a post occupancy evaluation of the dundee maggie … post occupancy evaluation of the dundee maggie...
TRANSCRIPT
A post occupancy evaluation of the Dundee Maggie Centre
Final Report for Sust. March 2007
Dr. Fionn Stevensonwith Professor Mike Humphris
Ecological Design GroupSchool of ArchitectureUniversity of Dundeein association with Bute Medical School,University of St. Andrews and the Maggie’s Centres
Executive Summary 03 Acknowledgements 05
1. Introduction 06 2. Background 07 3. Aims and Objectives 09 4. Methodology 10 5. Programme 12 6. Results and Analysis 13 a) background demographics 13b) environment behaviour 13 c) the building design 15 d) the visit 16 e) comfort issues 17f) sense of wellbeing and health 20g) staff and volunteer perspective 23h) the building process 26 7. Conclusions and Recommendations 31 8. Bibliography 34 I. User Interview Guide 35 II. Technical Interview Guide 37 III. Drawings –plans/sections/elevations 39 IV. Benchmarking for Fuel Costs 41V. Tables 42VI. Architectural Brief 52
Contents
AnevaluationoftheDundeeMaggie’sCentrewascommissionedbySust.TheLighthouseonSustainabilityinOctober2005andcompletedinMarch2007byEDG(EcologicalDesignGroup)attheSchoolofArchitecture,UniversityofDundeeinassociationwithButeMedicalSchool,TheUniversityofSt.AndrewsandtheMaggie’sCentres.TheDundeeMaggie’sCentreisoneoffivecompletedprojectsinScotland,withafurther10projectedforcompletionintheUK.ThefundamentalremitoftheMaggie’sCentres,whichwereinspiredbyMaggieJencks,istoprovideinformationandpsycho-socialsupportforcarersandpeoplewithexperienceofcancer.
Theaimsofpilotstudyweretoevaluate:
• visitorandstaffresponsesas usersofthebuilding• physicalperformanceof thebuilding• designandconstructionprocess
and:
• developacross-evaluativemethodologyforwideruseinsmallscalehealthcarebuildingsinordertoimprovethebriefingprocess.
The evaluation aimed to establish:
a) theeffectivenessofthedesign conceptintermsoftheoriginal briefandcaremodelb) theoverallusersatisfactionwith thebuildingc) theextenttowhichpeopleperceive thebuildingascontributingtotheir senseofcomfort,wellbeingand health,andthereasonsforthisd) thecomparisonoftheease, speed,andcostofconstruction withastandarddomesticscale palliativecarebuildinge) thebuilding’sphysicalperformance andsustainability,including managementandmaintenance issues,andthelevelofenergy costscomparedtonormative measuresf) recommendationsforthefuture MaggieCentrebriefingprocessand furtherdevelopmentofthe evaluationmethodologyforother smallscalehealthcarebuildings.
Semi-structuredinterviewswereundertakenwith4staffand2volunteers,aswellasanarchitectrepresentativeandtheCentreHead.Questionnaireswerecompletedby34visitors.Fuelbillswereobtainedforaoneyearperiodfromtheenergysupplierandcomparedtouserscomments.
Theresultsofthesmallpilotsurveyindicatethatthebuildinghassuccessfullyachievedthefollowingobjectivesofthebrief:
• ahighlyeffectivedesignconcept inrelationtotheMaggieCentre’s caremodel• veryhighusersatisfactionoverall, withfacilitiesprovidingacalmand friendlyspaceandanappropriate degreeofprivacy• highlevelofoverallcomfort• usersperceptionofincreased healthandwellbeingduetovisiting thebuilding• particularappreciationoftheviews outofthebuilding• lowlevelofmaintenancerequired
Thebuildinghasbeenlesssuccessfulinachievingtheremainingobjectives:
• flexibleofficespacewhichis separateyetvisiblefrom welcomearea• adequatestoragefacilitiesforthe officeareaandotheractivities• thermalcomfort
Executive Summary
Evidenceonrunningcostsfromfuelbillsobtainedforafullyearindicatesthatenergyusewaswellwithingovernmentenergytargetsof35-55GJ/100cu.mfornewbuildingsintheNHSEstate(2001-2010),cominginat29.4GJ/100cu.m.Energyrunningcostswere£64perweekfor286kwh/m2.Totalcarbonemissionsforthebuildingwere4.4tonnesfortheyear.
Additionalissueswhichemergedfromthesurveyincluded:
a) adegreeofoverheatingdueto solargain,lackofcross-ventilation andpoorheatingsystemcontrolb) adegreeofglareduetolowangle solarpenetrationinthe kitchenareac) thedifficultyofhavinganoffice areaimmediatelyattheentranced) userdissatisfactionwithseating ergonomicse) lackofadequate car-parkingfacilitiesf) flexibilityofsmallertherapyrooms
Thehighlevelofoverallusersatisfactionvalidatesadesignapproachwhichhasplacedanemphasisonthequalityoftheinternalspace.Gooddesignalsogivesthebuildingahigh“forgiveness”factorinrelationtoissuesofthermalcomfort,ventilation,glareandlackofhumidity.
ThereareanumberofareaswherethebriefingprocessfortheMaggie’sCentrescouldbestrengthenedinordertoimprovetheoverallperformanceoftheirbuildings,includingtherequirementfor:
a) simpletounderstandandeasy touseheatingsystems,controls andprogrammerswhichcan respondtorapidlychanging occupancylevelsb) low-noisemechanicalventilation equipmentinuserenvironmentsc) adequatesolarshadingand provisionofcross-ventilationd) specificstorageareasandfacilities tobemoreclearlyidentifiedor systemforremovingitemse) adequatecirculationinofficeareasf) sustainabledesignand specificationwithincost constraints.
Thefollowingaspectspresentopportunitiesforfurtherresearch:
• awiderstudyofallMaggieCentresusingafurtherrefinementofthemethodologyestablishedinthispilotstudytoascertainspecificoutcomesandresearchquestionswhichexaminekeydesignfeaturesinrelationtouser’sperceptionhealthandwellbeing.
• awiderstudyoftherelationshipbetweenuser’sabilitytocontroltheirenvironmentandtheirperceivedstateofhealthandwellbeing.
• thedesignofventilationandheatingstrategiesinrelationtothepresence,orabsence,ofthermalmassinsmall-scalehealthcarebuildingsandtheeffectthishasonenergyefficiencyandcomfort.
“Maggie’s welcomes the report’s positive and constructive findings. Suggestions for change have been noted and where appropriate incorporated within the management of the Centre whilst at no time compromising the relaxed and non-institutional ethos which underpins the Maggie’s environmental and programme objectives.”
Laura Lee, Chief Executive, Maggie’s Centres
Executive Summary
Theresearchteamforthisprojectwas:
Dr. Fionn Stevenson PrincipalInvestigator,UniversityofDundeeProfessor Gerry Humphris Co-investigator,UniversityofSt.AndrewsLesley Howells ClientRepresentative,CentreHead,Dundee Maggie’sCentreAnita Laidlaw PostdoctoralPsychologist,UniversityofStAndrewsSusanne Monka GraduatePsychologist,UniversityofStAndrews
Theauthorswouldliketoacknowledgethegeneroustimedonatedtothisstudybythefollowingpeople:
Laura Lee ChiefExecutive,Maggie’sCentresGlynn Jarvis ProgrammeDirector,Maggie’sCentresCharles Jencks AuthorandfounderoftheMaggie’sCentresMark O Connor SchoolofArchitecture,UniversityofDundeeMichael Spens SchoolofArchitecture,UniversityofDundeeFred Stephens JamesFStephensArchitectsDoug Reid JamesFStephensArchitects
TheauthorswouldalsoliketothanktheotherstaffandusersofDundeeMaggie’sCentrewhokindlygavetheirtimeforinterviewsorcompletedthequestionnaire–withoutthem,thisworkwouldnotbepossible.
Acknowledgements
1 TheLighthouseCentreforArchitecture,DesignandtheCitybasedinGlasgow,Scotlandaimstodevelopthelinksbetweendesign,architecture,andthecreativeindustries,seeingtheseasinterconnectedsocial,educational,economicandculturalissuesofconcerntoeveryone.Aspartofitspromotionofsustainabledesign,thisstudywasindependentlycommissionedinOctober2005bytheSust.programme,tofillagapintheknowledgeconcerningthedesignandsmallscalehealthcarebuildingsinrelationtotheuserexperienceandbuildingperformanceinScotland.ItwascompletedinJanuary2007byEDG(EcologicalDesignGroup)attheSchoolofArchitecture,UniversityofDundeeinassociationwithButeMedicalSchool,TheUniversityofSt.Andrews,andtheMaggie’sCentres.
2 Itisonlywithinthelastfewyearsthatenvironmentalissues,beyondtheneedforenergyconservation,havebeenconsideredwithinhealthcarebuildingdesignstrategies,butasyetthereislittle“joinedup”thinkingwhichdirectlylinksenvironmentalperformancewithqualityofdesignandusersatisfaction.Thiscasestudy,drawingontheinnovativetypologyoftheMaggie’sCentres,evaluatedboththeseelementsandthencross-validatedtheminordertoprovideauniquelyholisticappraisalofaparticularbuildingsolution.
3 Underlyingasustainabledesignstrategyforsmallscalehealthcareenvironmentsaretwoprerequisites:
• Therecognitionthatenvironmentaldesignisanintrinsicpartofhealthcaredesignandprovidesmultiplebenefitsincluding:economic,psychologicalandsocial.
• Theunderstandingofdesignwithinanecologicalframework,recognisingthatthedesignofbuildingsisfundamentallyaprocessratherthanjustaproduct.
4 Aprimarywayofimprovingthedesignofsmallscalehealthcarebuildingsisbyfocusingonhowusersexperiencethem,bothintermsoforientationandtheirsenses.Therolethattheenvironmentplaysinthiscanbemosteffectivelyassessedthroughanalysiswhich
combinesbothqualitativeandquantitativemethods.
5 ThisstudyintroducesthedevelopmentofapostoccupancyevaluationandbriefingprocessthatcanbeappliedtoallMaggie’sCentres.Thedesignlessonsmaybeextendedtoothersimilarhealthcaretypologies.
1. Introduction
1 TheUKgovernmentresponsetotheneedforgreaterqualityofdesignandsustainabilityinhospitalshasfocusedonseveralinitiatives.TheNHSnowhasspecifictargetsforachievingsustainabilityaswellasanindependentbodytopromotegooddesigninhospitals1.InScotland,theNHScurrentlyusesatoolknownas“Greencode”fortheevaluationofitsestateinrelationtokeyenvironmentalperformanceindicators,whicharereportedonanannualbasis2.AtthesametimeCABEhasprioritisedthedevelopmentofqualitydesigninhealthcareenvironments,mostrecentlywithalimitedcompetitiontoexploreideasaswellasadetailedlookattherelationshipbetweenhealthandthebuiltenvironment3.ArchitectureandDesignScotland,inrelationtoCABE,hastakenasimilarinterestwithitsowncolloquiumonthedesignofhealthcarebuildingsin2006.
2 Postoccupancyevaluation(POE)providesamoredetailedmeansofexaminingtheperformanceoftheNHSestateonabuilding-by-buildingbasis.ThehighlysuccessfulPROBEprogramme,whichcarriedoutPOEonanumberofdifferentbuildingsduringthe1990’s,onlyexaminedonehealthcarebuilding4.TodatetherehasbeennosystematicevaluationandcrosscomparisonofhealthcarebuildingtypologiesintheUK,althoughtherehavebeenanumberofimportantindividualstudieselsewhere5.
3 SeminalPOEworkbyProfessorLawsonandcolleaguesinSheffieldUniversityhasproventhelinkbetweengooddesignandimprovedbed-patientrecoverytimes,demonstratingtheimportanceofpatientsbeingabletoviewnature,gooddaylighting,ventilationandpatient’sabilitytocontroltheirenvironmentalconditions6.ThefindingshaveinformedarevisedversionofAEDET,theNHStoolforauditingdesignqualityinhospitals.Atthesametime,CharlesJencks,anarchitectandcriticwithinternationalstature,haspioneeredanewhealingtypology,TheMaggieCentre,whichaimstoempowercancerday-carepatientsandtheircarers7.
4 TheMaggie’sCentresorganisationhasfourmaingoals:
• Tolowerthestresslevelofapatient• Toprovidepsychologicalsupport• Tohelppatientsnavigatethe
information-explosiononcancer• Toprovidepeacefulandstriking
environmentswithanimportantplaceforartandgardens
5 TherearecurrentlyfiveMaggie’sCentresopeninScotland,withtenmorebeingdevelopedintheUK.Asbespokeanddistinctivehealingenvironments,theyrepresentanalternativeapproachtothetraditionalcost-drivendesignofhealthcarebuildingsbydeliberatelyfore-groundingdesignasakeyfactorinpromotingwellbeing.
2. Background
1TheFutureHealthcareNetworkisalearningnetworktoexploretheshapeofhealthcareandwhatwillberequiredby2010andbeyond;thewebsiteiswww.nhsconfed.org/fhn.TheNHSEnvironmentalAssessmentTool(NEAT,availablefromNHSEstates)setsouttargetsandachecklistforsustainabledesigninhealthbuildings.
2Seehttp://www.show.scot.nhs.uk/pef/guest/forlatestreport.NHSScotlandalsorunaPropertyandEnvironmentForumwhichisbasedatthesamewebsite.
