A Systematic Review of Research Gaps in the Built Environment of Inpatient Healthcare Settings.

OBJECTIVE: This study utilized the evidence-gap map method and critically examined the scope, methodologies, and focus of the studies that investigated the influence of the built environment on inpatient healthcare settings over a decade (2010-2021). METHODS: We conducted a systematic review per the preferred reporting items for systematic reviews and meta-analyses guidelines and surveyed 406 articles, primarily from North America and Europe. RESULTS: Our findings revealed a dominant focus on architectural features (73%), such as room design and ward layout. Comparatively, there was less emphasis on interior-, ambient-, social-, and nature-related features. Most previous studies explored multiple environmental features, which indicated the intricacy of this field. Research outcomes were diverse, with person-centered care (PCC) being the most frequently investigated, followed by safe care, emotional well-being, activity, and behavior. Furthermore, research methods varied considerably based on the study's outcomes and features. Clinical outcomes and safe care favored quantitative methods, activity and behavior favored mixed methods, and PCC favored qualitative research. CONCLUSION: This review provides an in-depth overview of the existing studies on healthcare design research and sheds light on the current trends and methodological choices. The insights garnered can guide future research, policy-making, and the development of healthcare facilities.

A Structured Literature Review on the Research and Design of Rehabilitation Environments.

AIM: This literature review is conducted to identify knowledge gaps and shape a framework for the development of guidelines and future research on programming and design of rehabilitation environments. BACKGROUND: Patients suffering from trauma, stroke, neurological or cardiopulmonary conditions, or recovering from surgery or cancer treatment require rehabilitation services. A comprehensive rehabilitation program can support continuum of care for inpatient and outpatient groups. However, within most facilities, rehabilitation environments are found to be outdated and undersized compared to other programs or lack the correct adjacencies within the facility. Unfortunately, this deficiency is echoed by limited guidelines on programming, planning, and design of these environments. General guidelines derived from healthcare environments research is not adaptable to rehabilitation environments, because the paradigm used in most healthcare environment research does not address specific needs of rehabilitation patients in regaining confidence or relearning daily life skills. METHOD: We conducted a structured literature review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses as a basis for reporting the available body of work on evidence-based research in rehabilitation environments. RESULT AND CONCLUSION: Through analysis of the limited literature, specific mediators such as patient confidence and motivation were identified. An environment that creates a balance between privacy and social interaction can promote these mediators. Creating enriched environments through elements that engage the senses and encourage more social and physical interaction is essential for recovery. Finally, accessibility and wayfinding are of great importance in these environments due to potential limited mobility or cognitive impairments of patients.

Vitality and nature in psychiatric spaces: Challenges and prospects for 'healing architecture' in the design of inpatient mental health environments.

Historically, nature has been considered central to healing and recovery in institutional mental health settings, with inpatient spaces designed to mirror the restorative forces nature may afford. Within contemporary healthcare architecture, the discourse surrounding nature's role has once again become prominent, especially in the concept of 'healing architecture'. While the literature on 'healing architecture' primarily considers how to connect recovery to nature through interventions in the built environment, less interest has been directed towards how nature is configured in design processes and what implications that has for the everyday experiences of patients and staff. In this paper we consider the design and implementation of one particular psychiatric hospital in Denmark to show that the 'nature' brought into this healthcare space can be experienced as anything but 'natural' and may reduce rather than enhance a felt sense of 'vitality' amongst patients. Based on our analysis, we end the paper by suggesting four principles for future healthcare design.

Digital technologies and healthcare architects' wellbeing in the National Health Service Estate of England during the pandemic.

