ARTICLE
Wingler, D., & Hector, R. (2015). Demonstrating the effect of the built environment on staff health-related quality of life in ambulatory care environments. Health Environments Research & Design Journal, 8(4), 25-40.
Abstract
Objective: To determine the impact of the built environment on staff health-related quality of life (HRQoL) in a federally qualified health center (FQHC).
Background: Staff within FQHCs face many challenges that can significantly impact their HRQoL. Design features directed toward reducing stress have been shown to improve staff health outcomes in acute care environments. However, minimal literature exists linking design features to health outcomes within FQHCs.
Method: A cross-sectional, observational study was conducted involving three FQHCs that contain varying levels of enhancements to their interior features. A total of 75 staff across the sites participated in the indoor environmental quality (IEQ) survey, measuring satisfaction and perceived productivity. Measurements for staff HRQoL were captured using the quality of well-being (QWB) scale, which was administered to 10 staff at each site. Standard regression diagnostics were used to examine fit and find influential observations.
Results: QWB scores were normally distributed, and a dose-response relationship was found between QWB scores and level of enhancements. As the categories of satisfaction and perceived productivity increased, the average QWB score increased. Regression models showed overall statistical significance and predicted between a quarter to a half of the change in QWB scores.
Conclusion: This pilot study suggests that the more enhancements included in the interior features of a FQHC, the greater the returns to staff HRQoL. Findings also suggest that staff with a lower QWB appreciate enhancements more. Design strategies associated with improved staff well-being should be evaluated in terms of the amount of HRQoL they contribute.
Keywords: ambulatory care; built environment; disparities; evidence-based design; health-related quality of life
Experts
As Principal and Global Practice Director for Applied Research at HKS, Dr. Deborah Wingler collaborates across sectors to develop and implement applied deep dive studies and research services that drive innovation and achieve meaningful and measurable impact across the firm and health practice, globally. She also holds an appointment as Adjunct Faculty for Clemson University with the Center for Health Facilities Design and Testing and Architecture + Health program in the School of Architecture. Deborah’s research focuses on improving the user experience by eliciting insight into users’ affective responses to high stress healthcare environments. During her tenure at HKS, Deborah’s research has contributed to building the evidence base and developing the experience strategy for over 20 million sq ft of healthcare infrastructure. Through her research, she has worked with some of the most forward-thinking top 5 Fortune 500 companies, healthcare organizations and manufacturers, to reimagine primary, specialty, acute, and home healthcare. She is a well-known passionate patient and family advocate for healthcare design, researcher, speaker, and published author. She holds a Ph.D. from Clemson University in Healthcare Architecture and earned a M.S.D. in Healthcare Innovation from The Herberger Institute of Design at Arizona State University. Deborah holds several industry and academic awards. Most recently she was awarded HCD 10 researcher of the year for 2022 by Healthcare Design Magazine.