3SeeHealthyHospitalsReport2003http://www.cabe.org.uk/publications/#healthandCABEHealthWeek,Healthyplaces,healthypeople15-19thMay2006,www.cabe.org.uk/events
4See“BuildingandResearchInformation”,Vol29,Number2,March-April2001whichisaSpecialIssueonPost-occupancyEvaluation,andhasanumberofpapersreportingonthePROBEexperience.Vol33,Number4,September2005providesanupdateonthisarea.Seealsowww.usablebuildings.co.ukforanuptodateaccountofPOEstudiesintheUK.
5AnexcellentexampleisBurt-O’Dea.K.(2005)DesignImpactStudy,TheEuropeanHealthPropertyNetwork,whichstudiesfivedifferenthealthcarebuildingsindifferentEuropeancountries.
6Lawson,B.etal(1998-2001)TheArchitecturalHealthcareBuildingandItsEffectsonPatientHealthOutcomes,UniversityofSheffield.
7SeeJenks,C.TheMaggieCentresMovementEightYearsIn…,FourthDoorReview,Nos.7,2005pp.30-33
6 TheDundeeMaggie’sCentre,whichisthesubjectofthisstudy,wasdesignedbyFrankGehryandopenedinSeptember2003.Inresponsetothis,TheUniversityofDundeehostedaonedayinternationalsymposium,“BreathingSpace”,atthesametime,whichgeneratedsignificantdiscussionontherelationshipbetweenarchitecturaldesignandcancercare,includingtheroleofsustainabledesignandmateriality8.Theproposalforthisstudygrewoutofthefindingsofthesymposium.
7 Largescalehospitaltypologieshavereceivedthegreatestattentionintermsofpostoccupancyevaluation,butwiththeshiftingovernmentpolicytowardsdeliveryofhealthcareinsmallscaleenvironmentswherepractical,itwasfelttimelytoexaminesuchtypologies.ThedevelopmentoftheMaggie’sCentresasasmallscaleindependentnewbuildingtypologyaffordedauniqueopportunitytolearnfromhighqualitydesignenvironmentsandprovideabenchmarkfromwhichtomeasurethecombinatoryvaluesofsustainabledesignandhealthpromotingdesigninallsmall-scalehealingenvironments.
8Anumberofthepaperspresentedhavebeensubsequentlypublishedintheinternational“FourthDoorReview”,Nos.7,2005,pp26-50,includingStevenson,F.“Environmentalarchitectureandthehealthbuilding;thematerialityperspective”pp.38-42
1 The overall aim of this study was to provide a detailed post occupancy evaluation of a small scale healthcare environment which can in turn inform the future design of similar typologies within the NHS and other healthcare agencies.
2 The study had four key objectives:
1. Tocarryoutanin-depthqualitativereviewofusersresponsetotheDundeeMaggieCentre
2. Tocarryoutatechnicalreviewofthebuilding’sphysicalperformance
3. Toevaluatethedesignandconstructionprocess
4. Todevelopacross-evaluativemethodologyforwideruseinsmallscalehealthcarebuildingsinordertoimprovethebriefingprocess
3 The study specifically aimed to establish:
a) theeffectivenessofthedesignconceptintermsoftheoriginalbriefandcaremodel
b) theoverallusersatisfactionwiththebuilding
c) theextenttowhichpeopleperceivethebuildingascontributingtotheirsenseofcomfort,wellbeingandhealth,andthepossiblemechanismsforthis
d) thecomparisonoftheease,speed,andcostofconstructionwithastandarddomesticscalepalliativecarebuilding
e) thebuilding’sphysicalperformanceandsustainability,includingmanagementandmaintenanceissues,andthelevelofenergycostscomparedtonormativemeasures
f) recommendationsforthefutureMaggie’sCentresbriefingprocessandfurtherdevelopmentoftheevaluationmethodologyforothersmallscalehealthcarebuildings.
3. Aims and Objectives
1 AsmallSteeringGroup,whichconsistedoftheDundeeMaggie’sCentreHead,aprevioususeroftheCentreaswellasthetwoprincipalresearchcontractors,wasinitiallyformedtoguidetheproject.TheProfessionalAdvisoryGroupfromtheMaggie’sCentrescommentedonthedesignandformatforthepost-occupancyevaluationquestionnaire.
2 AninitialdesktopreviewofexistingliteratureontheevaluationofhealthcareandotherbuildingsintheUKandelsewherewasundertaken.ItwasfeltthatwhiletheAEDETEVOLUTIONandASPECTtoolsfortheNHSprovidedavaluablemeansofauditingthedesignqualityofhealthcarebuildings,thepre-definedstatementsapproachdidnotallowforamoreopenendedformofinquirywhichmightrevealhiddenfactors.Bycontrast,theapproachdevelopedbyBuildingUseStudiesLtd.andadoptedbyPROBEaskstheusertoofferupfactorswhichworkordonotworkwell.Thisprovidesamorefundamentalappraisalofdesignqualityasitisdirectlyexperiencedbytheuser.
3 Asaresultofthedesktopreview,itwasdecidedtoadopta‘mixedmethods’approach,involving6semi-structuredinterviewswith2full-timestaff,2part-timestaffand2volunteers,andaPROBE-stylequestionnaireforvisitors.BothactivitieswerecarriedoutwithinthebuildingovertheperiodofonedayonMarch23rd2006.Astandardquestionnaireonitsownwasrejectedonthegroundsthatitwouldnotyielda“rich”textureofinformation.Theaimofthein-depthsemi-structuredinterviewswastosupplementthequestionnairewiththecollectionofmoredetailedinsightsfromparticipants.
4 AnumberofqualitativequestionsweredevisedwithadvicefromtheMaggie’sCentresChiefExecutive,ProgrammeDirectorandClientRepresentative,toascertainresponsestothedesign(seeappendixIandV).Theseaugmentedtheinitialstandardpost-occupancyevaluationquestionsprovidebyBuildingUseStudiesLtd.whichconcentratedoncomfortissuesandworkconditions.TheadditionalquestionsweredrawnfromAEDETandASPECT,butwererephrasedtoallowforamoreopenendedresponse.Twokeyquestionsonvisitor’ssenseoftheirownhealthandqualityoflifeweredrawnfromtheEORTC9standardisedquestionnaireforoncology.Theinitialquestionnairewasthensuccessfullypilotedwithnomajorchangesrequired.
5 Visitorstothecentrewerediscreetlyapproachedbyaresearchassistantonentryandhandedaquestionnairetocompleteintheirowntimeandpostanonymouslyintoaboxplacedneartheentranceofthebuilding.Staffwereinterviewedusingtheinterviewguideandatapedrecordingwasmadeoftheinterview.Additionally,theinterviewerobservedhowtheusersandstaffinteractedwiththebuildingduringbreaksintheday.Anythingunusualthatmightinfluencetheeffectivenessofthedesignprinciplesinvolvedwasnoted.
6 FuelbillsforaoneyearperiodfortheDundeeMaggieCentrewereobtainedfromTheMaggie’sCentresHQ.ThesewererelatedtothecurrentbenchmarksforenergyefficiencypromotedbytheUKgovernmentfortheNHSEstate.
7 Copiesoftheoriginalbriefandworkingdrawingswereobtainedasreferencepointforusersexperienceandexaminedintermsofhealthcaredesign,energyefficiency,flexibledesign,anduseofsustainableandlocalmaterialsaswellasefficientconstructionprinciples.Thedrawingswereusedasabasisforthetechnicalanalysisundertakenonthedayofthesurveywhichinvolvedtheuseofamulti-modalmetertomeasuretemperature,humidity,lightingandnoiselevelsbothinsideandoutsideofthebuildingatfivestrategicpoints.
4. Methodology 9seehttp://www.eortc.be/home/qol/-accessedMay2006
8 Theinterviewswithstaffandthetechnicalteamwereusedtofurtherestablishiftherewereanysignificantworkissuesarisingfromtheinnovativedesignoftheprojectoverthetwoandahalfyearssinceitscompletion(seeAppendicesIandII).
9 Allfindingsfromtheinterviewswiththetechnicalandstaffteamswerecomparedtothosefromtheuserquestionnairetoestablishpointsofconvergenceanddivergence.Thiswascarriedoutinrecognitionoftheintersubjectivityinvolvedinthestudyandtheneedtounderstandandanalyseallpointsofview.
10Thequalitativefindingsfromalltheinterviewsandquestionnaireswerecross-evaluatedagainsttheobservedenvironmentbehaviour,thebrief/drawings/specificationsandthephysicaldataobtainedontheday,todetermineiftheissuesraisedwerereinforcedorcontradicted.A“walk-through”tourofthebuildingwasconductedwiththeClientRepresentativetohelpclarifycontradictoryfindingsandprovidefurtherinformationonissuesraised.
11Finally,aSWOTanalysiswasusedtoestablishtheoverallefficacyofthedesignandfuturestrategiesinrelationtotheresultsoftheinterviewsandfuelcostassessmentsandtheinitialprojectobjectives.
4.
1 Giventhecomplexityoftheareaunderinvestigation,carefullydefinedparametersweredrawntoproduceamanageableworkloadwithinthetimescaleallowed.Theworkfellinto6distinctivephases:development,survey,analysis,crossevaluation,draftandfinalreport.
Programme for Dundee Maggie’s Centre Pilot Study
1. Developmentofformats Arrangementsforvisits,interviews,
datagathering Gatheringoftechnicaldata
2. Interviews,Survey Questionnaires
3. Useranalysis Technicalanalysis
4.Cross-evaluation
5. DraftReport CommentonDraftReport/meetings
6.FinalReport SteeringGroupmeetingsx3
5. Programme
1 The analysis of the project was broken down into 8 evaluative stages:
A) backgrounddemographicsB) environmentbehaviourC) thebuildingdesignD) thevisitE) comfortissuesF) senseofwellbeingandhealthG)staffandvolunteerperspectiveH) thebuildingprocess
A Background demographics
2 TheusersoftheDundeeMaggieCentrecanbesplitintofourgroups:staff,volunteers,carersandthosecurrentlysufferingfromcancerorinremission.
3 Abasicdemographicdescription
ofthe34visitorswhorespondedtothequestionnaire(Table1inAppendixV)showsthatthetypicalDundeeMaggiecentrevisitorwasover30,likelytobefemaleandsufferingfromcancer,althoughjustunderathirdofvisitorswerecarers.Theoverwhelmingmodeoftransportwasbyprivatecarwithmostvisitorshavingreturned5ormoretimesforvaryinglengthsoftime.Themostcommonvisitinglengthwasoneortwohours.Visitorsgenerallyratedtheirownhealthasbeingaboveaveragewithoverhalfratingtheirqualityoflifeasaboveaveragealso,althoughthelevelofratingsweregenerallylowerthantheaverageforthosesufferingfromcancer(seesection6.f).
4 ThevisitorprofilesuggeststhatthebrieffordesigningMaggie’sCentresneedstostressthevariablelengthofvisitsandtheneedforthebuildingtobeabletocaterforrapidlychangingoccupancylevels.
B Environment behaviour
1 Onthedaywhichtheinterviewsandquestionnairesurveywascarriedout,theinterviewertooktimetoobservevisitors’behaviourinthebuildingatregularintervalsandoveranextendedlunchtimeperiod.Thissectionbrieflydescribesthoseobservationstoprovideapictureofthebuildinginuse.
2 Thebuildingwasopenfrom9a.m.-5p.m,andverybusy,withaTaiChiclassat1.30pm,arelaxationclassat3p.m.,aswellasabenefitsadvicedropinserviceallmorning.Thekitchenwasparticularlybusyatlunchtime,justbeforetheTaiChiclass,butnotovercrowded.Themainroomwasusedprimarilybygroups,whilethesmallerretreatroomdownstairswasusedforthestudyinterviews.Theupperroomwasusedonanintermittentbasis.
3 Theuseoftheopenplanspacedemonstratedarelaxedandsensitiveinteractionbetweenstaffandvisitors,withtheentranceareaactingasapermeablethresholdforarrivals.Oftenstaffappearedfromeitherthekitchenorlibrarytogreetarrivalsattheentrance.Newarrivalsappearedtohoverintheentranceareabythedeskratherthancomedirectlyintothekitchenarea,untiltheyweremet.Atonepointintheafternoonaformalfundraisingmeetingtookplaceinthekitchenarea,whichwasrelativelyquietasotherspaceswereoccupied.Thisseemedtoworkwell,andsuggestedaveryfluidandmobilewayofusingthespace,butonewhichdemandedthatstaffandvisitorsweretolerantofotheractivitieswithinthevicinity.
4 Visitors,bothfirsttimersandregulars,congregatedinthekitchenarea,withsubtlelevelsofinteractionthatsawsomesittingquietlyawayfromthetableconversation,whileothersengagedmoredirectlywitheachother.Withallfacilitiesinthekitchenbeingimmediatelyaccessibleandwithplentyofroom,therewasasenseofeasewithwhichpeopleseemedtonegotiatethespace.Thelibraryappearedlesswellusedandthecommonroomwasusedonlyforthegroupeventsthatday.
6. Results and analysis
Visitors tended to chat in the bright kitchen; the common room was used for group activities
5 Theofficeareawasbusywiththefund-raiser,CentreHead,informationsupportofficeraswellasotherstryingtousetheareaandthephone.Itwasnotedthatduetolackofstoragespace,largeamountsoffilingandotherpaperworkwerestoredinboxesunderthedeskareainthedesignatedfootspace.Additionalitemswerestoredthroughoutthebuilding,includinganumberofitemsintheboilerroom,ontheseatingareabehindtheoffice,andinthegrouproom.
6 Nowindowswereopeninthemorning,butbylunchtimeonewindowinthekitchenareahadbeenopenedaswellasawindowinthecommonroom.Bytheendoftheafternoon,threewindowshadbeenopenedinthekitchenaswellasthedoorleadingontothebalcony.
