Method to understand value generation in healthcare built environments based on the means-end chain approach

Baldissera Leitte-Teixeira, GA, Formoso, CT and Tzortzopoulos, P ORCID: https://orcid.org/0000-0002-8740-6753, 2025. Method to understand value generation in healthcare built environments based on the means-end chain approach. Health Environments Research and Design Journal. ISSN 1937-5867 (Forthcoming)

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Abstract

Background: Existing literature highlights the crucial role of Healthcare Built Environments (HBE) in generating value and shaping service experiences. HBE 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.

Objective: It aims to propose a method to understand value generation in HBE by examining the relationships between built environment attributes and healthcare service delivery, from the perspectives of multiple user groups.

Method: Design Science Research was the methodological approach adopted in this investigation. Two empirical studies were undertaken in different hospitals.

Results: The primary output is the i3 method, a novel approach for understanding value generation in HBE. 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 HBE.

Conclusions: Findings highlight the importance of analysing 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.

Item Type:	Journal article
Publication Title:	Health Environments Research and Design Journal
Creators:	Baldissera Leitte-Teixeira, G.A., Formoso, C.T. and Tzortzopoulos, P.
Publisher:	Sage
Date:	3 June 2025
ISSN:	1937-5867
Identifiers:	Number Type 2468469 Other
Rights:	Accepted for publication in Health Environments Research & Design Journal. Reuse is restricted to non-commercial and no derivative uses.
Divisions:	Schools > School of Architecture, Design and the Built Environment
Record created by:	Jonathan Gallacher
Date Added:	16 Jul 2025 12:49
Last Modified:	16 Jul 2025 12:49
URI:	https://irep.ntu.ac.uk/id/eprint/53958

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