Post Occupancy Evaluation Maggiecentre

8/3/2019 Post Occupancy Evaluation Maggiecentre

1/55

A post occupancyevaluation o theDundee Maggie Centre

Final Report or Sust.

March 2007

Dr. Fionn Stevenson

with Proessor Mike Humphris

Ecological Design GroupSchool o ArchitectureUniversity o Dundeein association with Bute Medical School,University o St. Andrews and the Maggies Centres


2/55

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) comort issues 17) sense o wellbeing and health 20g) sta 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 or Fuel Costs 41V. Tables 42VI. Architectural Brie 52

Contents


3/55

AnevaluationotheDundeeMaggiesCentrewascommissionedbySust.TheLighthouseonSustainabilityinOctober2005andcompletedinMarch2007byEDG(EcologicalDesignGroup)attheSchooloArchitecture,UniversityoDundeeinassociationwithButeMedicalSchool,TheUniversityoSt.Andrewsandthe

MaggiesCentres.TheDundeeMaggiesCentreisoneovecompletedprojectsinScotland,withaurther10projectedorcompletionintheUK.TheundamentalremitotheMaggiesCentres,whichwereinspiredbyMaggieJencks,istoprovideinormationandpsycho-socialsupportorcarersandpeoplewithexperienceocancer.

Theaimsopilotstudywereto

evaluate:

visitorandstaresponsesas usersothebuilding physicalperormanceo thebuilding designandconstructionprocess

and:

developacross-evaluativemethodologyorwideruseinsmallscalehealthcarebuildingsinorder

toimprovethebriengprocess.

The evaluation aimed to establish:

a) theeectivenessothedesign conceptintermsotheoriginal brieandcaremodelb) theoverallusersatisactionwith thebuildingc) theextenttowhichpeopleperceive thebuildingascontributingtotheir

senseocomort,wellbeingand health,andthereasonsorthisd) thecomparisonotheease, speed,andcostoconstruction withastandarddomesticscale palliativecarebuildinge) thebuildingsphysicalperormance andsustainability,including managementandmaintenance issues,andtheleveloenergy costscomparedtonormative measures

) recommendationsortheuture MaggieCentrebriengprocessand urtherdevelopmentothe evaluationmethodologyorother smallscalehealthcarebuildings.

Semi-structuredinterviewswereundertakenwith4staand2volunteers,aswellasanarchitectrepresentativeandtheCentreHead.Questionnaireswerecompletedby34visitors.Fuelbillswereobtainedoraoneyearperiodromthe

energysupplierandcomparedtouserscomments.

Theresultsothesmallpilotsurveyindicatethatthebuildinghassuccessullyachievedtheollowingobjectivesothebrie:

ahighlyeectivedesignconcept inrelationtotheMaggieCentres caremodel veryhighusersatisactionoverall,

withacilitiesprovidingacalmand riendlyspaceandanappropriate degreeoprivacy highlevelooverallcomort usersperceptionoincreased healthandwellbeingduetovisiting thebuilding particularappreciationotheviews outothebuilding lowlevelomaintenancerequired

Thebuildinghasbeenlesssuccessul

inachievingtheremainingobjectives:

fexibleocespacewhichis separateyetvisiblerom welcomearea adequatestorageacilitiesorthe oceareaandotheractivities thermalcomort

Executive Summary


4/55

Evidenceonrunningcostsromuelbillsobtainedoraullyearindicatesthatenergyusewaswellwithingovernmentenergytargetso35-55GJ/100cu.mornewbuildingsintheNHSEstate(2001-2010),cominginat29.4GJ/100cu.m.Energyrunningcostswere64perweekor286kwh/m2.Totalcarbonemissionsorthe

buildingwere4.4tonnesortheyear.

Additionalissueswhichemergedromthesurveyincluded:

a) adegreeooverheatingdueto solargain,lackocross-ventilation andpoorheatingsystemcontrolb) adegreeoglareduetolowangle solarpenetrationinthe kitchenarea

c) thedicultyohavinganoce areaimmediatelyattheentranced) userdissatisactionwithseating ergonomicse) lackoadequate car-parkingacilities) fexibilityosmallertherapyrooms

Thehighlevelooverallusersatisactionvalidatesadesignapproachwhichhasplacedanemphasisonthequalityotheinternalspace.Gooddesignalsogivesthe

buildingahighorgivenessactorinrelationtoissuesothermalcomort,ventilation,glareandlackohumidity.