7 Thewoodstove-effectgasfirewasgenerallyleftonintheupperfloorroom,evenwhennobodywasthere,leadingtoincreasedandunnecessaryheating.Itwasobservedthatthefiretakesconsiderabletimetostartupandthismightexplainageneralreluctancetoswitchitonandoff.
8 Artificiallightingwasgenerallyleftonthroughoutthebuildingapartfromupstairs.Thismightrelatetothecare-modeladoptedandtheintentionforthelightingtoprovideawelcomingsignal,butitalsomightrelatetotheslowresponseofthelow-energylightbulbs.Theblindsonthelowerpartofthewindowsfacingthehospitalwerepulledup,whichwhileprovidingadditionalprivacy,tendedtomakethesenorth-facingroomsslightlydarker.
9 Externally,itwasnotedthatthecarparkwasfullfromearlyon,withpeopleresortingtoparkingonthevergesandthedrivewayapproachingthecarparkasaresult.
Conclusions:
10Thebehaviourofusersinthebuildingsuggeststhatwhiletheyaregenerallyverymuchateaseinthebuilding,thereisadistinctissuewithventilationcontrolwithoccupantstryingtoincreasetheventilationinordertoreduceoverheatingusingwhatmeanstheyhaveavailable.
11Theprincipalmeansofaccessisbycardespitethedirectpublictransportthatisavailableonsite.ItmaybethatfutureMaggie’sCentreswillneedtoconsideralarger,landscapedcarparkfacility,particularlyasruralvisitorsareoftenpoorlyservedbypublictransport.PeoplemayalsotendtouseacarratherthanpublictransportduetothenatureoftheirtreatmentinhospitalbeforeoraftertheirvisittotheMaggie’sCentre.
12Thesmallamountofcirculationspaceintheofficehasledtostaff“choreographing”theiruseofthespace,whichisnotalwaysconducivetoeffectiveworking.
6.
Lack of storage space and cramped office space may hinder effective working
People come to the Dundee Maggie’s Centre mainly by car, leading to parking problems
CThe building design
1 TheDundeeMaggie’sCentreislocatedonthewesternoutskirtsofDundee,withintheNinewellsTeachingHospitalCampus.Itsitstothesouthofseverallargehospitalbuildings,onaraisedgrassyplain,adjacenttothehospital’shelipadandontheedgeofwoodland.ThesitewaschosenforitsspectacularviewsovertheTayEstuary,whichareconsideredsomeofthefinestintheUK.Thebudgetforthebuildingwas£0.97mforafloorareaof225m2,workingoutat£4311perm2whichisaboutoneandhalftimesthecostpersquaremetreforanequivalenthealthcarebuilding.Thejustificationforthisisperceivedtobeintheiconicnatureofthebuilding,thespecificrequirementsofthebrief,andintheinitialhighcapitalinvestmentinordertominimisefuturemaintenancecosts.
2 Thebuilding,whichhasbeenoccupiedforovertwoandhalfyearssinceitopened,consistsoffourmainareas(office,library,kitchen/dining,commonroom)linkedbyacentralentrancelobbyandstairwellrisingtoaretreatspaceonthefirstfloor(seeAppendixIII).
3 Thequestionnairepromptedvisitorstocommentonthebuilding’simage,layout,useofspace,theirneedsandtheviewsbothwithinandlookingoutofthebuilding.Thesewereratedintermsofeffectiveness,withadditionalcommentsmadewherenecessary.
4 Theoverallbuildingdesignwasratedveryhighly(Table2,AppendixV),althoughaboutaquarterofvisitorsexpressedsomedifficultyinunderstandingthelayout.Themostpositiveimpressionofthebuildingwasoftheviewsoutside,whichreceivedthehighestratingofanyaspectofthedesign.Therewereslightlylowerratingsforfunctionalaspectssuchaslayout,useofspaceandmeetingpeople’sneeds.
5 Awidevarietyofimageswereassociatedwiththebuildingbyvisitorsincluding:
“special,qualitynotcheap!,bird,light,comfort,enveloping,home,beautiful,waves…..Ithinktheroundcentralpartislikeaship’sfunnelrisingfromthewaves.Abrilliantconcept!”
Theoverallimpressionwasoneoftranquilityandcalmness.
6 Thelayoutofthebuilding,whilebeinggenerallywellappreciated,presentedparticularchallengesforfirsttimevisitorssuchas:findingthetoiletwhichhadnosignonitsdoor,andthelocationoftheofficearea,summarisedbyonevisitorwhofoundit“protrudesslightlytoofarandlimitstheuseofthecentralspaceinfrontofthedoor”.Thespaceinthebuildingwasgenerallyperceivedtobewellused.
6.
The site for the Dundee Maggie Centre was chosen for its spectacular views
Images of waves, funnels and wings
7 VisitorswereveryimpressedbyboththeinternalviewsthroughtheopenplanbuildingandfromthebuildingacrosstheTayestuary.Forsome,thenaturalviewwasquitetranscendentalwithcommentssuch“verymeditative”and“AbsolutelyspectacularandconducivetocalmreflectionandawarenessofGod.”Othercommentsweremorespecificsuchas“Ilovethelightandthewood”and“Heightoffersausefulperspective”.
Conclusions:
8 Theoveralldesignofthebuildingisverymuchappreciated.Visitorswouldappeartopositively“tradeoff”certaindesignqualitiesofthebuildingsuchastheexploitationofexternalviewsanditsoverallimpressionagainstcertainfunctionalaspectssuchaslayout,useofspaceandpeople’sneeds.Thisleadstothebuildinghavingahigh“forgiveness”factor,wherebypeoplearewillingto“forgive”functionalissuesbecauseoftheirappreciationofotherdesignqualities10.
D The visit
9 ThepurposeofthevisitmadebyvisitorsissummarisedinTable3(AppendixV).Thepurposeforthemajorityofthevisitorsonthedayofthestudyobservationwastoattendgroupactivities.
10Intermsoftheactualvisititself(Table4,AppendixV),visitorsweremostpositiveabouttheirfreedomtousethebuildingandfeltverymuchateaseinit.Theywereslightlylesscomfortableabouttalkingtoothersandslightlylesspositiveaboutthebuildingmeetingtheirspecificneeds,althoughnearly78%thoughtthatthebuildingmettheirneedswellorverywell.
11Inrelationtotheirspecificneeds,visitorsfelthinderedbyalackofcar-parkingspacesandthecoldnessofthecommonroomattimes.Byfarthegreatestnumberofnegativecommentsrelatedtothepracticalityandcomfortofthefurnishings.Thiswassummedupbyonevisitoras“Theseatingcouldbemoreforcomfortratherthanlook–thistheonlythingIwouldsuggest”.
12Commentsabouthindrancesduringavisitwereheavilyoutweighedbypositivecommentsaboutthingswhichworkedwellinthebuilding.Thesefocussedonthekitchenareawhich“encourageseveryonetogatherandchat”,theopenplanlayout,andthe“abundanceofnaturallight”.Despitethequestionsbeingdirectedtowardsthenatureofthebuilding,visitorsconsistentlyreferredtothe“openandencouragingstaff“whichperhapsdemonstratesatendencybyuserstoviewthebuildingandthepeoplewithinitasoneentity.
6.
Visitors particularly appreciated the abundance of natural light and welcoming kitchen
10“Forgiveness”wasfirstidentifiedasafactorinPOEbyAdrianLeamanandBillBordassinthePROBEstudiesfeaturedinBuildingmagazine,UKandtheBuildingResearchInformationresearchjournal.
Conclusions:
13Visitorsclearlyfelt“athome”inthebuildingbutitisunclearhowmuchofthiscanbeattributedtothebuildingitselfandhowmuchtothewelcomeandsupportprovidedbystaff.ThisreflectstheMaggie’sCentresethosofsolvingproblemsbyworkingwithpeopleinanupliftingenvironment.Itsuggestsfuturestudiesconcernedwithvisitorsinhealthcarebuildingswillhavetoeitherbemorecarefully
tailoredtoseparateoutstaff-relatedobservationsfromobservationsaboutthebuilding,oralternativelyacceptahybridmodelofanalysiswhichacknowledgestheinfluenceofstaffonvisitors’perceptionsofthebuilding.ThelattermodelismoreappropriatefortheMaggie’sCentres.
14Thestrengthoffeelingaboutthe
furnishingsexhibitedbyvisitorssuggeststhatfuturebriefingneedstotakegreateraccountofergonomicrequirementsinrelationtoaestheticappearance.
15Theexistingbriefhasbeenparticularlysuccessfulintermsofthekitchenareaandcentralisedkitchenislandunit,whichvisitorscommentonveryfavourably.Visitorsalsofeltverymuchateaseinthebuilding–apositivereflectionontheoriginalbriefrequirementforawelcomingbuilding.
E Comfort issues
1 Amajoraspectofpostoccupancyevaluationisthedegreeofcomfortwhichusersexperienceinabuilding.Thisisparticularlyimportantinhealthcarebuildingswherevisitorsarelikelytobeextrasensitivetoenvironmentalconditionsduetotheirrelativelypoorstateofhealth.
2 Visitorswereaskedtoratetheirperceptionoftemperature,airquality,ventilation,noise,lightingandoverallcomfortinrelationtothebuilding.Noisewasgenerallynotanissueforvisitors;intriguingly,however,overathirdfeltthattherewasnotenoughnoisefromoutside.Althoughthelightingoverallwasfelttobeverypositive,40%ofvisitorsfelttherewastoomuchnaturallightand28%experiencedsomedegreeofglare.Itisunclearwhy66%ofvisitorsexperiencedsomeglarefromartificiallightingaswell,whenoverthreequartersfoundoverallcomfortleveloftheartificiallightingtobejustright.Nearly90%ofvisitorsfeltthebuildingwascomfortableoverall,despiteabouthalfthisnumbercomplainingaboutadegreeofoverheating,excessivenaturallightanddrynessoftheair.
3 Thetopratingsforcomfortweregenerallylowerthanthoseforthebuildingdesignoverall(Table5,AppendixV)againsuggestingthattheremaybeisakinaestheticcompensatoryfactoratworkwithvisitorsalso“tradingoff”theappreciationoftheviews,imageandoverallqualityofdesignagainstcomfortfactors.
4 VisitorscommentsrelatedmainlytotheissueofoverheatingandvariabilityoftemperaturebetweentheNorthandSouthsideofthebuildingwithoneobservingthat“Sometimes(ifthesunisshining!?)someareasbecometoohotbutotherdaysthebigroomwastoochillyforsittingcomfortably”.
6.
The strong contrast in these photos shows the glare factor from the natural light
5 Visitor’scommentsandratingsofcomfortconditionswerecorroboratedbythephysicalreadingstakenontheday(Table10,AppendixV).Indoortemperaturereadingsonthedayofthequestionnaireweresurprisinglyhighandreachedapeakof24.4˚CbymiddayindoorsonacoldMarchday,eventhoughthemainheatingcontrolwassetto22˚C.Humidityreadingswererelativelylowinsidethebuilding,averagingaround30%,comparedtoanoutsidehumiditylevelof50%.Thiswouldaccountforasignificantpercentageofvisitorsexperiencingtheairasbeingdry.Lightinglevelsinthebuildingwererelativelylowapartfromintheupperlevelroomwhichwasfloodedwithlightfromthelargeskylight.Withitbeingasunnydayoutside,thecontrastinglowlevelsofinternallightexacerbatedtheglarefromthesouthfacingwindows.Noiselevels,ontheotherhand,wereatanormalconversationallevelinmostpartsofthebuildingapartfromtheupper
levelspace.Thisareawasrelativelyquietdespiteconversationcarryingonbelow.
6 Visitorswerethenaskedtoconsiderthedegreetowhichtheyhadpersonalcontrolovertheircomfortconditions(Table6,AppendixV).Nearlyhalffelttheyhadabsolutelynocontrolovertheheatingornoiseconditions,witharoundathirdfeelingtheyhadnocontrolovercooling,ventilationandlighting.Interestingly,despitethevariouscomfortissuesraised,theoverwhelmingmajorityofusersstatedthatapersonaldegreeofcontrolovercomfortconditionswasnotimportant.Thissuggeststhateithertheyrelyonthestafftodealwiththeseaspects,orthatotheraspectsofthebuilding,suchastheviewsandwarmthofwelcome,compensatefortheseissues.Aninterestingissuethatwastestedwiththequestionnairedatawasthedegreeoftherelationshipbetweenthesenseofcontrolthatthevisitorshadaboutthecomfortfeaturesofthebuildingandtheirownself-reportedratingsofhealth,wellbeingandqualityoflife(seesection6.f).
7 Intermsofbenchmarking,theDundeeMaggieCentreperformsexceptionallywellwithasignificantnumberofvariablesagainstover50otherbuildingsintheUKthathavebeenevaluatedusingtheBUSquestionnaire(seetable11).Despitetheissuesraisedinrelationtothecontrolofheatingandotherareas,theratingsofthesevariablesarenodifferentfromtheaveragebuilding.Theonlytwovariablesthatwouldappeartofallsignificantlybelowthebenchmarkaretherelativestillnessofairinthebuildingandtheapparentlyexcessiveamountofnaturallight.Thelatterfindingiscurious,giventhatanumberofvisitorscommentedfavourablyontheamountofnaturallightinthebuilding.
6.
The programmer and lack of cross ventilation both contribute to the overheating
2AssociationforEnvironmentallyConsciousBuildersarticleonLightweight.v.Heavyweightconstruction.Vol.11,no.3pp.30-34Winter2001-02
Conclusions:
8 Thereareanumberofcomplexinteractingfactorswhichmayaccountforthemildoverheatingofthebuildingandrecommendationsarerelatedtotheseforfuturebriefinganddesignpurposes:
Open plan layout:Theopenplanlayoutofthebuildingmeansthattheusershavetoheatallthemainareastothesametemperature,regardlessoffunction.Inevitably,thewarmairwillriseandcausetheupperstoreyretreatareatobeevenwarmerthantheotherareasbelow.Thisisbestmitigatedbyadequateventilation.
