Which hospital ward layout works best? In the past, one response to this question has been to design layouts that minimise walking distances of healthcare workers, and increase the time spent with their patients. However, new research suggests that good face-to-face communication between doctors and nurses crucially impacts the health and safety of patients. Taking this into account, this research proposes a new single measure called Spaces for Communication Index (SCI). It assesses communication opportunities arising from the layout, and shows that a high index is associated with the provision of good healthcare. Six NHS wards were first studied in depth by collecting detailed information about movement and communication patterns of healthcare workers. The index was developed on this basis. Thirty-one NHS wards were then selected, based on their quality of care rating. These were used to test the index. Each ward was analysed with the Space Syntax method, which investigated the size of visual fields of healthcare workers on everyday movement paths through the ward. Large viewsheds provide good visibility and awareness of the environment. As a result, they accrue more communication opportunities by virtue of the layout. Statistical analysis was also used to test if the index can predict care quality. Other factors such as distances between key areas, number of patient beds or ward size were tested, too. Results showed that the higher the index, the better the quality of care. The other factors were not related to healthcare quality. In terms of design, these results high-light the importance of the openness of spaces that healthcare workers traverse to get from one key area to another. This research contributes to the development of an objective method that designers can use to compare different nursing unit designs, and anticipate the care quality that would be provided to patients.

The impact of the physical workplace on behaviors and attitudes at work is a much-studied topic. Major research streams over the last decades investigated either satisfaction with offices in relation to physical comfort, or how layout decisions influenced interaction and collaboration in the workplace with a focus on open-plan offices. Rather little is known on the effect a workplace layout (such as its openness) has on perceptions of staff regarding teamwork, focused work and perceived productivity. We aim to close this gap by taking a differential approach which appreciates detailed variations within open-plan offices. Not every corner of an office is the same, so the question arises whether satisfaction with workspace differs depending on where someone is sitting. Bringing results of a staff survey in the UK headquarters of a global technology company together with a detailed analysis of spatial qualities at desks based on isovist and visual field analysis, we find that staff are less likely to rate their workplace environment favorably when they have higher numbers of desks within their own field of vision; and when they are facing away from the room with a relatively larger area behind their back compared to the area surrounding them. Aspects of teamwork that are negatively affected include sharing information with others, as well as team identity and cohesion. Focused work (concentration) and working productively are impacted even more so with the largest effect sizes throughout. These findings highlight the relevance of investigating detailed spatial qualities of micro-locations in workplace layouts. Our results also raise important questions regarding the current popular practice in workplace design of providing large open-plan offices for technology companies.

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