Development of Hospice Environmental Assessment Protocol (HEAP): A Post Occupancy Evaluation Tool

Abstract

The post-occupancy evaluation (POE) of any building facility is essential for providing feedback to the architects and to the building owners for further improvement in design skills and management procedures. Since the 1990s several POE tools have been developed focusing on nursing home environments, but no POE tool has been developed for hospice environments. Generally, the nursing home POE tool has been used to assess hospice facilities, but in recent studies, a significant gap has been found in the usefulness because hospice patients are mostly bed-bound, their physical, social and spiritual demands are different, and a patient’s family accommodation plays a significant role in the patient’s dying experience. The need of developing a POE tool for hospice facilities is evident, and this study has focused on fulfilling that goal. To develop an indicative level of POE tool for hospice, the Professional Environmental Assessment Protocol (PEAP) was selected as a precedent model. PEAP was developed to provide a standardized method of expert evaluation of special-care units for people with dementia, and it not only assesses the physical setting but also includes some assessment of organizational and policy features of the environment. This doctoral thesis developed the Hospice Environmental Assessment Protocol (HEAP), which assesses only the physical setting and does not include assessment processes of organizational or policy features. It involved three research objectives: a) to identify the ‘Therapeutic Goals (TGs)’ of hospice environments; b) to develop a list of design considerations for each therapeutic goal, and c) to develop an evaluation matrix and a descriptive five-point rating scale for each goal. The qualitative research design was considered using three methods: a) a systematic literature review to identify TGs; b) the Delphi method to obtain expert opinions, and c) five case study surveys. HEAP provides a standardized method to evaluate building performance based on eleven TGs; provide continuity of self, provide access to nature, provide privacy, facilitate social interaction, maximize safety and security, provide autonomy, regulate stimulation and support sensory therapies, provide spiritual care, provide family accommodation, provide support after death, and maximize support for staff.