Thermal mass, heating systems and programmers:Thereismuchdebateonthevirtuesoflightweight.v.heavyweightconstruction11intheUKintermsofheatingstrategies.Lightweightconstructionisseenasbeingmoresuitableforquickresponseheatingsystems,whereasheavyweightconstructioncanworkwellwithaslowresponseheatingsystem,suchasunderfloorheating,inhelpingtoevenoutchangesintemperature.Intheory,theheatingsystemspecifiedforthisbuildingwouldseemtoideallycomplimentthelargeamountofthermalmasspresent.Infact,thesignificanttimelaginrespondingtotemperaturechangesaffordedbytheheatingsystem(2hours)combinedwiththeslowresponseofthethermalmassinthebuildinghasledtoadegreeofconfusionbystaffattemptingtoheatandcoolthespacequicklyinresponsetorapidchangesinoccupancylevels.Thisisnothelpedbytherelativelycomplexityofthemainunderfloorheatingprogrammer(HoneywellHometronicHCU30RemoteSetpointAdjuster)situatedbytheentrance,whichalsoperplexedstaff.Theguidanceforsimplyoperatingtheprogrammeristwentyonepageslong,whichspeaksforitself.Programmerswhicharerelativelyeasytounderstandandoperatebynon-technicalstaffshouldbeselectedinpreferencetomorecomplexones.
Solar Gain and ventilation:Thelackofadequateexternalshadingtothesouthernwindows,combinedwithinadequatecross-ventilation,pointstotheneedforcarefuldesignwhenusingnaturalventilation,ifoverheatingistobeavoided.Onesolutiontothisproblemwouldbetoensurethatthereisadequatecross-ventilationprovidedthroughthelayoutofroomsandthattheneedforexternalsolarshadingistakenfullyintoaccountthroughcarefuldesignanalysis.Shadingneedstotakeaccountoflow-levelaswellashighlevelsunpenetration.Thereareanumberofmechanicalextractfansinthebuildingtohelpwithventilation,buttheseareparticularlynoisyinthekitchenarea,makingstaffreluctanttousethemwhilepeoplearetryingtotalk.
User strategies for heating and ventilating:Itisclearfromtheanalysisthatstaffandusersarenotabletooptimisetheirheatingandventilationsystemsandhaveadoptedthecommonstrategyofoverheatingthebuildingtoensurethatitdoesnotgettoocold.Excessheatmustthenbeventilatedoutofthewindows.Duetothelow-levelplacementofrestrictedwindowopenings,thereisabuildupofheatinthemainvolumeandusershaveresortedtoopeningdoorsinanattempttocompensateforthelackofventilationneededtoclearthisbuildup.Highlevelventilationpointswouldsolvethisissueinfuturebuildings.
The need for user education:Lackofspecifictrainingontheheatingandventilationcontrolsforusersattheoutsetinthisinnovativeproject,andonanongoingbasisfornewstaff,mayalsohavecontributedtotheuseofinappropriatestrategiesforheatingandventilating.Userinductionisavitalaspectofbuildingprocurementandmanagement.
6.
The windows are left open while the heating is on due to its slow response to change
11AssociationforEnvironmentallyConsciousBuildersarticleonLightweight.v.HeavyweightconstructionVol.11,no.3pp.30-34Winter2001-02
Choice of heating system:Thesolerelianceonanunderfloorheatingsystemofthetypespecified,whichisrelativelyunresponsivetochange,mustbequestionedforfuturecentresofthiskindunlessthereisanadequatetopupsystemandgoodventilationoptions.Theheatingsystemispredicatedonasteadystatescenarioanddoesnotrespondquicklytotherapidchangesintemperaturewhichoccurwithvaryingnumbersofusersandactivities.Theheatingmanualrecommendsatwohourlead-intimetoobtainthedesiredheatlevelfromthesystem.Thestaffmustthereforeattempttopredicttemperaturesaheadoftimeandthiscanleadtothesystemfailingtoprovideadequatetemperatures,iftheweatheroroccupancylevelchangessuddenly.Thesupplementaryair-blownheatingsysteminthekitchenandgrouproomappearsnottobeusedtogreateffect.Therelianceongasasafossilfuel,withoutthebenefitofrenewableenergytechnologieswillinevitablyleadtoarelativelyhighcarbondioxideoutput.Thiscouldberelativelyeasilyaddressediftherequirementforrenewableenergywerebuiltintothebrieffromtheoutset.
9 Althoughtheoveralllevelofnaturallightingisclearlyappreciatedbyanumberofvisitorsthroughtheircomments,asignificantnumberfelttherewasaglareissueandtoomuchnaturallight.Thelatterfindingisunusualinstudiesofthiskindandmaybeattributabletovisitors’stateofhealth.Itwarrantsfurtherinvestigationinordertoestablishappropriatenaturallightlevelsinbuildingsforcancersufferers.Glarecouldbecausedbyexcessiveamountsofunshadedlow-levelsunlightorfromtheskylights.
10Thequalityofdesignwouldseemtosuggestthatvisitorsalsohaveahighdegreeof“forgiveness”forlowercomfortratings.Atthesametime,althoughthebuildingperformswellagainsttheBUSbenchmarkforallbuildingtypes,itshouldberememberedthatvisitorsusingthisbuildingdonotoccupyitforanygreatlengthoftimeandareinaparticularstateofmindduetotheirhealthsituation.Boththesefactorsmaytendtoresultinmorepositivereportingthanusualandmaskunderlyingissuesgenerallyexperiencedbythosewhousethebuildingforgreaterperiodsoftime.
F Sense of wellbeing and health
1 ThequestionnairecontainedtwoquestionstakenfromtheEuropeanOrganisationfortheRecognitionandTreatmentofCancerQualityofLifeCoreQuestionnaire(30Itemversion).ThetwoquestionsadoptedfromtheCoreQuestionnairewerechosenastheyassesssimpleglobalratingsbytherespondentthemselves(asopposedtotheclinician)oftheirhealthandhealth-relatedqualityoflife.Theratingsaregiveninresponseto7pointLikertscales.Theanswerstothesetwoquestionscanbecomparedtonumerousotherstudiesthathaveemployedtheseitemsintheirassessments.
2 Theoverallself-reportedratingofglobalhealth(overpastweek)demonstratedthattheirviewwasmoderateonlyforthesevisitors.TypicallytheEORTCnormforcancersurvivorsforthisratingisaround75%(thatisthosescoring5to7onthe1-7ratingscale)andforthesampleincludedinthesurveywefoundthatthispercentwas64.Thegeneralhealthratingthereforewassomewhatlessthanexpected.
3 Likewisethequalityoflife(overthepastweek)ratingforthevisitorswas57%(i.e.scoring5,6or7)whichisalsolowerthanmighthavebeenexpectedincancersurvivors.
4 Overallqualityoflifeoverthepastweekwasfoundtopositivelyrelatesignificantlytothelengthofvisit(rs=0.45,p<.05).Thiswouldappeartoshowthatthelongerthevisitorspendsinthecentrethegreaterthelikelihoodthattheirratingofqualityoflifewillbehigh.Thiseffectisrelativelyweak.Howeverwitharelativelysmallsampleitissuggestivethattheexperienceofvisitingthebuildinghasadose-responseeffect(testforlinearity:F=4.22,df(1,19),p=.05).Thatis,thelongerthepersonreportsthattheyspendinthebuildingthemorepositivetheyregardtheirqualityoflife.Suchafindingrequiresreplicationasthiswouldbesupportiveevidencefortheeffortspentonprovidingasconsiderateanenvironmentaspossibleforthevisitor.Cautionthereforeshouldbeexpressednottoover-stressthispositiverelationship.
6.
5 Theywerethenaskedtoratethedegreetowhichtheyperceivedthebuildingitselfimpactingontheirsenseofwellbeingandhealth.
6 Althoughthestudydidnotaimtoproveadirectconnectionbetweendesignandhealthbenefits,itwasfeltimportanttoascertainwhetherornotvisitorsthemselvesperceivedsuchalinkandwhetherthisrelatedinanywaytotheirperceivedqualityoflifeandhealthstatusatthetimeofthequestionnaire.Threesetsofassociationswereinspectedandtheresultsarediscussedinthenextthreesections.
7 Correlationswerecalculatedbetweentheself-reportedratingsofqualityoflifeandhealth(overthepastweek),andtheperceptionofthefeaturesofthebuilding.Inadditiontheratingsforhowthebuildinginfluencedtheirwellbeingandhealthwerealsoinspected.Spearman’scorrelationcoefficientswereadoptedastheindexofassociation.Statisticalassumptionssimplyrequiredtheratingstoberankorderscales,whichthisquestionnairedesignsatisfied.Henceinterpretationisstraightforward.Itwaspredictedthatpositiveratingsofthebuildingwouldbeassociatedwithsimilarpositiveratingsofhealth.Onthewholethesepredictionswereconfirmedformanyaspectsofthebuildingandthevisitors’ratingsoftheirwellbeingandhealth(Table6,AppendixV).Onlyonecorrelationwasfoundthatwasclosetosignificanceamongthequalityofliferatingsandthatwastheassociationwiththeabilityto‘talktoothers’.Hencethosewhoratedtheirqualityoflifestronglyalsofeltthattheyregardedthebuildingwasamenableforconversationwithotherpeople.
8 Thelackoffurthersignificantcorrelationsbetweenthehealthandqualityofliferatingsandtheotheraspectsofthebuildingcanbeexplainedbythenatureofthequestions.ThevisitorswereinvitedtogivetheirratingofhealthandqualityoflifeOVERTHEPASTWEEK.Itwouldnotbesurprisingthatvisitorsreferringtotheirhealthstatusoveraweekwouldnotassociatestronglywiththeiropinionofthebuildingduringtheirvisitonthedayofthequestionnairecompletion.Insupportofthisviewwerethestrongcorrelationsbetweenthehealthandwellbeingratingsandthebuildingfeatureperceptions.Thequestionsonhealthandwellbeingare‘state’measuresaskingthevisitortooffertheiropiniononhowtheyfeltabouthowthebuildingwasinfluencingeithertheirhealthorwellbeingatthetimeofansweringthequestionnaire.Hencetherelationshipsbetweenthesetwo‘state’questionitemsandtheperceptionofthebuildingfeaturesshowsignificantrelationships.Howevertheinterpretationoftheseassociationsisnotaltogetherstraightforward.
9 Onfirstglance(Table7,AppendixV)itwouldappearthatpositiveperceptionsofthebuildingfeaturesarelinkedwithhigherratingsofhealthandwellbeing.Thismaywellbethecaseespeciallyasthequestionsonwellbeingandhealthareinvitedwithreferenceinparticulartohowthebuildinginfluencestheirhealthandwellbeing.Itispossiblehoweverthatthepatternofcausalitymaybethereverse.Thatis,thosevisitorswhoratedtheirhealthorwellbeingpositivelymayfeelabletoratethebuildingenthusiastically.Specificpointsfromtheindividualitemsworthnotingare:
a. Firstandlastingimpressionsofthebuildingwerestronglypositivelyrelated.
b. Thevisitors’needsbeingmetwithinthebuildingwasassociatedwiththeirperceptionsofthebuildinginfluencingtheirhealthinapositivemanner.
c. Asignificantrelationshipwasfoundwiththebuildingsettingthepersonateaseandaperceptionofastrongerself-reportedratingofhealth.
d. Surprisinglytheinnerandouterviewswerenotsignificantlyassociatedwithratingsofhealthorwellbeing.Thisresultappearstocontradictthemanypositivecommentsthatvisitorsmadetotheviews.Thisdiscrepancymaybeexplainedbythefactthattherangeofvaluesforthequestionsconcerningtheperceptionofviewswassmall(i.e.positiveandveryfewnegativeratings).Fromatechnicalpointofviewthisrestrictsthesizeofthecorrelation.Inotherwordsthepositivedatacollectedontheperceptionofviewsmayhavepreventedastrongcorrelationwithhealthandwellbeing.Thisisanareaforfurtherinvestigation.
6.
10Thesecondsetofassociationsthatwasinspectedwasthecomfortratingsofthebuildingbythehealthandwellbeingratings(Table8,AppendixV).Wellbeingwasweaklyassociatedwiththecomfortratings.Ofsignificancewastheassociationofnoiseexperiencedinsidethebuildingandthesenseofwellbeingfromthebuilding.Thatis,thosewhoratedtheirwellbeingpositivelyperceivedthenoiselevelastowardsthe‘toolittle’endoftheinteriornoiseratingscale.Allmeasuresof‘overall’comfortsatisfaction(namely:temperature,comfort,noiselevelandlighting)werestronglycorrelatedwiththeratingofhealth.
11Ofparticularinterestistherelationshipofcontrolwithselfperceptionofhealth.Visitorswhoaresurvivingcancermayfindtheabilitytoexertsomecontroloftheenvironmenttheyareincontactwithsatisfyingandlifeconfirming,especiallywhenthediseaseitselfmayhavefosteredtheviewthattheirbodyhasbeen‘out-of-control’.Alternatively,thepsychologicalliteratureontheeffectsoftheenvironmentontheindividualwhoiscompromisedthroughsevereillnessshowsthatwithincreasinglackoffunction,theenvironmentexertsgreatereffectsontheindividual’shealthstatus.Henceitwasimportanttotesttheassociationsbetweenthesenseofcontrolthatthevisitorsindicatedandtheirperceptionofhealth.