Introduction: UK Built Environment is currently undergoing a digital transformation, as is happening in the National Health Service (NHS) of England. In this paper, the focus was on the intersection of the two sectors and specifically the potential digital transformation of the NHS Estate. The NHS has developed a strategy for its workforce, to improve staff health and wellbeing, and support equality, diversity, inclusion and the development of existing staff. Digital technologies (DTs) can relate to all Estates and Facilities Management priorities, as it cross-cuts all proposed actions. As opposed to most studies on the wellbeing of blue-collar workers, this article focuses on white-collar workers, specifically architects working in the NHS, especially since NHS at this stage is developing two important policies: the New Hospital Programme and the Workforce Action Plan. Therefore, it is important for the NHS to look at the digital transformation strategy in the prism of the other two. As architecture traditionally has low job satisfaction, it negatively impacts wellbeing. This study argues that this might have been accentuated during the pandemic for the architects working in the NHS and dealing with the added pressure from three new major tasks: adjusting the infrastructure capacity to fight Covid-19; and creating the infrastructure for the testing and vaccination programs. DTs in architecture potentially affect job satisfaction in terms of creativity, autonomy, time pressure, organisational commitment, and so on. Methodology: The methodology comprises a literature review and a pilot of interviews with healthcare architects/designers working in the NHS or on NHS-related projects. The research context is informed by the COVID-19 crisis that brought healthcare architecture to the frontline of the pandemic, with NHS architects creating new wards and vaccination centers, while private healthcare architects designed new hospitals. Results: In the niche area of healthcare architecture, architects were in their busiest year. Yet, the DTs available to them then could only support limited tasks and did not link well to operational data. Discussion: To explore how DTs transform the wellbeing of healthcare architects, understanding wellbeing in healthcare architecture in light of digital transformation is crucial for creating the necessary leadership for the sector to grow.

An Adaptable and Instructive Architectural Design Proposal for the Fight Against COVID-19 Pandemic in Existing Hospitals.

OBJECTIVES: It is aimed to make the spatial structure of an existing hospital that gave health service against COVID-19 during pandemic suitable to COVID-19 treatment in this article. The architectural arrangements aimed at preventing the contamination and spread of COVID-19 in this hospital are expressed in the study by offering practical revisions that reorganize the spaces and patient traffic. BACKGROUND: A state hospital in Turkey is chosen as an example, and the revisions intended for the reorganization of its existing spaces are made considering both the pandemic and post-pandemic period. Starting from the fact that the design parameters related with the spaces needed for the struggle against COVID-19 are common, it is hypothesized that the proposed arrangements be adaptable to many hospitals in different levels. METHODS: The existing physical situation and problems of the hospital during COVID-19 pandemic are determined by communicating with hospital administration and making survey study with the working staff; thereafter, the feasible architectural revisions and new circulation schemes are indicated in the article through the tables and revised architectural projects of the hospital. RESULTS: It is hypothetically expressed with these arrangements that the proposed design interventions are instructive and give clues for the solution of architectural design based problems that increase the risk of contamination of COVID-19 in hospitals. CONCLUSIONS: The highlighting of decreasing the risk of the contamination of disease in a hospital with simple architectural revisions and expressing the contribution it makes to the struggle against pandemic is the most important conclusion of this study.

Design-Related Impacts on End-of-Life Experience: A Brief Report of Findings from an Exploratory Qualitative Study.

BACKGROUND: Despite the general preference to die at home, many deaths occur in institutionalized settings. While biomedical interventions to ameliorate end-of-life (EoL) suffering have advanced, the end-of-life care (EoLC) environment is less understood as a means of palliative support. OBJECTIVE: This exploratory study considered the implications of clinical EoLC environments (facility buildings and their adjacent areas), aiming to understand how these designed spaces may be improved to better support experiences for patients, families, and staff. METHODS: Using an ethnography-driven approach, field observations (including participant commentaries) were captured at a standalone hospice and a palliative care ward at a general hospital. These were supplemented with semi-structured interviews. Content and thematic analyses were performed based on an interpretive-descriptive paradigm. Finally, informed by a review of field literature, analyses of all data were inter-related, and an interpretation was built to highlight key design considerations. RESULTS: Through the analysis, 6 socio-spatial dimensions of EoLC facilities were identified (locational contexts; service administration & management; common spaces; private spaces; in-between spaces; and nature-integrated spaces) as guiding concepts to appraise and improve such settings. CONCLUSION: Physical, emotional, and social wellbeing at the end of life is coalesced in and made visible by the designed environment. Therefore, evidence-based design serves as an important non-clinical intervention in such settings; however, patient involvement in such research remains difficult. Future scholarly research, new building schemes, and renovation projects should further examine the socio-spatial functions of clinical EoLC environments and investigate the challenges surrounding patient engagement within this domain.