ThereareanumberoareaswherethebriengprocessortheMaggiesCentrescouldbestrengthenedinordertoimprovetheoverallperormanceotheirbuildings,includingtherequirementor:

a) simpletounderstandandeasy touseheatingsystems,controls andprogrammerswhichcan respondtorapidlychanging occupancylevelsb) low-noisemechanicalventilation equipmentinuserenvironmentsc) adequatesolarshadingand provisionocross-ventilation

d) specicstorageareasandacilities tobemoreclearlyidentiedor systemorremovingitemse) adequatecirculationinoceareas) sustainabledesignand specicationwithincost constraints.

Theollowingaspectspresentopportunitiesorurtherresearch:

awiderstudyoallMaggieCentres

usingaurtherrenementothemethodologyestablishedinthispilotstudytoascertainspecicoutcomesandresearchquestionswhichexaminekeydesigneaturesinrelationtousersperceptionhealthandwellbeing.

awiderstudyotherelationshipbetweenusersabilitytocontroltheirenvironmentandtheirperceivedstateohealthandwellbeing.

thedesignoventilationandheatingstrategiesinrelationtothepresence,orabsence,othermalmassinsmall-scalehealthcarebuildingsandtheeectthishasonenergyeciencyandcomort.

Maggies welcomes the reports

positive and constructive fndings.

Suggestions or change have been

noted and where appropriate

incorporated within the management

o the Centre whilst at no time

compromising the relaxed and non-

institutional ethos which underpins the

Maggies environmental and

programme objectives.

Laura Lee, Chief Executive,

Maggies Centres

Executive Summary


5/55

Theresearchteamorthisprojectwas:

Dr. Fionn Stevenson PrincipalInvestigator,UniversityoDundeeProessor Gerry Humphris Co-investigator,UniversityoSt.AndrewsLesley Howells ClientRepresentative,CentreHead,Dundee MaggiesCentreAnita Laidlaw PostdoctoralPsychologist,UniversityoStAndrewsSusanne Monka GraduatePsychologist,UniversityoStAndrews

Theauthorswouldliketoacknowledgethegeneroustimedonatedtothisstudybytheollowingpeople:

Laura Lee ChieExecutive,MaggiesCentresGlynn Jarvis ProgrammeDirector,MaggiesCentresCharles Jencks AuthorandounderotheMaggiesCentresMark O Connor SchooloArchitecture,UniversityoDundeeMichael Spens SchooloArchitecture,UniversityoDundeeFred Stephens JamesFStephensArchitectsDoug Reid JamesFStephensArchitects

TheauthorswouldalsoliketothanktheotherstaandusersoDundeeMaggiesCentrewhokindlygavetheirtimeorinterviewsorcompletedthequestionnairewithoutthem,thisworkwouldnotbepossible.

Acknowledgements


6/55

1 TheLighthouseCentreorArchitecture,DesignandtheCitybasedinGlasgow,Scotlandaimstodevelopthelinksbetweendesign,architecture,andthecreativeindustries,seeingtheseasinterconnectedsocial,educational,economicandculturalissuesoconcerntoeveryone.Aspartoits

promotionosustainabledesign,thisstudywasindependentlycommissionedinOctober2005bytheSust.programme,tollagapintheknowledgeconcerningthedesignandsmallscalehealthcarebuildingsinrelationtotheuserexperienceandbuildingperormanceinScotland.ItwascompletedinJanuary2007byEDG(EcologicalDesignGroup)attheSchooloArchitecture,University

oDundeeinassociationwithButeMedicalSchool,TheUniversityoSt.Andrews,andtheMaggiesCentres.

2 Itisonlywithinthelastewyearsthatenvironmentalissues,beyondtheneedorenergyconservation,havebeenconsideredwithinhealthcarebuildingdesignstrategies,butasyetthereislittlejoinedupthinkingwhichdirectlylinksenvironmentalperormance

withqualityodesignandusersatisaction.Thiscasestudy,drawingontheinnovativetypologyotheMaggiesCentres,evaluatedboththeseelementsandthencross-validatedtheminordertoprovideauniquelyholisticappraisaloaparticularbuildingsolution.

3 Underlyingasustainabledesignstrategyorsmallscalehealthcareenvironmentsaretwoprerequisites:

Therecognitionthatenvironmentaldesignisanintrinsicpartohealthcaredesignandprovidesmultiplebenetsincluding:economic,psychological

andsocial.

Theunderstandingodesignwithinanecologicalramework,recognisingthatthedesignobuildingsisundamentallyaprocessratherthanjustaproduct.

4 Aprimarywayoimprovingthedesignosmallscalehealthcarebuildingsisbyocusingonhowusersexperiencethem,

bothintermsoorientationandtheirsenses.Therolethattheenvironmentplaysinthiscanbemosteectivelyassessedthroughanalysiswhich

combinesbothqualitativeandquantitativemethods.