12Significantcorrelationswere
foundbetweentheselfreportsof‘wellbeing’inthevisitorsandtheirperceptionofcontrolofthe‘cooling’and‘ventilation’(Table9,AppendixV). It would appear that if control was considered to be available this had a positive effect on wellbeing. Weakeffectswerealsofoundfor‘lighting’and‘heating’.Onlyoneeffect(andthiswasweak)wasfoundfor‘cooling’controlandselfperceived‘health’.
13Thefactthattherewereconsistentpositiverelationshipsfoundacrossthevariouscomfortfeatures,theircontrolandratingsofwellbeingintroducesafascinatingareaofstudy.Itcouldbearguedthattheseresultsreinforcetheviewthatmakinganenvironmenteasy‘toread’byvirtueofofferingsystemstoallowchangingcomfortparameterswillenhancewellbeingandpossiblyselfreportedhealth.Thisinterpretationisspeculativebutwouldbeafascinatingareatoconfirminafurtherinvestigationandcoulddevelopourunderstandingofthisperson-environmentinteraction.
14Positivecommentsfromvisitorsinrelationtohealthandwellbeingincluded:
“Feelings of calm”
“The building is a place where I have moved from ill-health to health by visiting regularly”
“The building/space and light lend themselves to people feeling welcome and safe –safe to explore difficult issues.”
6.
Positiveperceptionsofthebuildingarelinkedwithhealthandwellbeing–butwhichway?
Conclusions:
15GiventheaboveresultsanddiscussionthereareseveralissuesthatshouldbeconsideredinrelationtothefuturebriefinganddesignofMaggie’sCentresandpotentiallyothersimilartypologies.Itisclearfromthestudythatthereisapositivecorrelationbetweenmanydesignaspectsofthebuildingandvisitorssenseofhealthandwellbeingatthetime.Whatisnotcleariswhethervisitors’senseofwellbeingandhealthisinfluencingtheirperceptionofthebuilding’squalities,orwhetherthebuilding’squalitiesareaffectingvisitors’perceptionoftheirhealthandwellbeing.Additionalvisitors’commentswouldseemtosuggestthelatter,butthisisnotprovenandisclearlyanareaforfurtherinvestigation.
16Thefindingsrelatinghealthandwellbeingtovisitors’senseofcontroloverventilationandcoolingareimportantandsuggestthatgreaterattentionneedstobepaidtothedesignandspecificationofheating,ventilatingandcoolingcontrols,ifvisitors’senseofhealthandwellbeingaretobefurtherimproved.Whatisparticularlystriking,isthatwhilevisitorsconsciouslystatedthathavingadegreeofcontrolintheseareaswasnotimportanttothem,thedegreeofcontrolperceivedtobeavailableclearlyaffectedtheirsenseofwellbeingandhealth.Inotherwords,theymayliketofeel“incontrol”ofventilationandcooling(“IcanalwaysopenawindowifIwantto”),butwithoutnecessarilyhavingtoresorttoactuallycontrollingthesethemselves.
17TheabilityforvisitorstobeabletocontroltheirenvironmenttiesincloselywiththeMaggie’sCentresethosofempoweringpeopletobeabletoadapttotheirsurroundingsandtakecontrolratherthanbeingcontrolledaspassiverecipientsinacaresystem.
G Staff and volunteer perspective
1 Theinterviewguideforthestaffandvolunteersdeliberatelyadoptedthesamequestionsasthevisitorquestionnaireforcomparativepurposes,butdivergedinrelationtothenatureofactivityinthebuilding(AppendixI).Manyoftheresponsesechoviewsofthevisitors.
2 OnlytwoMaggie’sCancerCaringTrustfulltimemembersofstafftookpartintheevaluation,inadditionthreesessionalworkersandonevolunteerwereincludedininterview.TheClientRepresentativewasnotincludedinthisinterviewprocessbutparticipatedina“walk-through”discussionatalaterstage.Allstafflivedrelativelylocallyandalmostallcommutedtoworkbycarwithanaveragejourneytime20minutes.Mosthadworkedinthebuildingfortwototwoandhalfyears.Theyhadveryvariableworkpatterns,withrelativelylittleuseofVDUsandtendedtobecontinuouslyonthemoveinthebuilding.
3 Asurprisingvarietyofimageswereassociatedwiththebuildingwiththebuildingbeingseenascontemporary,unique,welcomingandcalminaveinsimilartothevisitorresponses.Thebuildingwasperceivedtobewellusedandinlotsofdifferentways.Generallythebuildingmetthestaffneedsapartfromsomekeyissueswhichareoutlinedintherestofthissection.
4 Levelsofprivacywereperceivedtobegoodforvisitors,butnotsogoodforstaffwhofelttheydidn’thaveaprivatespaceto‘escape’to.PartoftheMaggie’sCentresethos,however,istoensurethatstaffarealwaysawareofvisitors.Thisnecessarilyentailsstaffbeingvisiblemostofthetime.Thelibrarywasnotseenasanidealplaceforconversationwithpeopleindistressasitwasdirectlyoppositethefrontdoor.
5 Thelayoutofthebuildingwasfelttobewelcoming,easytounderstandandopen.Onememberofstaffsuggestedthatthetherapyandretreatroomsshouldbeknockedtogethertocreateamoreusefulspace,becausebothweretoosmallontheirown.Anothervolunteerwasunclearwhatthesesmallroomswerefor.
6.
Theofficemaylooklikeithasenoughspace...
...untiltheworkstationsareinuse.
6 Severalissuesinrelationtotheofficeareawereidentified:visitorstendedtowanderintotheoffice,notknowingquitewhatitwasfor,thedeskareawasawkwardbecauseittendedtosuggestareceptionpoint,whichitwasnotmeanttobe,andtheofficeareawasperceivedtobeabit“weird”–nobodywasclearwhattheseatingatthebackoftheofficewasforandasaresultithadbeenadoptedasatemporarystorageplace.Itwassuggestedthattheofficemightbebetterlocatedupstairs,butthiswasn’tnecessarilyperfecteither,asstaffneededtobeseenbyvisitors.Theofficewasgenerallyfelttobetoosmall,withnotenoughspaceforstorage.Oneintervieweesummedthisup:“Ican’tbearthelackofspaceintheofficearea;thechairsaretoocloseandtherearenofilingcabinetsandnostraightwalls.”
7 Likethevisitors,allintervieweesverymuchappreciatedtheviewswithinthebuilding,withtheheightofroomsgivinganadditionalsenseofspace.TheywereparticularlyfondoftheviewsacrosstheTayEstuarywithonecommentingthat“Ilovetheviews–theychangeallthetimeandraisemyspirits.Theyneverceaseto–thetrees,tide,skyandcolours–theychangeallthetime.Arealjoy”.Viewstothenorthofthebuildingwereseentobenotsoimportantbutcouldbeimprovedpossiblywithtreescaping.
8 Staffcarriedoutaverywidevarietyofworkfunctionswhichthefacilitiesgenerallyprovidefor.Itwasfeltthattheglasswindowinthemaindeskpartitiongavethewrongimpressionandthatpeopletendedtowaitattheentrancearea.Thisviewwasbackedupbythebehaviourofvisitorsindependentlyobservedonthedayoftheinterviews.Therewasasuggestionthatitmightbebettertohavethekitchenarearightnexttotheentrancetohelpencouragepeopletocomeintothebuilding.
9 Likethevisitors,intervieweesthoughtthatsomeofthefurniturewasnotappropriate.Theseatingwasfelttobetoolowanddidn’thavearmrestsforpeopletohelpthemselvesupwith.Thechairswereseentobegoodlookingbutnotalwaysfunctional.Theseatinginthecommonroomwasnotfelttobeconducivetomeetingsandwasdesignedmoreforindividualrelaxation.Theoutwardlycurveddeskintheofficewasfoundtobeawkward.Itwaspointedoutthatthebuildingneedstocaterforthefullspectrumofconditionsandpeopleandthatthereshouldbemorevarietyinthecrockeryprovided(olderpeoplemaypreferacupandsaucer,ratherthanamug).
10Thelackofstoragespaceinthebuildingbroughtoutthestrongestreactionamongstaff,whoendedupstoringthingsintheboilercupboard,creatingapotentialhealthandsafetyissue,andgenerallyspreadingitemsaroundthebuildingasdiscreetlyaspossible.
6.
Themaindeskandfurniturewerefelttobeinappropriateforvisitorsandstaff
Althoughstoragewasaproblemstaffverymuchappreciatedtherelaxingatmosphereinthecentre
11Keythingswhichusuallyworkedwellfortheintervieweesincluded:theatmosphereoftheplaceandfeelingofrelaxation,thekitchenandspecificallythekitchentablewhichwereseentobethebestaspectsofthebuilding,functioningasanautomaticmeetingpointandbeingperfectfortalking.Thecommonroomworkedwellforrelaxationclasses.
12Despitecertainissues,thebuildingdesignoverallwashighlyratedsuggestingthatitsoverridingqualitiesoutweightheissueswithasimilar“forgiveness”factoroperatingforstaffandvolunteersasthatnotedforvisitors.
13Interviewees’viewsoncomfortalsoechoedthoseofthevisitors.Themaincomfortissueswereoverheating,inadequateventilationandsolarglareinthewinterfromlowanglesunlightstreamingintothekitchenarea.Venetianblindsweresuggestedforthekitchentocounteractglareissues.Noisewasnotnormallyaproblemasstaffhadlearnedtolivewithitanditdidn’tgenerallyinterferewiththeirwork.Therewasarealissueofthefrontdoorbanging,especiallywhenitwasleftopeninordertotryandventilatethebuilding.Thequalityofnaturallightwasperceivedtobeverygooddespitetheissueofsolarglareandthekitchenwasfelttobethebrightestarea.Thecommonroomandsmallertherapyroomswerefelttobeabitdark,bycomparison.Thebigspotlightsupstairswerefelttobetoobrightandneededtobere-angled.
14Interviewees,incommonwithvisitors,felttheyhadlittlecontrolovercomfortconditions,withvirtuallyno-oneunderstandinghowtheheatingworked,butrecognizedthatthebuildingwasslowtorespondtochangingconditions,whichledtooverheating.Thewindowventilationwasfelttobeinadequateandthemechanismsforopeningthemratherimpractical.Intervieweeshadresortedtoleavingthefrontandbackdooropentotryandcreatecross-ventilation,butrecognizedthattherewaslittlecontroloverthismeansofventilation.Beingabletopersonallycontroltheheatingwasseentobemoreimportantthancontrollinglightingornoise.
15Despitethesignificantissueofoverheatingandlackofofficespace,staffratedtheoverallcomfortconditionsasbeingverygood,suggestingthatthey,likethevisitors,also“forgave”thebuilding’sparticularcomfortproblemsduetoitsoveralldesignquality.
16Intermsofwellbeing,healthandproductivity,nooverallconclusioncouldbedrawnfrominterviewee’sperceptionsaboutwhetherornottheconditionsofthebuildingactuallyaffectthese,withtwosayingthattheconditionsimprovedboththeirwellbeingsenseofhealthandproductivity,andthereststatingthatitmadenodifference.
Conclusions:
17Fromtheaboveitcanbeseenthattheviewsofthestaffandvolunteersareverysimilartothoseofthevisitors.Additionalissuesraisedbystaffinclude:poorergonomicdesignintheofficeareacombinedwithlackofspace,anambiguousreceptionarea,lackofstorageandunfamiliaritywiththeheatingcontrols.Itcanbeanticipatedfrompreviouspostoccupancyevaluationstudiesthatthelongersomeonehasworkedinabuildingthemoretheybecomeawareofanydeficiencies.Inthissense,itisvitalthatthebriefingprocessandresultantbuildingdesigntakecarefulaccountofstaffrequirementsaswellastheneedsoftheusers.
18RecommendationsforfuturebriefinganddesignofMaggie’sCentresarisingfromtheinterviewfindingsinclude:
a) therequirementfordiscreetandflexiblestoragefacilitiesrelatedtotheoffice.Thesecouldbedesignedtolookdomestic,e.g.builtinshelvingandfilingsystemswithdoorstocloseoffviewsofpaperwork.Baseunitscontainingfilingfacilitiesandotherstorageshouldbedesignedtobemoveabletoenableofficeusetobereconfiguredasnecessaryaccordingtowhoisusingit.
b) therequirementforadequatespaceintheofficeareaforallofficestationstobeusedatthesametimeifnecessary.
6.
c) separatingtheofficeareaofffromtheentrance,whilestillmaintainingadequatesightlines.Sightlinesneedtobecarefullycheckedatdesignstage.
d) providingasound-proofbutmoveablepartitionbetweenthesmallerretreatroomandtherapyroomtoallowthesetobeopenedupformoreflexibleuse.
H The building process
1 AnArchitectrepresentativewasinterviewedseparatelyusingquestionswhichrelatedspecificallytotheconstructionofthebuilding,maintenance,managementandenergyefficiencyinaseparateTechnicalInterviewGuide(AppendixI).Theresultsoftheinterviewwereanalysedinrelationtoacarefulexaminationoftheworkingdrawings,specificationsandheatingbillsforthebuildingtoprovideanoverallappraisalofsustainability.A“walkthrough”withtheClientRepresentativewasusedtofurtherclarifyidentifiedissues.Thebenefitofhindsightwasusedtoestablishwhat,ifany,additionalchangesmightbemadetothefuturebriefing,design,specificationandconstructionofsmall-scalehealthcarebuildingssuchasMaggieCentres.