Humanização na ambiência de Práticas Integrativas e Complementares: significado de bem-estar na perspectiva dos usuários / Humanisation in the Complementary and Integrative Practice ambience: the meaning of well-being from the users' perspective

Resumo Na busca pelo incremento qualitativo dos espaços de saúde e por uma experiência positiva de seus usuários, este artigo apresenta os significados de bem-estar relacionados à ambiência, atribuídos pelos usuários de ambientes terapêuticos de Práticas Integrativas e Complementares (PIC). A pesquisa qualitativa teve como um de seus objetivos "Identificar o significado de bem-estar e os estímulos que o influenciam, em ambientes de PIC". Foi realizada uma avaliação ambiental em três estudos de caso no ano de 2017, com múltiplos métodos, dos quais as entrevistas - com terapeutas, pacientes e coordenadores das instituições - e as observações sistemáticas foram os que melhor contribuíram para os resultados aqui apresentados. A categorização dos resultados sugere que os significados de bem-estar atribuídos pelos usuários de ambientes terapêuticos de PIC sejam: Acolhimento, Ânimo, Beleza, Concentração, Confiança, Relaxamento e Simplicidade. Neste artigo, apresenta-se a discussão da categorização em relação à revisão de literatura, às amostras de usuários, aos estímulos ambientais e aos métodos. Estima-se que essa categorização possa contribuir para a humanização das ambiências de PIC e para a melhoria de seus projetos arquitetônicos.

Abstract Aiming to have a qualitative increase in health spaces and provide a positive experience for its users, this article presents the meanings of well-being related to the environment, attributed by users of therapeutic environments with complementary and integrative practices (CIPs). One of the objectives of the qualitative research was to "Identify the meaning of well-being and the stimuli that influence it in CIP environments". An environmental assessment was carried out in three case studies in 2017, using multiple methods, of which interviews - with therapists, patients and coordinators from institutions - and systematic observations best contributed to the results presented here. The categorisation of the results suggests that the meanings of well-being attributed by users of therapeutic CIP environments are: Welcomeness, Motivation, Beauty, Concentration, Trust, Relaxation and Simplicity. In this article, the discussion of categorisation in relation to the literature review, user samples, environmental stimuli and methods is presented. It is estimated that this categorisation can contribute to the humanisation of CIP ambiences and to improving their architectural projects.

A Comparison of Hospital Area Measurement in Germany, Canada, Australia, and the United States: Part 1.

OBJECTIVES: This article compares national standards for area measurements of healthcare facilities in four countries and examines the risks and differences that can arise when comparing building areas of healthcare facilities internationally. BACKGROUND: In the planning and management of healthcare facilities, the utilization and comparison of building floor areas plays a major role. Differences in terminology, classification, and methodology help to reduce planning and cost risks when applied on a local and national level. The proper allocation of building floor space is vital in the design of room programs, determination of floor space, construction costs, and operating costs. METHODS: Each of the four hospital area measurement standards is compared to discern similarities and differences. RESULTS: Most countries use a three-tier system of hospital area measurement: building gross area, department gross area, and department net area. Few differences were found between country standards for department area, though the German standards do not fully address this tier. Variation is found in whether a country includes certain functions in the hospital area-such as research space, shell space, or central energy plants-which can have a significant impact on the overall hospital area. CONCLUSIONS: This article informs further development of individual country standards and highlights principles to consider for international hospital area comparison.

Enabling care: Maggie's centres and the affordance of hope.

This study explores the role of architecture in the affordance of hope for people with cancer. Specifically, it revisits 'enabling places' debates to understand the influence of spatial design in the experience of cancer care. Combining interviews and focus group data from two separate studies of visitors, volunteers, and staff members of Maggie's Centres, an organisation providing cancer support in the UK and internationally, the study investigates the emotional power of their buildings. In particular, we explore how Maggie's Centre buildings provide material, social, and affective resources for their users. We argue that Maggie's Centres help its visitors to orient themselves to their changing lives and uncertain futures in thoughtful ways and, thus, their buildings offer examples of the 'taking place' of hope.

Evaluation of Medical Staff Satisfaction for Workplace Architecture in Temporary COVID-19 Hospital: A Case Study in Gdansk, Poland.

This article analyses the architecture that was used in the temporary AmberExpo hospital in Gdansk, Poland which was installed during the COVID-19 pandemic. The construction of this type of facility is often based on experimental approaches, aimed at caring for patients suffering from an infectious disease in emergency conditions. In order to assess the level of employee satisfaction with the architectural and technical elements used in the first period of the hospital's activity, medical staff were asked to fill out a questionnaire. The analysis of the survey's results indicated that the majority of employees expressed satisfaction with the architectural and technical elements, with the design of the spatial layout of the individual medical zones receiving the most positive feedback. However, frequently selected drawbacks in the design included the lack of natural daylight, the artificial light that was used and the acoustics of the facility. This detailed examination of the satisfaction and feedback from medical employees working in this type of emergency facility enables the development of solutions that in the future will allow for the improved adaptive reuse and implementation of such structures, with enhanced time and economic efficiency, and most importantly, the ability to provide a safer workplace.

