Negotiation in Design: The Participatory Process in Designing Healthcare Facilities of a Public Hospital

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Soranart Sinuraibhan
Tanasi Samphantharak Petyim
Saithiwa Ramasoot
Supreeya Wungpatcharapon
Kuanchai Kakaew
Prowpannarai Mallikamarl


Healthcare policy and organizational system engaging with public health facilities in Thailand are directly and rigidly controlled by the Ministry of Public Health based on its centralized practice. As part of the inflexible system, public hospitals across the country are forced to accept standardized building designs provided by the Ministry. Consequently, several hospital buildings cannot respond properly to users’ requirements, including the needs of hospital personnel. By regarding hospital staff as an important part of healthcare service, this study examines perceptions, expectations and actions provided by a group of hospital users while they took part in the participatory design process. The study aims to gain a better understanding of how the participatory approach is implemented in design interventions for the improvement of public hospital environments built from standardized designs and run by the centralized organization system. A ninety-bed community hospital was selected and used as the setting of this study. Participant observations were conducted while groups of staff from a variety of sections in the hospital collaborated with designers through meetings and a series of activities to redesign the spaces of the Outpatient Department (OPD). The study shows that the hospital personnel expressed their needs to change their standard workplace to a more supportive environment in which work performances and their well-being are fostered. Also, the participatory approach allows two-way learning dialogues between hospital personnel and designers. The approach provided opportunities to the personnel to share their experiences with their colleagues and learn more about their workplace. Furthermore, it reflects that the negotiation process is a key to the success of the improvement of the hospital’s built environment. The causes of negotiation in a wide range of forms and scales are possibly involved in the design process.


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