Construction process
2 Fromthelocalarchitect’spointofview,therehadbeennoproblemsduringtheplanningstageandtheiconicstatusofthebuildinghadverymuchhelpedinthisrespect.Theconstructionhadbeenequallystraightforwardapartfromtheroof,forwhichtheholdingofdesignandconstructionworkshopsbeforegoingonsitehadeasedmatters.Thespecialised“angelhair”finishtothestainlesssteelroofhadtobecarriedoutintheUSAbecausenoonewoulddoitintheUK.Theconstructionprocesshadturnedouttobeslowerbutnotgreatlyso.Thebuildcontracthadbeenfor12monthswhennormallyitwouldhavebeen6-8months.Therehadbeennoparticularproblemsduringthedefectstagebecausepeoplehadtakenarealprideinthejob.
Maintenance
3 Accordingtothelocalarchitectsandstaff,ongoingmaintenancerequirementsforthebuildinghadbeenrelativelylowatthetimeofthisstudyalthough,fromrecordsanalysed,therehadbeenanumberofcalloutsrelatingtothepoorperformanceoftheheatingsystemandthenon-disabledw.c.AnymaintenancerequiredhadbeenarrangedonarelativelyinformalbasisbytheCentreHeadwiththeNHSestatesdepartment,thelocalarchitectsoragentsresponsibleformaintainingtheservices.
4 Thehoodedeffectoftheroofhadhelpedtosheltersomeoftheexposedtimber,althoughitwasthoughtthattheexternaltimberonthesouth/southwestwoulddeteriorateunlessitisregularlymaintained.Theexternaltimberseatingwillbeneedparticularattentioninthisregard.ThedesignarchitectshadspecifiedaverticalgrainimportedDouglasFirforaestheticreasons,evenalthoughthelocalarchitectshadrecommendedamoredurable
hardwoodbecauseofthesevererainfallinScotland.
5 Wallingareaswhichweresubjecttosignificantwearthroughfurnitureabrasionandhandprintshadbeenrepaintedandwerelikelytoneedrepaintingrelativelyfrequently.
6 Generallythefinishestothebuildingwerefelttobeofgoodquality,apartfromtheexternaltimber,anditwasanticipatedthatthehighercapitalcostandinvestmentinbetterqualitymaterialsshouldresultinlessmaintenance.
6.
Theexposedsoftwoodtimberonthesouthsideofthebuildingwillneedmaintenance
7 Atowerwillberequiredtochangetheinternallighting,anditwasrecommendedbythearchitectsthatthelow-energylightbulbswerereplacedallinonegowhenthefirstonegoes.Acherrypickerwillbeneededtoservicetheroofbecauseofitsparticulardesign.Thearchitectdidnotfeelthatmaintenanceexpenditureonthebuildinghadbeenexcessivetodate.
8 Itshouldbeaddedthatnolifecyclecostinghadbeenspecificallycarriedoutonthisdevelopmentatthedesignstagetominimisefuturemaintenancecosts.
Management
9 Accordingtothelocalarchitect,theperformanceofthebuildinghadgenerallyfulfilledthebriefrequirementsapartfromtheofficearea,wheretheergonomicswerenotthoughttobeoperable.TheofficedidnotcomplywiththeDisabilityDiscriminationAct,becauseitwasnotpossibleforawheelchairusertoworkintheoffice.Itwouldbepossible,however,forawheelchairusertobeaccommodatedelsewhere,giventheflexibilityofthebuilding.
10Thebuildingwasperceivedtobeveryflexibleinusebythelocalarchitect,whopointedoutthatalaptopfacilityhadrecentlybeenaddedtothekitchentableareatoenablepeopletouseITwhilehavingacupoftea.Itwassuggestedthattherewaslotsofopportunityforthiskindofflexibility.Storageareas,however,werefelttoberelativelyunprovidedforandthelocalarchitectssuggestedthattheclientwillneedtore-examinetherequirementforthis.
11Generally,althoughthebuildingwasfelttoworkwellandhadacompletelackofinstitutionalfeeling,thelocalarchitectsuggestedthatthebriefwasnotcomprehensiveenough.Neverthelessthedesignwasratedbyhimas“prettyclosetoexcellent”.
12The“walkthrough”revealedthatsightlinesfromthePCinformationstationandthekitchenareastotheentrancedoorwereblockedtoadegree,leadingtostaffhavingtopositionthemselvescarefullyatalltimestoensurethattheycouldhear/seevisitorsarriving.Thiswas,however,viewedpositivelyasitensuredthatstaffremainedattentivetoallpartsofthebuilding.
Energy efficiency
13Theprimarymeansofheatingthebuildingwasbyunderfloorheatingusingadomestic30kWcombinationgasboilerforthegroundfloorwetsystemandelectricityfortheupperfloorunderfloorheating.A6.6kWwoodstove-effectgasfireprovidedadditionalheatingtotheupperlevelareaabovethelibrary.Thewetsystemwasdesignedtoberunataconstanttemperaturesettingofaround18˚Cwithlocalisedheatingelementsinthekitchenareaandlargegrouproomtotopthisupasrequired.Theunderfloorheatingwassplituptoeightdifferentzonesrelatingtodifferentpartsofthebuilding,eachwithaseparatethermostat.Thesecouldonlybeadjustedbyoneortwodegrees,however,fromthemainprogrammesetting.Thelocalarchitectwasnotconvincedbythecontrolmechanismforthelocalisedheatingelementandatthetimeofthisstudytheheatingcoilitselfappearedtobemalfunctioning.
6.
14Serviceengineer’sreportsnotedseveraltimesthattheheatingprogrammerwasonthewrongsettingsandhadtobereset.Therehadalsobeensomepastproblemswiththeheaterunderthebenchunitinthekitchenandintheofficearea.Itisquiteclearfromtheengineer’sreportsthatstaffregularlyreportedproblemswiththeheatingwhichwerelargelyrelatedtothecomplexityoftheprogrammer.Theauthoralsoobservedthecomplexityofusingtheprogrammerduringthe“walkthrough”.
15Thelocalarchitectobservedthattherewasconsiderablesolargaininthebuildingasnotedalsobyusers.Onedesignsuggestionhadbeentousefrittedglassforthelargeskylightovertheconcretefloorinthecentreofthebuildingtopreventexcessiveheatbuildup,butthedesignarchitectshadbeenadamantthattheusersshouldbeabletoseetheskyjustasitwas.Thelocalarchitectalsostressedtheneedtocontinuouslyeducatethestaffonhowtousetheheatingsystemduetotheinevitableturnoverofpersonnel.
16Thebuildingwasdesignedtobenaturallyventilatedapartfromareaswithnooutsidewall,whichwereservedbymechanicalventilation.Thelocalarchitectrecognisedthattheshapeandvolumeofthemainspacestogetherwithnaturalventilationonlyoccurringthroughthelow-levelsashwindows,wasnotaltogetherhelpfulinthisregard.Itwassuggestedthatarapidextractsystemcombinedwithheatrecoverymayhelptoovercomeanyventilationoroverheatingissues.
17Thelevelsofinsulationinstalled(60mmRockwoolHPintheexternalwalls,35mmrigidinsulationinthefloor,and80mmFoamglassintheroof)werethoughttobeinexcessofthebuildingregulationsatthetimeandthelocalarchitectfeltthatthebuildingshouldbeverygoodintermsofenergyefficiency.Bestpracticeinthisareawouldhoweversuggestdoublingtheselevelsofinsulationinfutureprojectsinordertoreducecarbondioxideemissionstoasustainableratewhichwillmitigateclimatechangeinfuture12.
18Evidenceontherunningcostsfromfuelbillsobtainedforafullyear(Table12,AppendixV)indicatesthat,despitetheheatingcontrolissuesidentified,theenergyusewaswellwithinthegovernmentenergytargetof35-55GJ/100cu.mfornewbuildingsintheNHSEstate(2001-10),cominginat29.4GJ/100cu.m.Energyrunningcostswere£64perweekfor286kwh/m2.Totalcarbonemissionsforthebuildingwere4.4tonnesfortheyear.
6. 12Stevenson,F.andWilliams,N.(2000)SustainableHousingDesignGuideforScotlandp.36
Overall sustainability
19 AnappraisaloftheoverallsustainabilityoftheDundeeMaggieCentrebuildinginvolvedanassessmentofanumberofinterrelatedareas:resourceuse,pollution,biodiversity,healthyenvironments,peopleandcommunitiesandthebuildingprocessitselfdrawingontheheadingsinTable1313.Thelimitationofthisstudydidnotpermitafullassessmenttobemade,andwhatfollowsisabriefoverviewfollowingscrutinyofthedrawingsandspecificationtogetherwithvisitstothebuildingandinterviewswithvariousparties.
20 Resource Use: Thedesignofthebuildingitself
hasreducedenvironmentalimpactthroughtheextensiveuseofrenewabletimberinthestructuralframing,windows,doorsandcladding.Howeveritshouldbenotedthatthereislikelytohavebeenasignificantamountofembodiedenergytiedupinthetransportationofcertainelements,suchasthesteelcladdingfortheroof,whichhadtobetransportedtotheUSandbackagainforfinishing,andthetimberstructuralbeamswhichweremanufacturedinFinland.Theextensiveuseofbuildingproductsandmaterialsbondedtogetherbystrongadhesiveswillmakeitdifficulttorecyclethesecomponentsattheendoftheirlife,althoughthemaintimberelementscouldintheorybere-used.
21 Pollution and Biodiversity: Almostalluserswerecommuting
bycar,arelativelypollution-intensiveformoftransport,despiteaccessiblepublictransportfacilitiesonsite.ThesolutiontothisliesbeyondthecontroloftheMaggie’sCentres,possiblyintheformoflesspollutingcars.Thematerialsandproductsusedinthebuildingwererelativelystandardandnoparticularattempthadbeenmadetospecifylowpollutantsbeyondregulatorypractice.Biodiversityonthesiteremainedrelativelyunaffectedbecausethesiteitselfhadnoparticularmerittostartwith.Althoughnoattemptshadbeenmadetoenhancebiodiversitytodate,thepotentialisofferedthroughfuturelandscapinginitiatives.
22 Healthy Environment: Therehadbeensignificant
emphasisoncreatingahealthyenvironmentwithinthebuildingthroughthespecificationoflow-emissionpaintandvarnishfinishes,theextensiveuseofnaturalmaterialsinsidethebuilding,theuseofnaturalventilationanddaylight.Therewas,however,noparticularrequirementinthebrieftominimisetoxicityortooptimisehumiditylevels,bothofwhichhelppreventallergicreactions14.Neverthelesstheperceptionbyuserswasthattheairqualityinthebuildingwasrelativelygood,possiblyduetothegenerousvolumesprovidedbythedesignwhichprovidedadegreeofbufferingintermsofairquality.
6. 13Halliday,S.P.andStevenson,F.(2004)SustainableConstructionandtheRegulatoryFramework:AThinkPiece,GaiaResearch,Edinburgh,http://www.gaiagroup.org/Research/IDS/suc-con-reg/index.html
14Berge,B(2000)Ecologyofbuildingmaterials.ArchitecturalPress,Oxford.Thisbookextensivelydescribesthepropertiesofvariousconstructionmaterialsandishelpfulforspecificationpurposes.
Thedesignofthebuildinghasreducedenvironmentalimpactthroughtheuseoftimber
23 People and Communities: Theoutstandingdesignqualityof
thebuildinghadgreatlybenefitedthelocalcommunityintermsofraisingDundee’sprofileasacity,althoughthedirectbenefitstothelocalconstructionandmanufacturingeconomywererelativelyminimalgiventhatmostproductsforthebuildinghadbeenimportedtotheregion.Therewereno“locallabour”clausesspecifiedinthecontractassuch,tohelppromotethelocaleconomy.
24 Building Process: Thebuildingprocessdidnotutilise
anyparticularsustainabilitytoolsorbenchmarksandpostoccupancyevaluationwasnotspecifiedaspartofthebriefingprocessassuch.Therewas,however,extensivepre-evaluationofthedesignwiththeclientbodyandaverycloseandcontinuousrelationshipwiththearchitect.Futureexpansionofserviceshadbeenconsideredandratherthanexpandthebuilding,theclientwouldconsiderbuildinganotherbuildinginstead.Future-proofingthebuildingintermsoffuturelegislativerequirementsorupgradingelementswasdifficulttoanticipateandpotentiallyexpensive.Althoughthebriefspecificallyrequiredthatthebuildingshouldeconomicaltomaintain,therewasnobriefforthearchitectorcontractortoprovidesustainablemethodsofconstructionthatminimisedwaste,energyuseandaddressedclimatechangebeyondstatutoryrequirements.
Conclusions:
a) Design issues:
1 Thedomesticnatureofthedesignresultedinarelativelystraightforwardconstructionprocessapartfromtheroof.Thecontractlengthwasslightlylongerthanforabuildingofasimilarsize,butthedifferenceisrelativelyinsignificant.
2 Intermsofmaintenance,itisimportanttotakeaccountofthelocalclimatewhendesigningandspecifyingexternaltimberelements.Largeflattimbersurfaces,suchastheseatingonthe“jetty”shouldbeavoidedaswaterwillsitontheseandleadtoprematuredecay.
3 Althoughtheprovisionofanenvironmentallysustainabledevelopmentwasnotaprimaryaimoftheoriginalproject,thedesignhasaddressedtheseonanumberoflevelsincludinggoodlevelsofdaylighting,passivesolargainanddurability.Ithasalsominimisedenvironmentalimpacttoadegreethroughthespecificationofrelativelylowembodiedenergytimberforprimaryandsecondaryelementsofthedevelopment.Incorporatingthebriefingrequirementsrelatedtoresourceuse,pollution,biodiversity,healthyenvironments,peopleandcommunitiesandthebuildingprocess,wouldimproveperformanceinalltheseareas.