Architecture for Children With Autism Spectrum Disorder and Their Therapists.

OBJECTIVES: The objective of this study is to identify an architectural design framework that can be applied to create adaptable, transformative therapy rooms that benefit children with autism and their therapists. BACKGROUND: Previous research suggests that environment shapes and influences human behavior. However, there remains a lack of evidence of effective design for pediatric rehabilitation therapy rooms. This study specifically focuses on how the design of the therapy room influences the patient's level of comfort and participation as well as the therapists' quality and efficiency of treatment to improve the overall therapeutic experience. METHOD: Two different surveys were conducted to improve the design of a therapeutic room based on professional therapist experiences. A grounded theory approach was employed to identify specific codes and categories. RESULTS: The result of this study is an architectural framework based on specific design tenets and their properties that not only can be utilized by architects and interior designers for building a new therapy center but could also be used for remodeling existing therapy rooms.

A National Look at Hospital Bed Tower Design.

This study evaluates 171 hospital bed tower designs from the past decade. The Floor-building gross square feet (BGSF)/Bed, patient care area, ratio between them, and the bed count per unit were analyzed. The findings suggest that the average patient care area has decreased 5%-10% to a 305 departmental gross square feet (DGSF)/Bed average. The patient care area, support, circulation, and area grossing on floor were found to average 908 Floor-BGSF/Bed, and were impacted by the total beds/unit. It was determined that larger bed count per unit designs with 32-36 beds/unit average 21.9% less Floor-BGSF/Bed than designs with 24 beds/unit. The research evaluates design solutions impacted by a shifting environment of regulatory change and escalating costs. The hospital bed towers represent new facilities, horizontal/vertical expansions, and 25+ design teams. Design and/or construction took place during a 10-year period (2008-2018). The acute patient unit designs were reviewed and electronically quantified. The area measurement methodology aligns with the guidelines set forth in the "Area Calculation Method for Health Care" guidelines. Each project team was faced with a unique but similar set of circumstances. The balance between core values, guiding principles, budget, and quality of care was always present and included a diverse combination of owners, designers, construction delivery methods, profit models, and clinical approaches. In today's world, common solutions are grounded in providing the best value. Project teams face a number of challenges during design. The lack of information should never be one.

Lessons Learned From Decentralization of an Elective Surgery Medical-Surgical Unit.

OBJECTIVE: The objective of this study was to examine changes in healthcare practitioners' perception of supportiveness of their physical work environment, and trend in patient fall, when moving from a centralized to a decentralized unit configuration. BACKGROUND: Previous studies on decentralization have not uniformly provided findings consistent with desired outcome. METHOD: A pretest-posttest study was conducted in an elective surgery medical-surgical unit in the mid-Atlantic region of the United States. The independent variable was the physical design supporting centralized versus decentralized nursing models. Data were collected from healthcare staff with a self-report survey "before" (September 2017; n = 42) and "after" (June 2019; n = 22), and interviews. Before-after data were analyzed using both parametric and nonparametric tests to identify significant differences. Qualitative responses were analyzed to identify triangulating evidences. Monthly patient fall data were collected for a 3-year period and analyzed using log-linear Poisson Regression model. RESULTS: Results show favorable assessments in the areas of overall supportiveness of design, equipment and soiled utility location, peer support, process flow visualization, and overall satisfaction. A reduction in patient falls was observed. Unfavorable outcomes were found in the contexts of walking distance, multidisciplinary collaboration, alarm audibility, nurse station size, and PPE location. CONCLUSIONS: This study underscores that the success of a unit cannot be achieved without coordinated and successful interventions in the areas of operations, processes, policies, culture, and the physical design.

Hospital Architecture in Spain and Italy: Gaps Between Education and Practice.