5 ThisstudyintroducesthedevelopmentoapostoccupancyevaluationandbriengprocessthatcanbeappliedtoallMaggiesCentres.Thedesignlessons

maybeextendedtoothersimilarhealthcaretypologies.

1. Introduction


7/55

1 TheUKgovernmentresponsetotheneedorgreaterqualityodesignandsustainabilityinhospitalshasocusedonseveralinitiatives.TheNHSnowhasspecictargetsorachievingsustainabilityaswellasanindependentbodytopromotegooddesigninhospitals1.InScotland,

theNHScurrentlyusesatoolknownasGreencodeortheevaluationoitsestateinrelationtokeyenvironmentalperormanceindicators,whicharereportedonanannualbasis2.AtthesametimeCABEhasprioritisedthedevelopmentoqualitydesigninhealthcareenvironments,mostrecentlywithalimitedcompetitiontoexploreideasaswellasadetailedlookattherelationship

betweenhealthandthebuiltenvironment3.ArchitectureandDesignScotland,inrelationtoCABE,hastakenasimilarinterestwithitsowncolloquiumonthedesignohealthcarebuildingsin2006.

2 Postoccupancyevaluation(POE)providesamoredetailedmeansoexaminingtheperormanceotheNHSestateonabuilding-by-buildingbasis.Thehighly

successulPROBEprogramme,whichcarriedoutPOEonanumberodierentbuildingsduringthe1990s,onlyexaminedonehealthcarebuilding4.TodatetherehasbeennosystematicevaluationandcrosscomparisonohealthcarebuildingtypologiesintheUK,althoughtherehavebeenanumberoimportantindividualstudieselsewhere5.

3 SeminalPOEworkbyProessorLawsonandcolleaguesinSheeldUniversityhasproventhelinkbetweengooddesignandimprovedbed-patientrecoverytimes,demonstratingtheimportanceopatientsbeingabletoviewnature,gooddaylighting,ventilationandpatientsabilitytocontroltheir

environmentalconditions6.ThendingshaveinormedarevisedversionoAEDET,theNHStoolorauditingdesignqualityinhospitals.Atthesametime,CharlesJencks,anarchitectandcriticwithinternationalstature,haspioneeredanewhealingtypology,TheMaggieCentre,whichaimstoempowercancerday-carepatientsandtheircarers7.

4 TheMaggiesCentresorganisationhasourmaingoals:

Tolowerthestressleveloapatient Toprovidepsychologicalsupport Tohelppatientsnavigatethe

inormation-explosiononcancer Toprovidepeaceulandstriking

environmentswithanimportantplaceorartandgardens

5 TherearecurrentlyveMaggiesCentresopeninScotland,withten

morebeingdevelopedintheUK.Asbespokeanddistinctivehealingenvironments,theyrepresentanalternativeapproachtothetraditionalcost-drivendesignohealthcarebuildingsbydeliberatelyore-groundingdesignasakeyactorinpromotingwellbeing.

2. Background

1

TheFutureHealthcare

Networkisalearningnetwork

toexploretheshapeo

healthcareandwhatwillbe

requiredby2010andbeyond;

thewebsiteis

www.nhsconed.org/hn.

TheNHSEnvironmental

AssessmentTool(NEAT,

availableromNHSEstates)

setsouttargetsanda

checklistorsustainable

designinhealthbuildings.

2

Seehttp://www.show.scot.

nhs.uk/pe/guest/orlatest

report.NHSScotlandalsorun

aPropertyandEnvironment

Forumwhichisbasedatthe

samewebsite.

3

SeeHealthyHospitalsReport

2003http://www.cabe.org.

uk/publications/#healthand

CABEHealthWeek,Healthy

places,healthypeople15-

19thMay2006,www.cabe.

org.uk/events

4SeeBuildingandResearch

Inormation,Vol29,Number

2,March-April2001which

isaSpecialIssueonPost-

occupancyEvaluation,and

hasanumberopapers

reportingonthePROBE

experience.Vol33,Number4,

September2005providesan

updateonthisarea.Seealso

www.usablebuildings.co.uk

oranuptodateaccounto

POEstudiesintheUK.

5

Anexcellentexampleis

Burt-ODea.K.(2005)Design

ImpactStudy,TheEuropean

HealthPropertyNetwork,whichstudiesvedierent

healthcarebuildingsin

dierentEuropeancountries.

6

Lawson,B.etal(1998-2001)

TheArchitecturalHealthcare

BuildingandItsEectson

PatientHealthOutcomes,

University

oSheeld.

