Research highlights • The aim of the short paper is to set the problem and define the possible drivers for future research in exploring the relationship between healthcare built environment and staff retention • Today the physical environment, the architecture, of healthcare facilities is considered having various effects on patients and staff • Especially in the western world healthcare staff shrinking and ageing will have a significant impact • Hospital organizations are defining strategies for staff retention improvement • Usually, this issue concerns management of risk, leadership and motivational aspects but the built environment might as well play a role in this process • In the recent COVID-19 pandemic these issues have been raised considering staff burn out and stress • Future research will need to deepen the relationship between staff retention and physical space of healthcare settings starting from the proposed framework

Background: The relationship between Built Environment and Dementia is nowadays a fundamental theme to investigate in the healthcare field because the elderly population is growing worldwide. Epidemiological data show that Alzheimer's disease incidence is forecast to increase rapidly. Furthermore, the health and socio-sanitary structures for elderly patients represent a fundamental social infrastructure that collects significant investments but must be suitable to host people with dementia. This paper aims to describe the application of a tool able to evaluate architectural design features in facilities for patients with Dementia. Methodology: The evaluation framework is based on a Systematic Literature Review on the relationship between the built environment and patients with dementia, different case studies, and existing evaluation tools analysis. The tool comprises four criteria (Quality, Spaces, Activities, and Wayfinding), 19 indicators, and 71 variables validated by recognized experts in the geriatric, psychiatry, and architecture field. The tool has been applied to five facilities, all accredited to the Italian National Health System and located in Lombardy that differ in period of construction and type. Results: The maximum score is 100%, and results lower than 60% are considered inadequate, between 60 and 80% are sufficient, and more than 80 excellent. The results of the evaluation tool show that two are inadequate (47 and 54% of compliance), two sufficient (65 and 75%), and one excellent (92%). The newest building was evaluated as “excellent”, while the structure with the lowest score was created by reusing existing structures. Future applications are needed to make the results more scalable.

The paper reports and reflects on an evaluation project at Malmö Nya Sjukhus, NSM, Sweden, where the relationship between healthcare performance objectives and indi-cators in the built environment have been studied. The starting point of the study was the outcomes in performance set by the hospital and a retrospective analysis of how these could be related to evaluation of the design of the new hospital. The paper discusses evaluation against a backdrop of existing studies on evaluations and with an argument that that there is a need for tools and methods to strengthen design work in general. The main argument is that it is valuable to evaluate the work processes in healthcare against spatial configurations in addition to studying effects of specific design features. Con-necting healthcare process indicators to spatial design also envision several challenges and possibilities that are addressed in the paper. The study presented is mainly quali-tative with and explorative approach.