AIM: The research sheds light on the challenges and limitations of Spanish and Italian hospital design by looking at the gaps between education and practice. BACKGROUND: Hospital design plays an important role in providing high-quality and cost-effective facilities for any healthcare system. Spain and Italy face contemporary challenges (i.e., elderly population, staff retention, and obsolete healthcare facilities) and have similar issues of life expectancy, health expenditure, hospital beds provision, and decentralized tax-financed healthcare systems. METHOD: A cross-sectional, mixed-method study was used. This involved two different data collection strategies and analysis for each area of investigation: (i) education and (ii) practice. For the former, educational programs were reviewed via a web search; for the latter, an online survey of 53 architectural/engineering offices involved in hospital design was conducted. RESULTS: Hospital design education is limited to 0/58 in Spanish and 2/60 courses in Italian universities, although each country offers three postgraduate courses. The practitioners' survey shows that even though their offices have a long history of healthcare design, only 48% in Spain and 60% in Italy have received specific university training. Office staff lack employees with medical backgrounds, which hinders any partnership between health and design fields either for design practice or the education fields. Laws, national regulations, technical guidelines, and previous experience are the most useful information sources, while international scientific publications appear underused by practitioners. CONCLUSIONS: Italian and Spanish healthcare architecture could be improved by promoting multidisciplinary teams (in practice and education) and improving the education offer by tailoring it to national needs.

mHealth Apps: Disruptive Innovation, Regulation, and Trust-A Need for Balance.

mHealth, the use of mobile and wireless technologies in healthcare, and mHealth apps, a subgroup of mHealth, are expected to result in more person-focussed healthcare. These technologies are predicted to make patients more motivated in their own healthcare, reducing the need for intensive medical intervention. Thus, mHealth app technology might lead to a redesign of existing healthcare architecture making the system more efficient, sustainable, and less expensive. As a disruptive innovation, it might destabilise the existing healthcare organisation through a changed role for healthcare professionals with patients accessing care remotely or online. This account coincides with the broader narrative of National Health Service policy-makers, which focusses on personalised healthcare and greater patient responsibility with the potential for significant cost reductions. The article proposes that while the concept of mHealth apps as a disruptive technology and the narrative of personalisation and responsibilisation might support a transformation of the healthcare system and a reduction of costs, both are dependent on patient trust in the safety and security of the new technology. Forcing trust in this field may only be achieved with the application of traditional and other regulatory mechanisms and with this comes the risk of reducing the effect of the technology's disruptive potential.

The Creative Healthcare Architect.

The objectives of the research described in this article focus on an understanding of factors that influence creativity in healthcare design. Two areas of emphasis include the personality strengths of successful healthcare architects and elements of the current project delivery process. As part of the research, 48 healthcare architects participated in a battery of personality and creativity tests including Myers/Briggs, The Big Five, the Remote Associates Test (RAT), and an architectural creativity test. Results of the test point to strong "openness" for new ideas, particularly with the designers sampled. As a group, respondents scored low in "narcistic" bias (indicating emotional stability) and did not score high in verbal creativity. Compared to earlier studies of creative architects, the sample group included significantly fewer "perceiver" (Myers/Briggs), associated with a high level of curiosity. A second interesting finding was a significant difference between younger and older architects in the architectural creativity test. One possible hypothesis is the experience of the older architects. A second, and potentially more alarming, hypothesis is that technological disruptions are interfering with the ability to stimulate divergent thinking, particularly in the younger generation raised with smart phones and other network tools. Creativity in healthcare architecture demonstrates the case for domain-specific experience and skills along with creative input from other knowledge domains. The ability to establish group creativity may be inhibited by pressures to condense project time lines and not fully implement lean and other process strategies for exploring alternative solutions. Effective participation in group creativity tasks is particularly important for the complex world of healthcare design.

Affecting care: Maggie's Centres and the orchestration of architectural atmospheres.

This article presents research on the architecture of Maggie's Centres, a series of buildings for those with cancer, their families and friends. In particular, we explore the way in which their architectural atmospheres are spoken of by architects who have designed individual Maggie's Centres, in interviews with staff members and volunteers in the buildings and in focus groups with visitors to their sites. We bring together qualitative research from two separate projects, and present findings from interviews, across the UK and internationally, with 66 visitors, 22 staff members and 7 architects of Maggie's Centres. How our research participants discussed the atmospheres of their Maggie's Centres is broken down into an analysis of, respectively, how building materials are used in these buildings; how colour and light are experienced in the buildings, and how the shape of the buildings in themselves affect the ways in which people use the spaces. These separate aspects of the buildings combine to become what can be described as the generators of architectural atmospheres. We discuss how architects, staff members, volunteers and visitors translated their intuition of intangible atmospheres into a recognition of architectural qualities, and linked these to questions of care. Maggie's Centres, we argue, are emotionally charged buildings that shape the ways in which care is staged, practiced and experienced in everyday ways, through the orchestration of architectural atmospheres. We use the example of Maggie's Centres as a comparison with how social scientists have characterised the design of mainstream hospital settings, in order to draw out the implications for questions of healing and recovery from illness, and how buildings may hold the potential to affect care.

