This review of the literature on health care environments and patient outcomes considers three research themes: patient involvement with health care (e.g., the role of patient control), the impact of the ambient environment (e.g., sound, light, art), and the emergence of specialized building types for defined populations (e.g., Alzheimer's patients). The article also describes the challenges presented in doing high-quality research focused on health care environments and contrasts the contributions made by two different traditions: architecture and behavioral science. The implications of managed care and opportunities for research are considered.

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The ability to successfully navigate in healthcare facilities is an important goal for patients, visitors, and staff. Despite the fundamental nature of such behavior, it is not infrequent for planners to consider wayfinding only after the fact, once the building or building complex is complete. This review argues that more recognition is needed for the pivotal role of wayfinding in healthcare facilities. First, to provide context, the review presents a brief overview of the relationship between environmental psychology and healthcare facility design. Then, the core of the article covers advances in wayfinding research with an emphasis on healthcare environments, including the roles of plan configuration and manifest cues, technology, and user characteristics. Plan configuration and manifest cues, which appeared early on in wayfinding research, continue to play a role in wayfinding success and should inform design decisions. Such considerations are joined by emerging technologies (e.g., mobile applications, virtual reality, and computational models of wayfinding) as a way to both enhance our theoretical knowledge of wayfinding and advance its applications for users. Among the users discussed here are those with cognitive and/or visual challenges (e.g., Down syndrome, age-related decrements such as dementia, and limitations of vision). In addition, research on the role of cross-cultural comprehension and the effort to develop a system of universal healthcare symbols is included. The article concludes with a summary of the status of these advances and directions for future research.

Qualitative research can add significantly to our understanding of the healthcare experience and may inform design decisions.