4 ThereisalsoscopeforfutureMaggie’sCentrestoreducecarbondioxideemissionstoamoresustainablelevel,forrelativelylittleextracapitaloutlay,byintroducing“quickwins”tothebriefwhichrecognisethecostconstraintsofanorganisationdependentonfundraising.Theseinclude:
• increasedloftinsulation• useofmaterialsandproductswith
recyclateinthem• wasteminimisationprocedures
duringconstruction• minimaluseoftimbertreatments• category“A”boilers.
b) User related issues:
5 Themaintenanceandrunningofthebuildingisrelativelytraightforwardapartfromtheheatingsystem.Atpresentmaintenanceiscarriedoutonarelativelyinformalbasis.ItmaybeusefulfortheMaggie’sCentres,atthisstageofdevelopmentasanorganisation,toconsideremployingapermanentbuildingsmanagerfortheirstock,whowouldbeablehelpstaffunderstandproblemsrelatedtoheating,ventilationandgeneralmaintenanceandensurecontinuinginductionfornewstaffunfamiliarwithhowtoruntheirbuilding.Thispersoncouldalsobechargedwithcyclicalmaintenanceplanningandbroughtinonthebriefingprocessfornewprojectsinordertoprovidetechnicalfeedbackonproposedspecificationsrelatedtotheactualrequirementsofusers.
6.
1 ThelimitedscopeofthisshortstudypresentsasnapshotoftheDundeeMaggie’sCentreandcannotseektoreplicateafullmonitoringexerciseoveralongerperiodoftime.
2 Themethodologyadoptedhashowever,revealedagreatdealofbothsubjectiveandfactualinformationwhichhasprovidedarichpictureofhowwellthebuildingisperformingandcouldbereplicatedforfuturebuildings.
3 Theresultsofthesmallpilotsurveyindicatethatthebuildinghassuccessfullyachievedthefollowingobjectivesofthebrief:
• ahighlyeffectivedesignconceptinrelationtotheMaggie’sCentre’scaremodel
• veryhighusersatisfactionoverall,withfacilitiesprovidingacalmandfriendlyspaceandanappropriatedegreeofprivacy
• highlevelofoverallcomfort• usersperceptionofincreased
healthandwellbeingduetovisitingthebuilding
• particularappreciationoftheviewsoutofthebuilding
• lowlevelofmaintenancerequired
4 Thebuildinghasbeenlesssuccessfulinachievingthefollowingobjectives:
• flexibleofficespacewhichisseparateyetvisiblefromwelcomearea
• adequatestoragefacilitiesfortheofficeareaandotheractivities
• thermalcomfort
5 Evidenceontherunningcostsfromfuelbillsobtainedforafullyear(Table12,AppendixV)indicatesthat,despitetheheatingcontrolissuesidentified,theenergyusewaswellwithinthegovernmentenergytargetof35-55GJ/100cu.mfornewbuildingsintheNHSEstate(2001-10),cominginat29.4GJ/100cu.m.Energyrunningcostswere£64perweekfor286kwh/m2.Totalcarbonemissionsforthebuildingwere4.4tonnesfortheyear.
6 Thehighlevelofoverallusersatisfactionvalidatesadesignapproachwhichhasplacedanemphasisonthequalityandgeneroussizeofinternalspaces.Goodqualityinternaldesignalsogivesthebuildingahigh“forgiveness”factorinrelationtocomfortissuesconcerningoverheating,humidity,ventilationandglare.
7 ThereareanumberofissuesarisingfromtheevaluationinthelightoftheoriginalbriefanddevelopedproposalwhichshouldbeinvestigatedfurthertohelpimprovethedesignqualityofMaggie’sCentresandothersmallscalehealthcarebuildings:
Design Issues:
a) largeareasofsouthfacingglazingcanleadtooverheating,unlessadequateexternalsolarshadingandventilationmeasuresaretaken
b) thesizeoftheofficeshouldtakeaccountoftheneedforflexibility,storageandadequatecirculation
c) thespecificationoftheunderfloorheatingsystemneedsanadequateandinstantaneoustop-upsysteminthelightofthefluctuatingnumberswhichuseaMaggie’sCentre.
d) thespecificationanddesignofwindowsmustallowforadequateventilationathighlevelandshouldbedesignedtoalloweasyopeningbyoneindividual
e) adequatecrossventilationisneededbetweenroomsifthissizeofbuildingistobenaturallyventilated
f) thepossibilityofprovidingasound-proofmoveablepartitionbetweenthesmallerretreatroomandtherapyroomtoallowformoreflexibleuse.
7. Conclusions and Recommendations
User-related issues:
a) userinductionshouldbeaninherentfeatureofanynewbuildingandneedstobecontinuous,especiallyinrelationtoheatingandventilationcontrols,toavoidpotentialmisunderstanding
b) complexheatingprogrammersshouldbeavoided–thedesignteamneedtoensuretheyaresimpletounderstandwithnounnecessaryoptionsforsettings
c) thepositionoftheofficeshouldbeconsideredcarefullyinrelationtostaffrequirementsaswellasuserrequirements,andavoidbeingseenasa“receptionarea”.Thekitchenshouldideallyleadimmediatelyoffthemainentrance,astheprimarysocialspace,toavoidfirsttimevisitors“hovering”attheentrance
d) theuseofchairswithoutarmrestsoradequatebacksupportforconversationalmodeisnotrecommendedforambulantdisabledusers
e) thereisaneedforincreasedcarparkingprovisionatpeaktimes.
8 Positiveoutcomesthatshouldbeadoptedfromthebuildingdesigninfuturebriefingincludetheuseof:
Design principles:
a) emphasisonexternalviewsofnaturefromthebuilding,whicharenaturalandupliftingforusers
b) relativelygenerousspacestandards
andvolumecombinedwithacarefullydesignedabundanceofnaturallighting,whichallowsairtoremainfresh
c) theuseofhighqualitymaterialsandfinishestominimisemaintenancecostsandincreasedurability
d) theuseoftimberforboththeprimaryandsecondaryelementsofconstructiontominimiseenvironmentalimpact.
User-related principles:
a) openplanlayout,whichwhileprovidingasenseofwelcomealsomakescirculationandinternalmanagementrelativelyeasy
b) thegenerous“farmhouse”kitchenastheprimarysocialspace,whichisthekeytothesuccessoftheMaggie’sCentre
c) theinclusionofavarietyofdifferenttypesofspaceswhichallowdifferentactivitiestooccurinthem.
9 ThereareanumberofareaswherethebriefingprocessfortheMaggie’sCentrescouldbestrengthenedinordertoimprovetheoverallperformanceoftheirbuildings,includingtherequirementfor:
a) simpletounderstandandeasytouseheatingsystems,controlsandprogrammerswhichcanrespondtorapidlychangingoccupancylevels
b) low-noisemechanicalventilationequipmentinuserenvironmentswhichdon’tinterferewithquietconversation
c) adequatesolarshadingandprovisionofcross-ventilation
d) specificstorageareasandfacilitiestobemoreclearlyidentifiedorsystemforremovingitems
e) adequatecirculationinofficeareas
f) sustainabledesignandspecificationwhichdrawson“quickwins”withincostconstraints.
10ASWOTanalysisbasedonthestudyfindingstoestablishtheoverallefficiencyofthedesignandfuturestrategiesinrelationtotheinitialprojectobjectivesisshownoverleaf.
7.
Strengths
successfuldesignconceptinrelationtoMaggieCentrecaremodel
qualitativenatureofdesignbrief
outstandingscenicviewsfrombuilding
qualityandabundanceofnaturallight
openplanlayout
welcomingandengagingkitchenarea
flexibilityofdesignfordifferentuses
staffethos
7.
Weaknesses
inadequateventilationdesignandlackofsolarshadingleadingtooverheating
poorthermalcomfortconditionsduetounderfloorheatingsystemandthermalmasswhichcannotrespondquicklytorapidchangesinuseractivitiesandnumbers.
complicatedheatingprogrammer
unergonomicchairsandseating
relativelyundevelopedbriefingdocumentationandfeedbackproceduresforprojects
Opportunities
addmoveablesolarshadingtosouthfacingkitchenwindowstoreduceglare
remodelofficearea
continuoususerinductiontohelpunderstandthebuilding’sheatingandventilationandcontrolitbetter.
improveddesignbrieftotakeaccountofidentifieddesign,sust-ainability,andmaintenanceissues
employmentofbuildingsmanagertoprovidestrategicsupport
Threats
staffdissatisfactionwithworkingconditionsinofficearea
futurelegislativerequirementsinrelationtosustainabledesign
increasingenergybillsforfossilfuels
longtermmaintenanceofexposedtimber
11Thefollowingaspectspresentopportunitiesforfurtherresearch:
• awiderstudyofallMaggieCentresusingafurtherrefinementofthemethodologyestablishedinthispilotstudytoascertainspecificoutcomesandresearchquestionswhichexaminekeydesignfeaturesinrelationtouser’sperceptionhealthandwellbeing.
• awiderstudyoftherelationshipbetweenuser’sabilitytocontroltheirenvironmentandtheirperceivedstateofhealthandwellbeing.
• thedesignofventilationandheatingstrategiesinrelationtothepresence,orabsence,ofthermalmassinsmall-scalehealthcarebuildingsandtheeffectthishasonenergyefficiencyandcomfort
SWOT analysis of Dundee Maggie’s Centre
AssociationforEnvironmentallyConsciousBuildersarticleonLightweight.v.Heavyweightconstruction,Vol.11,no.3pp.30-34Winter2001-02
Berge,B(2000)Ecologyofbuildingmaterials.ArchitecturalPress,Oxford.
BuildingandResearchInformation,Vol29,Number2,March-April2001SpecialIssueonPost-occupancyEvaluation
BuildingandResearchInformation,Vol33,Number4,September2005
Burt-O’Dea,K.(2005)DesignImpactStudy.Plan&Projectpartners,EuropeanHealthPropertyNetwork.
DepartmentoftheEnvironment,TransportandtheRegions(2000)BuildingaBetterQualityofLife:AStrategyformoreSustainableConstruction,HMSO,Norwich
Halliday,S.P.,andStevenson,F.(2004),SustainableConstructionandtheRegulatoryFramework:AThinkPiece,GaiaResearch,Edinburgh,http://www.gaiagroup.org/Research/IDS/suc-con-reg/index.html
Jencks,C.TheMaggieCentresMovementEightYearsIn…,FourthDoorReview,Nos.7,2005pp.30-33
Lawson,B.etal(1998-2001)TheArchitecturalHealthcareBuildingandItsEffectsonPatientHealthOutcomes,UniversityofSheffield
Roaf,S,Fuentes,MandThomas,S.(2001).Ecohouse:ADesignGuide,ArchitecturalPress,Oxford.
Stevenson,F.andWilliams,N.(2000),SustainableHousingDesignGuideforScotland,TheStationeryOffice,Norwich
Stevenson,F.(2005)Environmentalarchitectureandthehealthbuilding;thematerialityperspective,FourthDoorReview,Nos.7,pp.38-42
Wagenaar,C.(ed.)(2006),TheArchitectureofHospitals,NAiPublishers,Rotterdam
AEDETEvolution:DesignEvaluationToolkit,NHSEstatesDept,Londonhttp://knowledge.nhsestates.gov.uk
ASPECT:StaffandPatientEnvironmentCalibrationToolkit,NHSEstatesDept,Londonhttp://knowledge.nhsestates.gov.uk
NHSEnvironmentalAssessmentTool(NEAT),NHSEstatesDept,Londonhttp://www.dh.gov.uk
8. Bibliography
Appendix 1User Interview Guide
Staff Interview Prompt Sheet for Questions
Interviewer:IamcarryingoutthisinterviewaspartofastudytohelpwithfutureplanninganddesignofMaggieCentres.Theinformationcollectedwillbetreatedascompletelyconfidential.Thefinalreportofthestudywillusesummariesoftheinformationandnotrevealtheidentitiesofanyindividuals.Anynotesontheinterviewwillbedestroyedattheendofthestudy.
Theinterviewwilllastaboutanhouranditwouldbehelpfulifyoucouldanswerasmanyquestionsasyoucan.
A Background Questions:
1. Whatisyourage?
2. Whatisyoursex?
3. Whatisyourhomepostcode?
4. Howdidyougethere?
5. Doyousitnexttoawindowatyournormalworkplace?
6. Howlonghaveyouworkedinthisbuilding?
7. Howmanydaysdoyouspendinthebuildinginanormalweek?
8. Howmanyhoursperdaydoyouspendatyourdeskorinyournormalworkareaonanormalworkingday?
9. Howmanyhoursperdaydoyounormallyspendworkingwithacomputerscreen(VDU)?
B The Building Overall
10.Whatimagedoyoufeelthebuildingprojects?
11.Howwouldyoudescribethelevelsofprivacyitprovides?
prompts-foryourwork-forvisitors
12.Howdoyoufindthelayoutofthebuilding?
prompts-howeasytounderstand-howpractical
13.Howwelldothinkthespaceisusedinthebuildingasawhole?
14.Doesthebuildingasawholemeetyourneeds?
15.Howwouldyoudescribetheviewsinsideofthebuilding?
16.Howwouldyoudescribetheviewsfromtheinsidetotheoutside
ofthebuilding?
17.Whatdoyouthinkofthestoragearrangementsinthebuilding?
prompts-foryourwork
18.Allthingsconsidered,howdoratethebuildingdesignoverall?
C Your Work Requirements
19.Pleasebrieflydescribetheworkthatyoucarryoutinthisbuilding
20.Specificallyforthepurposeofyourwork,howwelldothefacilitiesmeetyourneeds?
21.Canyougiveexamplesofthingswhichcanhindereffectiveworking?
