this Higher Education Institute (HEI) between students and the dean, which caused tension and diminished their well-being.

Using 3D design models, this study aims to better involve patients in the design of hospitals by investigating what physical environmental characteristics in hospital patient rooms are valued by patients. There is a plea for shared-decision-making and collaborative design processes with representatives from healthcare and the construction sector based on evidence and end users’ perspectives. Existing research is hampered by poor conceptualization of environmental design factors, as these are differently operationalized between medical and technological sciences. Architects communicate through visuals, whereas medical professionals and researchers tend to communicate in words. By using 3D-modeling to research the relationship between health and well-being on the one hand, and the affordances the built environment offers, this knowledge gap can be better addressed. Two hundred four respondents, 60% patients and 40% medical professionals, engaged in discrete choice experiments visualizing a single patient room. A main finding is that patients and medical professionals consistently choose for hospital rooms with the highest amount of daylight access. What this study adds is that the orientation of the windows matters as well. Horizontal windows, allowing for a panoramic view, were twice as much chosen than were vertical windows. Another important finding concerns patients’ preferences for an open door, suggesting patients prefer to stay “connected” to the outside world. This study is important as it shows, empirically, that patients may make different choices if in research the rooms are better conceptualized and thus visualized and if multiple design features are assessed as configuration rather than using a sequential, “one-design-characteristic-after-another” approach.