Interdependence between healthcare design and stakeholders: A designers’ view

The concept of ‘design quality’ during the design, construction and occupancy
phases of healthcare environments is complex. There are multiple stakeholder
groups (e.g. architects, contractors, the NHS, patients) with potentially conflicting
requirements interacting with each other during the project lifecycle.
There is a growing body of evidence demonstrating the impact of design
elements on medical and non-medical outcomes for stakeholder groups (Huisman,
2012; Macmillan 2006) and as a result, the need for the healthcare construction
industry to focus on design quality (Walker et al., 2009). This research
looks at this issue from the perspective of ‘stakeholder management’: a field
which can be used to analyse the attributes and interactions of stakeholder
groups.
A series of semi-structured interviews was conducted with eleven healthcare
designers and architects in the UK to explore their perceptions and experiences
of interactions with other stakeholders, and their opinions of design quality
within the healthcare design process. Based on the ‘stakeholder’ definition
(Freeman, 1984), a novel matrix exercise was used with the participants to examine
the two-way relationship between design quality and stakeholders during
and after project delivery. ‘Framework’ method (Ritchie and Lewis, 2005)
was used to thematically analyse the qualitative data. A conceptual framework
was then developed, which defined the design/stakeholder interdependence
as well as ‘procurement system’, ‘building type’, and ‘project lifecycle stage’ as
variables affecting this relationship. Significantly, the findings showed the
critical role of effective stakeholder interactions in order to compensate for
the unequal distribution of power on design quality decisions. The ongoing
research continues to validate the framework via a large-sample survey of
industry practitioners.

D4H2013