7

SeeJenks,C.TheMaggie

CentresMovementEight

YearsIn,FourthDoor

Review,Nos.7,2005pp.30-33


8/55

6 TheDundeeMaggiesCentre,whichisthesubjectothisstudy,wasdesignedbyFrankGehryandopenedinSeptember2003.Inresponsetothis,TheUniversityoDundeehostedaonedayinternationalsymposium,BreathingSpace,atthesametime,whichgeneratedsignicant

discussionontherelationshipbetweenarchitecturaldesignandcancercare,includingtheroleosustainabledesignandmateriality8.Theproposalorthisstudygrewoutothendingsothesymposium.

7 Largescalehospitaltypologieshavereceivedthegreatestattentionintermsopostoccupancyevaluation,butwiththeshitingovernmentpolicytowardsdelivery

ohealthcareinsmallscaleenvironmentswherepractical,itwaselttimelytoexaminesuchtypologies.ThedevelopmentotheMaggiesCentresasasmallscaleindependentnewbuildingtypologyaordedauniqueopportunitytolearnromhighqualitydesignenvironmentsandprovideabenchmarkromwhichtomeasurethecombinatoryvaluesosustainabledesignandhealthpromotingdesigninallsmall-scale

healingenvironments.

8

Anumberothepapers

presentedhavebeen

subsequentlypublishedin

theinternationalFourthDoor

Review,Nos.7,2005,pp26-

50,includingStevenson,F.

Environmentalarchitecture

andthehealthbuilding;the

materialityperspective

pp.38-42


9/55

1 The overall aim o this studywas to provide a detailed postoccupancy evaluation o a smallscale healthcare environmentwhich can in turn inormthe uture design o similartypologies within the NHS andother healthcare agencies.

2 The study had our keyobjectives:

1. Tocarryoutanin-depthqualitativereviewousersresponsetotheDundeeMaggieCentre

2. Tocarryoutatechnicalreviewothebuildingsphysicalperormance

3. Toevaluatethedesignandconstructionprocess

4. Todevelopacross-evaluativemethodologyorwideruseinsmallscalehealthcarebuildingsinordertoimprovethebriengprocess

3 The study specifcally aimed

to establish:

a) theeectivenessothedesignconceptintermsotheoriginalbrieandcaremodel

b) theoverallusersatisactionwiththebuilding

c) theextenttowhichpeopleperceivethebuildingascontributingtotheirsenseocomort,wellbeingandhealth,andthepossiblemechanismsorthis

d) thecomparisonotheease,speed,andcostoconstructionwithastandarddomesticscalepalliativecarebuilding

e) thebuildingsphysicalperormanceandsustainability,includingmanagementandmaintenanceissues,andtheleveloenergycostscomparedtonormativemeasures

) recommendationsortheutureMaggiesCentresbriengprocessandurtherdevelopmentotheevaluationmethodologyorothersmallscalehealthcarebuildings.

3. Aims and Objectives


10/55

1 AsmallSteeringGroup,whichconsistedotheDundeeMaggiesCentreHead,aprevioususerotheCentreaswellasthetwoprincipalresearchcontractors,wasinitiallyormedtoguidetheproject.TheProessionalAdvisoryGroupromtheMaggiesCentrescommentedonthedesignandormator

thepost-occupancyevaluationquestionnaire.

2 AninitialdesktopreviewoexistingliteratureontheevaluationohealthcareandotherbuildingsintheUKandelsewherewasundertaken.ItwaseltthatwhiletheAEDETEVOLUTIONandASPECTtoolsortheNHSprovidedavaluablemeansoauditingthedesignqualityohealthcare

buildings,thepre-denedstatementsapproachdidnotalloworamoreopenendedormoinquirywhichmightrevealhiddenactors.Bycontrast,theapproachdevelopedbyBuildingUseStudiesLtd.andadoptedbyPROBEaskstheusertooerupactorswhichworkordonotworkwell.Thisprovidesamoreundamentalappraisalodesignqualityasitisdirectlyexperiencedbytheuser.

3 Asaresultothedesktopreview,itwasdecidedtoadoptamixedmethodsapproach,involving6semi-structuredinterviewswith2ull-timesta,2part-timestaand2volunteers,andaPROBE-stylequestionnaireorvisitors.Bothactivitieswerecarriedoutwithinthebuildingovertheperiod

oonedayonMarch23rd2006.Astandardquestionnaireonitsownwasrejectedonthegroundsthatitwouldnotyieldarichtextureoinormation.Theaimothein-depthsemi-structuredinterviewswastosupplementthequestionnairewiththecollectionomoredetailedinsightsromparticipants.