22.Canyougiveexamplesofthingswhichusuallyworkwell?
23.Howdoyouratetheusabilityofthefurnitureprovidedatyourdeskornormalworkarea?
24.Doyouhaveenoughspaceatyourdeskornormalworkarea?
D Comfort
25.Howwouldyoudescribethecomfortconditionsinthebuilding?
prompts:-temperature-airquality
26.Howwouldyoudescribenoiseinthebuilding?
prompts: -noisefromotherpeople-othernoisefrominside-noisefromoutside
27.Howwouldyoudescribethequalityoflightinginthebuilding?
prompts-lightingoverall-naturallight-glarefromsunandsky-artificiallight-glarefromlights
E Personal Control
28.Howmuchcontroldoyoupersonallyhaveoverthefollowingaspectsofthebuildingduringyourvisit?
-heating-cooling-ventilation-lighting-noise
29.Howimportantisittobeabletocontrolthesefactors?
30.Allthingsconsidered,howwouldyouratetheoverallcomfortofthebuildingenvironment?
31.Isyouroverallwellbeingincreasedordecreasedbytheenvironmentalconditionsinthisbuilding?
32.Doyoufeelthatthebuildingaffectsyourhealthbymakingyoufeelmoreorlesshealthy?
33.Doyouthinkyourproductivityatworkisdecreasedorincreasedbytheenvironmentalconditionsinthisbuilding?
34.Anyotherscomments?
Thankyouforagreeingtotakepartinthisinterview,whichshouldtakeabout45minutes.CanIassureyouthatnorecordsoftheinterviewwillbekeptwithyournameonthem.IwillbetapingthisinterviewbutthetapewillbedestroyedonceIhavemadeanonymousnotes.Canyoupleasetrytoanswerallquestionsasfullyasyoucan.
Background:
1.Howoftenhaveyouvisitedthebuilding(onceitwascomplete)
2.Whatwasyourinvolvementwiththebuilding?
Section A: Performance Aspects
3.Howdoyouthinkthedevelopmenthasmeasureduptotheoriginalexpectationsofthebrief?
Probes-layout-useofspace-viewsinside-viewsoutside-flexibility-privacy
Appendix II Technical Interview Guide
Section B: Construction
4.Wasconstructioneasierormoredifficultcomparedtostandardsmallscalepalliativecaredesign?
Probes-structure-superstructure-foundations-services-fittings-finishes
5.Wasconstructionfasterorslowercomparedtostandardsmallscalepalliativecaredesign?
Probes-structure-superstructure-foundations-services-fittings-finishes
6.Werethereanyproblemsduringtheplanningstageofthescheme?
7.Werethereanyproblemsduringtheconstructionstageofthescheme?
8.Werethereanyproblemsduringthedefectsstageofthescheme?
9.Howeasyisthebuildingtomaintainandclean?
Probes-maintenancedifficulties-cleaningdifficulties-lifecyclesformaterials,finishes
10.Whatimprovementswouldyoumaketothebuildingintermsofconstructioninhindsight?
Section C: Heating, Ventilation and Lighting
11.Howisthebuildingmeanttobeheated?
Probes-whenduringday/season-usingwhat
12.Howwellhastheheatingsysteminthebuildingperformed?
Probes-comfortlevels-temperaturesinallseasons-easeofuse-responsiveness-qualityofheat-anyproblems
13.Howisthebuildingmeanttobeventilated?
Probes-whenduringday/season-usingwhat
14.Howwellhastheventilationstrategyinthebuildingperformed?
Probes-comfortlevels-easeofuse-responsiveness-airquality-anyproblems
15.Howisthebuildingmeanttobelit?probes-natural-artificial
16.Howwellhasthelightingstrategyperformed?
17.Howenergyefficientisthebuildinginyourview?
18.Whatimprovementswouldyoumaketotheheating,ventilationorlightinginhindsightifany?
Section D: Flexibility
19.Howflexibleisthebuildinginaccommodatinguserneeds?
probesuseofroomsworkspaceacousticprivacy
20.Howwelldoyouthinkthebuildingcouldaccommodatefutureuserneeds?
probes-storage-disability-growinguse-workspace/IT
21.Whatimprovementswouldyoumaketotheschemeintermsofflexibilityinhindsightifany?
Section E: General
22.Pleasegiveexamplesofthingsaboutthebuildingwhichworkwell?
23.Pleasegiveexamplesofthingsaboutthebuildingwhichhinderitseffectiveoperation?
24.Inonewordwhatimagedoyoufeelthebuildingprojects?
25.Allthingsconsidered,howdoyouratethedesignoverall?
26.Arethereanyothercommentsyou’dliketomake?
Appendix IIIDrawings – plans/sections/elevations
Ground Plan
Section looking North
Section looking North
Appendix III
Appendix IV Benchmarking for fuel costs
Table x: Energy/ C02 Benchmarking for Fuel Costs
Building Type Total Volume M3 Kwh/m2/year CO2/tonnes/m2/year NHS EstatesBenchmark (2001-2010) GJ/m3/year
New buildings 35-55
DundeeMaggie’s Centre 785 286 0.07 29.4
Appendix V Tables
1: User Demographics (Questionnaire)
Parameters Age Over30yrs=97% Under30yrs= 3%
Sex Female=69% Male= 29%
Status Sufferingfromcancer=71% Carer= 29%
Travel mode Car=82% Walk= 9%
Nos. of visits 5timesormore=73% firsttime= 12%
Length of visits Variable 1-2hours= 43%
Rating of health in past week 62%aboveaverage 19%underaverage
Rating of quality of life in past week 56%aboveaverage 10%underaverage
2: Visitor Satisfaction (Questionnaire)
Parameters Criteria Nos. of visitors rating this at top of scale (1-7) image verygood 71%
lastingimpression verygood 68%
layout easytounderstand 53%
spaceuse effectively 41%
meetingmyneeds verywell 52%
viewsinside good 76%
viewstotheoutside good 82%
designoverall satisfactory 70%
3: Purpose of visit (Questionnaire)
Reason stated N Counselling/chat 5
Before / after treatment 2
Women’s group 6
Relaxation group 10
Carer’s group 5 Medical student placement 1
Care of plants 1
Volunteer 1
Collect Information 1
Not ascertained 2
Total 34
4: Specific Needs for Visit (Questionnaire)
Parameters Criteria Nos. of visitors rating this at top of scale (1-7) meetingmyneeds verywell 52%
talkingtoothers verycomfortableto 67%
feelingatease atease 72%
freedomtouse alot 76%thebuilding
Appendix V Tables
6: Personal Control
Parameters Criteria Nos. of visitors rating this at top of scale (1-7) Heating nocontrol 46%
Cooling nocontrol 35%
Ventilation nocontrol 35%
Lighting nocontrol 27%
Noise nocontrol 42%
5: Comfort (Questionnaire)
Parameters Criteria Nos. of visitors rating this at top of scale (1-7) Comfortoverall satisfactory 58%
Noiseoverall satisfactory 58%
Lightingoverall satisfactory 58%
Appendix V Tables
7: Relationship of Features with Health Ratings (Questionnaire)
Self Reported Ratings Scales
Overall* Overall Well being* Health* Health QoL Past week Past week
1st Impression + +++ Lasting Impression † ++
Layout -
Space Use ++ +
Needs +++ +++
Views Inside
Views Outside
Visit Needs +++ +++
Talk to others + +
At ease +++ ++
Freedom of use + +
Overall design +++ +
*highScoreispositiverating†lowscoreispositiveratingblankcellrepresentsnoconsistentrelationshipfound- weaknegativerelationship(p<.1)--moderatenegativerelationship(p<.05)---strongnegativerelationship(p<.01)+ weakpositiverelationship(p<.1)++moderatepositiverelationship(p<.05)+++strongpositiverelationship(p<.01)
Appendix V Tables
8: Self Reported Rating Scales
Well being* Health*
Overall Temperature* + ++ Overall Comfort ++
Noise Overall* +++
Noise from Inside† -- -- Noise from Outside† -
Lighting* Overall + +++
* highScoreispositiverating† lowscoredenotes‘toolittle’noise blankcellrepresentsnoconsistentrelationshipfound- weaknegativerelationship(p<.1)-- moderatenegativerelationship(p<.05)--- strongnegativerelationship(p<.01)+ weakpositiverelationship(p<.1)++ moderatepositiverelationship(p<.05)+++ strongpositiverelationship(p<.01)
9: Self Reported Rating Scales
Control of... Well being* Health*
...Heating + … Cooling ++ +
… Ventilation ++
… Lighting +
… Noise
Appendix V Tables
10: Technical Measurements on 24th March 2006 in Dundee Maggie Centre
Outside Reception Kitchen Main room Upstairs Noise levels dB 9 am 65 52 50 32 31 1 pm 65 62 66 32 45
5 pm 53 62 55 31 31
Lux levels dB 9 am 1200 288 269 187 797 1 pm 900 350 218 209 1900
5 pm 271 314 748 (light) 131 (off) 400
Relative Humidity 9 am n/a 33 31 31 30 1 pm 51 46 31 29 31
5 pm n/a n/a 30 29 31
Temp C 9 am 19.7 21 20.5 21.7 1 pm 11.4 23.3 23.8 24.2 24.4
5 pm n/a 22.8 23.4 23.8 22.5
Appendix V Tables
Outside Reception Kitchen Main room Upstairs
Windows open? 9 am no no yes (1) no 1 pm no yes (1) yes (1) no 5 pm no yes (3) no no jetty door
Other things - draughts, smells etc. no smells/draughts
General Comments: Very sunny all day, little wind, average humidity. Snow melting. Tai Chi class at 1.30 Relaxation class at 3 Benefits advisor in morning Busy in kitchen at lunchtime Building open from 9-5pm. Main room unused in morning, but all other rooms used. Need to check boiler room.
Appendix V Tables
11: Variables better than BUS benchmark
Air in Winter: fresh/stuffy
Comfort: overall
Design:
Health (perceived):
Image to visitors:
Lighting: artificiallight,glarefromlights,overall
Needs:
Noise: overall,noisefromotherpeople
Space in the building:
Temperature: overall
Summary: Variables no different from BUS benchmark
Air in Winter: dry/humid Controlovercooling,heating,lighting,noise,ventilation
Lighting: glarefromsunandsky
Noise: othernoisefrominside,noisefromoutside
Temperature: hot/cold,stable/varies
Summary: Variables worse than BUS benchmark
Air in Winter: still/draughty
Lighting: naturallight
Appendix V Tables
12: Heating costs and CO2 emissions
Heating Period Cost Units Energy, CO2 and Carbon Emissions
Oct–Dec2005 Electricity£525 4084 ThesewerecalculatedusingtheEnergy SavingTrust“energycalculator”at
www.est.org.uk
Oct–Dec2005 Gas£320 1357Jan–March2006 Electricity£679 5347
Jan–March2006 Gas£456 1858
April–Sept2006 Electricity£1048 7261April–Sept2006 Gas£281 1003Totalsforyear Electricity£2252 16692 Gas£1057 4218
kwh/pa Electricity 16692kwh 7044kgCO2/pa (1kwh/unit) (60GJ)
Gas 47705kwh 9254kgCO2/pa (11.31kwh/unit) (172GJ) (1kwh=0.0036GJ)Total overall £3309/pa 232GJ/pa 16.3tonnesCO2/paenergy cost and (£64p.w.) 64397kwh/paCO2 emissions/pa
Total carbon 4.4tonnescarbon/paemissions/pa (0.019 tonnes carbon/sq.m/pa)
Overall energy £15/sq.m 1.03GJ/sq.m 0.07tonnesCO2/sq.m/pacostand CO2 (225sq.mtotal (286kwh/sq.m)emissions/pa/sq.m floorarea) Government energy target 225x3.5m Target =35-55GJ/100cu.mfor new build in NHS Estate av.height=(2001-10) 787.5cu.m Actual =232GJ/7.87 =29.4GJ/100cu.m
Appendix V Tables
13: Distilled Parameters for Evaluating Sustainable Construction15
Principle Parameters Factors to consider
1.DesignforEffectiveResourceUse Wasteminimisationinproduction, recyclingandlandfill Conservenon-renewableresources Minimisingrateofuseof renewableresources Designforleanconstruction,repair,re- use,flexibilityanddeconstruction Re-useandimproveexisting builtassets Designwithclimate/microclimate Designforsoilretention 2.MinimisingPollution Minimiseair,waterandlandpollution inrelationtobuildinguseanddesign specification Relateland-useplanningtotransport infrastructureandstrategy Locateappropriately Minimiselightpollution LifeCyclestudies Wasteminimisationandtreatment
3.RespectforPeople,Communities, Designquality andLocalEnvironmen Benefitinglocaleconomyandecology MinimiseFuelpoverty Access/Safetyissues
4.PromotingBiodiversity Globalecologyandproductionof materialsandcomponents Habitatcreationandconservation Waterfeatures/SUDS Locatebuildingsappropriately(local) Preserveandenhanceexisting localbiodiversity
5.CreatingHealthyEnvironments Optimisehumiditylevels Minimisetoxicity Indoorairquality Optimisenaturalventilation Optimiselightquality Optimisepersonalcontrol ofenvironment
6.ManagingtheBuildProcess Contractorrequirements (sustainableconst.) Futureproofing–legislation CriticalPath,toolsandbenchmarks Logbooks Pre-andPostOccupancyEvaluation
Appendix V Tables
15Halliday,S.P.,Stevenson,F.(2004)SustainableConstructionandtheRegulatoryFramework:AThinkpiece,GaiaResearch,Edinburgh
Appendix VIArchitectural brief
Suggestions towards requirements
Appendix VIArchitectural brief
Appendix VIArchitectural brief