Method to Understand Value Generation in Healthcare Built Environments Based on the Means-End Chain Approach

BackgroundExisting literature highlights the crucial role of Healthcare Built Environments (HBEs) in generating value and shaping service experiences. HBEs must fulfil their intended purpose during the operational phase of construction projects to generate value. Additionally, many design requirements for facilities are shaped by the needs of clinical and support services, as well as those of users. Therefore, understanding value generation requires considering the dynamic interdependence between physical space and service needs. However, previous studies have not thoroughly explored these relationships, leaving a critical research gap.ObjectiveIt aims to propose a method to understand value generation in HBEs by examining the relationships between built environment attributes and healthcare service delivery, from the perspectives of multiple user groups.MethodDesign Science Research was the methodological approach adopted in this investigation. Two empirical studies were undertaken in different hospitals.ResultsThe primary output is the i3 method, a novel approach for understanding value generation in HBEs. It integrates the laddering technique, which is based on the means-end chain conceptual model, with additional sources of data, such as design documents, interviews with stakeholders, and direct observations of the HBEs.ConclusionsFindings highlight the importance of analyzing the interactions between the HBE and services, revealing opportunities to enhance value generation. The hierarchical value maps generated through the i3 method offer a structured approach to support design decision-making. The i3 method helps identify overlooked constructs and relationships, such as the need for HBE adaptability to address service changes or respond to unforeseen service demands.