× You are not currently logged in. To receive all the benefits our site has to offer, we encourage you to log in now.

Demonstrating The Effect Of The Built Environment On Staff Health-Related Quality Of Life In Ambulatory Care Environments

December 2015
EBD Journal Club


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.


Objectives: To determine the impact of the built environment on staff health-related quality of life
(HRQoL) in a federally qualified health center (FQHC).

Methods: 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.

Conclusions: 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: evidence-based design, health-related quality of life, ambulatory care, built environment, disparities