4 Anumberoqualitativequestionsweredevisedwithadvicerom

theMaggiesCentresChieExecutive,ProgrammeDirectorandClientRepresentative,toascertainresponsestothedesign(seeappendixIandV).Theseaugmentedtheinitialstandardpost-occupancyevaluationquestionsprovidebyBuildingUseStudiesLtd.whichconcentratedoncomortissuesandworkconditions.TheadditionalquestionsweredrawnromAEDETandASPECT,butwererephrasedtoalloworamoreopen

endedresponse.TwokeyquestionsonvisitorssenseotheirownhealthandqualityolieweredrawnromtheEORTC9standardisedquestionnaireoroncology.Theinitialquestionnairewasthensuccessullypilotedwithnomajorchangesrequired.

5 Visitorstothecentrewerediscreetlyapproachedbyaresearchassistantonentryandhandedaquestionnairetocompleteintheirowntimeandpostanonymouslyintoaboxplacedneartheentranceothebuilding.Stawereinterviewedusingtheinterviewguideandatapedrecordingwas

madeotheinterview.Additionally,theinterviewerobservedhowtheusersandstainteractedwiththebuildingduringbreaksintheday.Anythingunusualthatmightinfuencetheeectivenessothedesignprinciplesinvolvedwasnoted.

6 FuelbillsoraoneyearperiodortheDundeeMaggieCentrewereobtainedromTheMaggies

CentresHQ.ThesewererelatedtothecurrentbenchmarksorenergyeciencypromotedbytheUKgovernmentortheNHSEstate.

7 Copiesotheoriginalbrieandworkingdrawingswereobtainedasreerencepointorusersexperienceandexaminedintermsohealthcaredesign,energyeciency,fexibledesign,anduseosustainableandlocalmaterialsaswellasecientconstruction

principles.Thedrawingswereusedasabasisorthetechnicalanalysisundertakenonthedayothesurveywhichinvolvedtheuseoamulti-modalmetertomeasuretemperature,humidity,lightingandnoiselevelsbothinsideandoutsideothebuildingatvestrategicpoints.

4. Methodology9

seehttp://www.eortc.

be/home/qol/-accessed

May2006


11/55

8 Theinterviewswithstaandthetechnicalteamwereusedtourtherestablishitherewereanysignicantworkissuesarisingromtheinnovativedesignotheprojectoverthetwoandahalyearssinceitscompletion(seeAppendicesIandII).

9 Allndingsromtheinterviewswiththetechnicalandstateamswerecomparedtothoseromtheuserquestionnairetoestablishpointsoconvergenceanddivergence.Thiswascarriedoutinrecognitionotheintersubjectivityinvolvedinthestudyandtheneedtounderstandandanalyseallpointsoview.

10Thequalitativendingsromalltheinterviewsandquestionnaires

werecross-evaluatedagainsttheobservedenvironmentbehaviour,thebrie/drawings/specicationsandthephysicaldataobtainedontheday,todetermineitheissuesraisedwerereinorcedorcontradicted.Awalk-throughtourothebuildingwasconductedwiththeClientRepresentativetohelpclariycontradictoryndingsandprovideurtherinormationonissuesraised.

11Finally,aSWOTanalysiswasusedtoestablishtheoverallecacyothedesignanduturestrategiesinrelationtotheresultsotheinterviewsanduelcostassessmentsandtheinitialprojectobjectives.

4.


12/55

1 Giventhecomplexityotheareaunderinvestigation,careullydenedparametersweredrawntoproduceamanageableworkloadwithinthetimescaleallowed.Theworkellinto6distinctivephases:development,survey,analysis,crossevaluation,dratandnalreport.

Programme or Dundee Maggies

Centre Pilot Study

1. Developmentoormats Arrangementsorvisits,interviews,

datagathering Gatheringotechnicaldata

2. Interviews,Survey Questionnaires

3. Useranalysis Technicalanalysis

4.Cross-evaluation

5. DratReport CommentonDratReport/meetings

6.FinalReport SteeringGroupmeetingsx3

5. Programme


13/55

1 The analysis o the project

was broken down into 8

evaluative stages:

A) backgrounddemographicsB) environmentbehaviourC) thebuildingdesignD) thevisitE) comortissues

F) senseowellbeingandhealthG)staandvolunteerperspectiveH) thebuildingprocess

A Backgrounddemographics

2 TheusersotheDundeeMaggieCentrecanbesplitintoourgroups:sta,volunteers,carersandthosecurrentlysueringromcanceror

inremission.3 Abasicdemographicdescription

othe34visitorswhorespondedtothequestionnaire(Table1inAppendixV)showsthatthetypicalDundeeMaggiecentrevisitorwasover30,likelytobeemaleandsueringromcancer,althoughjustunderathirdovisitorswerecarers.Theoverwhelmingmodeotransportwasbyprivatecarwithmostvisitorshavingreturned5or

moretimesorvaryinglengthsotime.Themostcommonvisitinglengthwasoneortwohours.Visitorsgenerallyratedtheirownhealthasbeingaboveaveragewithoverhalratingtheirqualityolieasaboveaveragealso,althoughtheleveloratingsweregenerallylowerthantheaverageorthosesueringromcancer(seesection6.).

