While most designers may agree that pre- and post-occupancy surveys are important tools, these valuable insights into the design process rarely are utilized. However, with the advent of evidence-based design and the collection of project data, facility evaluation may increase. According to Mardelle McCuskey Shepley’s new book Health Facility Evaluation for Design Practitioners, “The impediments to conducting facility evaluations are identical to the barriers for conducting any type of research. They range from lack of alignment between disciplines regarding the nature of the task to cost factors. Such obstacles appear to be diminishing over time as the nature of the [design] profession shifts toward the goal of accountability, the hallmark, and motive behind most evaluation studies.”2
From the sharing of knowledge from lessons learned, project teams can contribute to the baseline knowledge of the design profession. While this may seem frightening regarding competitive advantage and possible litigation issues, projects must meet codes and standards for the health, safety, and welfare of the public. The survey process can help distinguish projects that deliver positive results from pre-established drivers influencing the design. Depending on the purpose and timing of the survey, pre- and post-occupancy surveys provide insightful information that can influence the design process. Survey results may reveal client values that become design drivers and later gauges for project success.
Survey Purpose and Process
Typically, survey questions are used when measuring indirect variables or constructs, which may include feelings about a space, the quality of light, or access to nature1. The types of questions asked are dependent on the data intending to be gathered. Many factors weigh into the development and process of surveys including but not limited to the following:
• Goal of survey
• Structure of research team—designer, client (owner, staff, or facility manager), and academic researcher
• Level of objectivity
• Populations surveyed—patients, family, staff, administration
• Timing of the survey
• Types of questions asked—open ended versus directed questions
• Internal review board (IRB) approval
• Pilot testing
• Quantity of questions per construct
• Quantity of questions overall—length of survey could deter participation
• Order of questions
• Use of graphics in surveys
• Professionalism in presentation
• Structure of questions
• Language used in questions—jargon or specialty terms
• Method of administering the survey—online, printed, or both
• Method of evaluating results
• Consistency of survey—using the same questions for pre- and post-occupancy surveys
Surveys in Practice
For the Children’s National Medical Center (CNMC) Michael and Hilda Edlavitch Cardiology Clinic in Washington, D.C. (shown above and right; photos by Maxwell MacKenzie), a pre- and post-occupancy survey was administered to staff in order to evaluate the qualitative aspects of the design solution. Since constructs were being evaluated, survey was the best available method. A research team including the designer and client (Director of Outpatient Nursing & Ambulatory Services) developed the questions and agreed to utilize the online platform of Survey Monkey (www.surveymonkey.com) in order to reach the broadest audience of clinic staff including those who were and were not a part of the design process. The online platform also assisted in developing a professional looking survey as well as provided tools for data collection and evaluation.
The goal of the pre-occupancy survey was to gather data from clinic staff about their perceptions of the existing clinic space. Based on goals established early in the design process, eight "agree or disagree" questions about design drivers, light, and workspace; one range question about noise levels (too quiet to too noisy), and one open-ended comment question were given to the staff one month prior to moving into their new space. Data was collected and evaluated.
After three months in the new clinic, the same survey was administered to the staff in order to evaluate their initial reactions to being in the new clinic space. One additional "agree or disagree" question about workspace was added to the survey as a result of pre-occupancy survey responses in the open-ended comment section. Generally, the post-occupancy survey responses reveal that the design solution accounts for the goals of the design drivers, including access to daylight, controlling noise levels, adequate workspaces, and intuitive wayfinding.
Jeanne Ricks, BSN, MS, RN, commented, “Staff and providers are elated to work in an environment that facilitates professional practice and service excellence.” Ricks' comment is only strengthened by the comparison of pre- and post-occupancy survey responses from the clinic staff; however, additional surveys at six, 12, 18, and 24 months after occupancy would account for seasonal change and provide comparative data. This comparative data could become a foundation for remodeling and informing future projects2.
Since the design process is deadline driven, any task not thoroughly integrated into the design process is a barrier to success. Including surveys or evaluations into the design process allows teams to compare the effectiveness of design solutions. While no design team wishes to learn of negative survey results, the survey process provides a platform for lessons learned. As more information is gathered and (hopefully) disseminated within design firms and throughout the industry, an informed foundation can develop to gauge the effectiveness of proposed design solutions in projects2. Not only would this benefit a project team, the design industry would benefit from the open communication about projects successes and improvements.
Matthew J. DeGeeter, ASID, LEED AP ID+C, is an interior designer at Perkins+Will in Washington, D.C., where he incorporates his graphic design and research into design work, presentations, and writing. He can be reached at firstname.lastname@example.org.
Helen Lanes, AAHID, IIDA, LEED AP BD+C, is a senior associate at Perkins+Will in Washington, D.C., where she has more than 20 years of focused, client driven, and award winning projects. Lanes combines research with experience to inform all of her projects that yield a high level of functionality, efficiency, and comfort. A member of AAHID and a spokesperson for sustainable interior products, Lanes can be reached at email@example.com.
1. Etchegaray, J.M., and W.G. Fischer, "Understanding Evidence-Based Research Methods: Reliability and Validity Considerations in Survey Research," Health Environments Research and Design Journal, Vol. 4, No. 1. Fall 2010.
2. Shepley, M. M., Health Facility Evaluation for Design Practitioners. Asclepion Publishing, LLC. 2011.
Past installments of "Designing for Health" include (click on title to access the full article):
• Perkins+Will Research Journal—Integration of Design and Research within a Global Practice
• The Role of Designers in Helping with Infection Control in Hospital Environments
• The Unexpected Oasis—A medically, spiritually, and emotionally caring environment
• Integrating Research into the Design Process • Altruism in the Profession—The Implementation of Social Responsibility
• Altruism in the Profession
• How Green is Your Furniture
• Workspaces for Well-being