Abstract: The design of healthcare buildings influences healthcare quality: hospital and ward design features can increase patient and staff satisfaction, improve treatment outcomes and reduce stress. However, due to societal changes, there is increasing attention to outpatient healthcare facilities close to the communities, such as healthcare centers (HCC). However, few studies concerned HCC. Nor has there been much attention to entrance areas of healthcare buildings. This study, therefore, investigates four health-related design features (i.e., privacy, nature, daylight, and wayfinding) in the entrance area of two award-winning Dutch HCC. Research question – How does the entrance design of HCC support views on nature, privacy, daylight, and wayfinding? This study compares two awarded HCCs based upon a selective thematic analysis focused on descriptions and observations of the four features in the HCC design. Data include descriptions by professionals, jury reports, floor plans and photos. The data show that views on nature are not mentioned in the data, privacy is mentioned and observed implicitly in both projects, and daylight and wayfinding are only observed in the floor plans and pictures. Most attention concerned daylight, wayfinding, and privacy in the waiting areas. However, while the importance of view of nature has been highlighted in many previous studies, these projects show little attention to view of nature and privacy for HCCs. The study revealed that the awarded healthcare buildings incorporate health-related design features, mostly implicit in the designs. However, in the descriptions by professionals and jury, they are not explicitly mentioned.

Highlights: Future elderly are willing to share facilities and take care of each other, as long as they do not have to help others with getting dressed, washing or going to bed. The preferences for ways of living and receiving care vary largely between future elderly. Concepts for shared living are elaborated that may contribute to suitable environments that fit with the specific needs of future elderly.

The term ‘hospice’ refers to both a philosophy of end-of-life care and a building type, dedicated to offering this care. Hospice care strives to offer dignity, personal choice, peace, calm, and freedom from pain. Hospice care is anchored in space and spatial practices; however this relation is understudied. It is a rather new building type, for which architects have few historical references, post-occupancy evaluations, or direct experiences available. The prospect of replacing a Belgian hospice offered an opportunity for a case study. We aim to understand how the built environment of a hospice affects experiences of care, and discuss design considerations derived from that. Our qualitative research approach was based on principles of Grounded Theory and combined observations with semi-structured interviews with six staff members, six volunteers, three relatives and eight patients. Our analysis shows that the built environment contributes to hospice care by the balance it affords between privacy and social interaction, by the discrete ways in which it affords offering high-level care, and by its human scale and relation to the natural environment. Insights gained challenge hospice designers to consider how meaningful encounters are often spontaneously triggered by daily activities; guests’ lifeworld changes in size; a delicate balance is required between proximity and seclusion; the built environment can support the ethos of staff and volunteers; aspects of environmental support (e.g. accessibility) are intertwined with aspects of emotional comfort (e.g. hominess); high-level care can be offered in discrete ways.