4 Thevisitorprolesuggeststhat

thebrieordesigningMaggiesCentresneedstostressthevariablelengthovisitsandtheneedorthebuildingtobeabletocaterorrapidlychangingoccupancylevels.

B Environmentbehaviour

1 Onthedaywhichtheinterviewsandquestionnairesurveywascarriedout,theinterviewertooktimetoobservevisitorsbehaviourinthebuildingatregularintervalsandoveranextendedlunchtime

period.Thissectionbriefydescribesthoseobservationstoprovideapictureothebuildinginuse.

2 Thebuildingwasopenrom9a.m.-5p.m,andverybusy,withaTaiChiclassat1.30pm,arelaxationclassat3p.m.,aswellasabenetsadvicedropinserviceallmorning.Thekitchenwasparticularlybusyatlunchtime,justbeoretheTaiChi

class,butnotovercrowded.Themainroomwasusedprimarilybygroups,whilethesmallerretreatroomdownstairswasusedorthestudyinterviews.Theupperroomwasusedonanintermittentbasis.

3 Theuseotheopenplanspacedemonstratedarelaxedandsensitiveinteractionbetweenstaandvisitors,withtheentranceareaactingasapermeablethresholdorarrivals.Otenstaappearedromeitherthekitchenorlibrarytogreetarrivalsattheentrance.Newarrivalsappearedtohoverintheentranceareabythedeskratherthancomedirectlyintothekitchenarea,untiltheyweremet.Atonepointintheaternoonaormalundraisingmeetingtookplaceinthekitchenarea,whichwasrelativelyquietasotherspaceswereoccupied.Thisseemedtoworkwell,andsuggestedavery

fuidandmobilewayousingthespace,butonewhichdemandedthatstaandvisitorsweretolerantootheractivitieswithinthevicinity.

4 Visitors,bothrsttimersandregulars,congregatedinthekitchenarea,withsubtlelevelsointeractionthatsawsomesittingquietlyawayromthetableconversation,whileothersengaged

moredirectlywitheachother.Withallacilitiesinthekitchenbeingimmediatelyaccessibleandwithplentyoroom,therewasasenseoeasewithwhichpeopleseemedtonegotiatethespace.Thelibraryappearedlesswellusedandthecommonroomwasusedonlyorthegroupeventsthatday.

6. Results and analysis

Visitors tended to chat in the bright kitchen; the

common room was used or group activities


14/55

5 Theoceareawasbusywiththeund-raiser,CentreHead,inormationsupportoceraswellasotherstryingtousetheareaandthephone.Itwasnotedthatduetolackostorage

space,largeamountsolingandotherpaperworkwerestoredinboxesunderthedeskareainthedesignatedootspace.Additionalitemswerestoredthroughoutthebuilding,includinganumberoitemsintheboilerroom,ontheseatingareabehindtheoce,andinthegrouproom.

6 Nowindowswereopeninthemorning,butbylunchtimeonewindowinthekitchenareahadbeenopenedaswellasawindowinthecommonroom.Bytheendotheaternoon,threewindowshadbeenopenedinthekitchenaswellasthedoorleadingontothebalcony.

7 Thewoodstove-eectgasrewasgenerallyletonintheupperfoorroom,evenwhennobodywasthere,leadingtoincreasedandunnecessaryheating.Itwasobservedthattheretakesconsiderabletimetostartupandthismightexplainageneralreluctancetoswitchitonando.

8 Articiallightingwasgenerallylet

onthroughoutthebuildingapartromupstairs.Thismightrelatetothecare-modeladoptedandtheintentionorthelightingtoprovideawelcomingsignal,butitalsomightrelatetotheslowresponseothelow-energylightbulbs.Theblindsonthelowerpartothewindowsacingthehospitalwerepulledup,whichwhileprovidingadditionalprivacy,tendedtomakethesenorth-acingroomsslightlydarker.

9 Externally,itwasnotedthatthecarparkwasullromearlyon,withpeopleresortingtoparkingonthevergesandthedrivewayapproachingthecarparkasaresult.

