Hospital ward design : implications for space and privacy
Alalouch, Chaham Rajab
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This thesis examines the relationships between hospital ward design and aspects of visual privacy as a design criterion. It involves three stakeholders: users (potential and actual patients), experts and architects. In particular it explores the relationships between the spatial design of the plan configuration of buildings, in this case hospital open wards, and subjective judgments on spatial location for privacy across different demographics and cultural backgrounds. These variables are considered in the context of the current guidelines on, and regulations of, ward design criteria, and architects’ prioritisation of these criteria. Mixed methodological approaches – i.e. qualitative and quantitative methods – are employed. Space Syntax theory and its particular technique Visibility Graph Analysis (VGA) are used to quantify the spatial structure of six generic open ward types. A series of statistical analyses allowed the investigation of the relationships between measures of plan configurations and patterns of preferences in relation to beds’ spatial location for privacy assessed by means of a questionnaire. This is followed by qualitative policy analyses and semi-structured interviews with experts to provide a set of the relevant ward design criteria, which is used to conduct choice-based conjoint analysis to explore architects’ prioritisation of ward design criteria including patient’s privacy. Results showed a systematic relationship between the chosen location for privacy and spatial properties of the ward plans best represented by two measures: Integration and Control, with integration being the best predictor of preference. This was found to encompass universal preference for spatial locations of privacy across culture, age and gender and a specific significant difference as a result of previous experience of space. A reasonable awareness of the importance of patient’s privacy as a design criterion was found not only in the current guidelines and regulations on ward design but also in experts’ perception and architects’ prioritisation of ward design criteria. However, it appears that there is no framework to assess people’s privacy preference or specific information to guide architects on spatial preference. Systematic findings with respect to plan configurations are not only important in themselves, they provide the context within which detailed design choices can be made.