Impact of window views on recovery-an example of post-cesarean section women.

OBJECTIVE: The objective of this study was to examine the impact of urban landscape from window views on quality of care for women who underwent Cesarean Section (C-section) in Taiwan. DESIGN: The participants were randomly assigned into 46 different hospital rooms to see the effects of various window views and daylight exposure on women's recovery from post C-section care. SETTING: We carried out this study in the obstetrics departments of three tertiary hospitals located in two major cities of Taiwan: Taipei City and New Taipei City. PARTICIPANTS: A total of 296 women who underwent C-sections and used patient-controlled analgesic (PCA) for pain control after their surgery during the 10-month data collection period were recruited for this study. INTERVENTION: The 46 different patient rooms provided diverse window views and different daylight exposure for the participants. MAIN OUTCOME MEASURES: Recovery for the women who underwent C-sections in this study was defined as PCA usage and perceived pain measured by Brief Pain Inventory (BFI). RESULTS: Higher satisfaction of window view significantly decreased analgesic usage (P = 0.057), reduced the scores of overall perceived pain (P = 0.046), pain severity (P = 0.004), and 'pain's interference with relations with others, enjoyment of life, and mood (REM).' (P = 0.095). CONCLUSIONS: To maximize benefit and well-being of patients recovering from surgery, health care architects should design patient rooms to create maximum satisfaction with visual impacts and optimize window views. By doing so, it may decrease the use of pain medication and substantially reduce healthcare costs.

Design Quality in the Context of Healthcare Environments: A Scoping Review.

OBJECTIVE: We explored the concept of design quality in relation to healthcare environments. In addition, we present a taxonomy that illustrates the wide range of terms used in connection with design quality in healthcare. BACKGROUND: High-quality physical environments can promote health and well-being. Developments in healthcare technology and methodology put high demands on the design quality of care environments, coupled with increasing expectations and demands from patients and staff that care environments be person centered, welcoming, and accessible while also supporting privacy and security. In addition, there are demands that decisions about the design of healthcare architecture be based on the best available information from credible research and the evaluation of existing building projects. METHOD: The basic principles of Arksey and O'Malley's model of scoping review design were used. Data were derived from literature searches in scientific databases. A total of 18 articles and books were found that referred to design quality in a healthcare context. RESULTS: Design quality of physical healthcare environments involves three different themes: (i) environmental sustainability and ecological values, (ii) social and cultural interactions and values, and (iii) resilience of the engineering and building construction. Design quality was clarified herein with a definition. CONCLUSIONS: Awareness of what is considered design quality in relation to healthcare architecture could help to design healthcare environments based on evidence. To operationalize the concept, its definition must be clear and explicit and able to meet the complex needs of the stakeholders in a healthcare context, including patients, staff, and significant others.

Community-Engaged Public Health Research to Inform Hospital Campus Planning in a Low Socioeconomic Status Urban Neighborhood.

OBJECTIVE: To compare sociodemographic and motivational factors for healthcare use and identify desirable health-promoting resources among groups in a low socioeconomic status (SES) community in Chicago, IL. BACKGROUND: Disparities in health services and outcomes are well established in low SES urban neighborhoods in the United States and many factors beyond service availability and quality impact community health. Yet there is no clear process for engaging communities in building resources to improve population-level health in such locales. METHODS: A hospital building project led to a partnership of public health researchers, architects, and planners who conducted community-engaged research. We collected resident data and compared factors for healthcare use and choice and likelihood of engaging new health-promoting services. RESULTS: Neighborhood areas were strongly associated with ethnic groupings, and there were differences between groups in healthcare choice and service needs, such as, proximity to home was more important to Latinos than African Americans in choice of healthcare facility ( p adj = .001). Latinos expressed higher likelihood to use a fitness facility ( p adj = .001). Despite differences in vehicle ownership, >75% of all respondents indicated that nearby public transportation was important in choosing healthcare. CONCLUSION: Knowledge of community needs and heterogeneity is essential to decision makers of facility and community development plans. Partnerships between public health, urban planning, architecture, and local constituents should be cultivated toward focus on reducing health disparities. Further work to integrate community perspectives through the planning and design process and to evaluate the long-term impact of such efforts is needed.