Conclusions:

10Thebehaviourousersinthebuildingsuggeststhatwhiletheyaregenerallyverymuchateaseinthebuilding,thereisadistinctissuewithventilationcontrolwith

occupantstryingtoincreasetheventilationinordertoreduceoverheatingusingwhatmeanstheyhaveavailable.

11Theprincipalmeansoaccessisbycardespitethedirectpublictransportthatisavailableonsite.ItmaybethatutureMaggiesCentreswillneedtoconsideralarger,landscapedcarparkacility,particularlyasruralvisitorsareotenpoorlyservedbypublictransport.

PeoplemayalsotendtouseacarratherthanpublictransportduetothenatureotheirtreatmentinhospitalbeoreoratertheirvisittotheMaggiesCentre.

12Thesmallamountocirculationspaceintheocehasledtostachoreographingtheiruseothespace,whichisnotalwaysconducivetoeectiveworking.

6.

Lack o storage space and cramped ofce

space may hinder eective working

People come to the Dundee Maggies Centre

mainly by car, leading to parking problems


15/55

CThe building design

1 TheDundeeMaggiesCentreislocatedonthewesternoutskirtsoDundee,withintheNinewellsTeachingHospitalCampus.Itsitstothesouthoseverallargehospital

buildings,onaraisedgrassyplain,adjacenttothehospitalshelipadandontheedgeowoodland.ThesitewaschosenoritsspectacularviewsovertheTayEstuary,whichareconsideredsomeothenestintheUK.Thebudgetorthebuildingwas0.97morafoorareao225m2,workingoutat4311perm2whichisaboutoneandhaltimesthecostpersquaremetreoranequivalenthealthcarebuilding.Thejusticationorthisisperceived

tobeintheiconicnatureothebuilding,thespecicrequirementsothebrie,andintheinitialhighcapitalinvestmentinordertominimiseuturemaintenancecosts.

2 Thebuilding,whichhasbeenoccupiedorovertwoandhalyearssinceitopened,consistsoourmainareas(oce,library,kitchen/dining,commonroom)linkedbyacentralentrancelobbyandstairwellrisingtoaretreatspaceontherstfoor

(seeAppendixIII).

3 Thequestionnairepromptedvisitorstocommentonthebuildingsimage,layout,useospace,theirneedsandtheviewsbothwithinandlookingoutothebuilding.Thesewereratedintermsoeectiveness,withadditionalcommentsmadewherenecessary.

4 Theoverallbuildingdesignwas

ratedveryhighly(Table2,AppendixV),althoughaboutaquarterovisitorsexpressedsomedicultyinunderstandingthelayout.Themostpositiveimpressionothebuildingwasotheviewsoutside,whichreceivedthehighestratingoanyaspectothedesign.Therewereslightlylowerratingsorunctionalaspectssuchaslayout,useospaceandmeetingpeoplesneeds.

5 Awidevarietyoimageswereassociatedwiththebuildingbyvisitorsincluding:

special,qualitynotcheap!,bird,light,comort,enveloping,home,beautiul,waves..Ithinktheroundcentralpartislikeaships

unnelrisingromthewaves.Abrilliantconcept!

Theoverallimpressionwasoneotranquilityandcalmness.

6 Thelayoutothebuilding,whilebeinggenerallywellappreciated,presentedparticularchallengesorrsttimevisitorssuchas:ndingthetoiletwhichhadnosignonitsdoor,andthelocationotheoce

area,summarisedbyonevisitorwhoounditprotrudesslightlytooarandlimitstheuseothecentralspaceinrontothedoor.Thespaceinthebuildingwasgenerallyperceivedtobewellused.

6.

The site or the Dundee Maggie Centre

was chosen or its spectacular views

Images o waves, unnels and wings


16/55

7 VisitorswereveryimpressedbyboththeinternalviewsthroughtheopenplanbuildingandromthebuildingacrosstheTayestuary.Forsome,thenaturalviewwasquitetranscendentalwithcommentssuchverymeditativeandAbsolutelyspectacularandconducivetocalmrefection

andawarenessoGod.OthercommentsweremorespecicsuchasIlovethelightandthewoodandHeightoersauseulperspective.

Conclusions:

8 Theoveralldesignothebuildingisverymuchappreciated.Visitorswouldappeartopositivelytrade

ocertaindesignqualitiesothebuildingsuchastheexploitationoexternalviewsanditsoverallimpressionagainstcertainunctionalaspectssuchaslayout,useospaceandpeoplesneeds.Thisleadstothebuildinghavingahighorgivenessactor,wherebypeoplearewillingtoorgiveunctionalissuesbecauseotheirappreciationootherdesignqualities10.

D The visit

9 ThepurposeothevisitmadebyvisitorsissummarisedinTable3(AppendixV).Thepurposeorthemajorityothevisitorsonthedayothestudyobservationwastoattendgroupactivities.

10Intermsotheactualvisititsel

(Table4,AppendixV),visitorsweremostpositiveabouttheirreedomtousethebuildingandeltverymuchateaseinit.Theywereslightlylesscomortableabouttalkingtoothersandslightlylesspositiveaboutthebuildingmeetingtheirspecicneeds,althoughnearly78%thoughtthatthebuildingmettheirneedswellorverywell.

11Inrelationtotheirspecicneeds,visitorselthinderedbyalackocar-parkingspacesandthecoldnessothecommonroomattimes.Byarthegreatestnumberonegativecommentsrelatedtothepracticalityandcomortotheurnishings.ThiswassummedupbyonevisitorasTheseatingcouldbemoreorcomortratherthanlookthistheonlythingIwouldsuggest.

12Commentsabouthindrancesduring

avisitwereheavilyoutweighedbypositivecommentsaboutthingswhichworkedwellinthebuilding.Theseocussedonthekitchenareawhichencourageseveryonetogatherandchat,theopenplanlayout,andtheabundanceonaturallight.Despitethequestionsbeingdirectedtowardsthenatureothebuilding,visitorsconsistentlyreerredtotheopenandencouragingstawhichperhapsdemonstratesatendencybyuserstoviewthebuildingandthepeoplewithinitasoneentity.

6.

Visitors particularly appreciated the abundance

o natural light and welcoming kitchen

10

Forgivenesswasrst

identiedasaactorinPOE

byAdrianLeamanandBill

BordassinthePROBEstudies

eaturedinBuildingmagazine,

UKandtheBuildingResearch

Inormationresearchjournal.


17/55

Conclusions:

13Visitorsclearlyeltathomeinthebuildingbutitisunclearhowmuchothiscanbeattributedtothebuildingitselandhowmuchtothewelcomeandsupportprovidedbysta.ThisrefectstheMaggiesCentresethososolvingproblems

byworkingwithpeopleinanuplitingenvironment.Itsuggestsuturestudiesconcernedwithvisitorsinhealthcarebuildingswillhavetoeitherbemorecareully

tailoredtoseparateoutsta-relatedobservationsromobservationsaboutthebuilding,oralternativelyacceptahybridmodeloanalysiswhichacknowledgestheinfuenceostaonvisitorsperceptionsothebuilding.Thelattermodelis

moreappropriateortheMaggiesCentres.14Thestrengthoeelingaboutthe

urnishingsexhibitedbyvisitorssuggeststhatuturebriengneedstotakegreateraccountoergonomicrequirementsinrelationtoaestheticappearance.

15Theexistingbriehasbeenparticularlysuccessulintermsothekitchenareaandcentralised

kitchenislandunit,whichvisitorscommentonveryavourably.Visitorsalsoeltverymuchateaseinthebuildingapositiverefectionontheoriginalbrierequirementorawelcomingbuilding.

E Comort issues

1 Amajoraspectopostoccupancyevaluationisthedegreeocomortwhichusersexperienceinabuilding.Thisisparticularlyimportantinhealthcarebuildingswherevisitorsarelikelytobeextrasensitivetoenvironmental

conditionsduetotheirrelativelypoorstateohealth.

2 Visitorswereaskedtoratetheirperceptionotemperature,airquality,ventilation,noise,lightingandoverallcomortinrelationtothebuilding.Noisewasgenerallynotanissueorvisitors;intriguingly,however,overathirdeltthattherewasnotenoughnoiseromoutside.Althoughthelightingoverallwaselt

tobeverypositive,40%ovisitorselttherewastoomuchnaturallightand28%experiencedsomedegreeoglare.Itisunclearwhy66%ovisitorsexperiencedsomeglareromarticiallightingaswell,whenoverthreequartersoundoverallcomortlevelothearticiallightingtobejustright.Nearly90%ovisitorseltthebuildingwascomortableoverall,despiteabouthalthisnumbercomplainingaboutadegreeooverheating,excessive

naturallightanddrynessotheair.

3 Thetopratingsorcomortweregenerallylowerthanthoseorthebuildingdesignoverall(Table5,AppendixV)againsuggestingthattheremaybeisakinaestheticcompensatoryactoratworkwithvisitorsalsotradingotheappreciationotheviews,imageandoverallqualityodesignagainst

comortactors.

4 VisitorscommentsrelatedmainlytotheissueooverheatingandvariabilityotemperaturebetweentheNorthandSouthsideothebuildingwithoneobservingthatSometimes(ithesunisshining!?)someareasbecometoohotbut

otherdaysthebigroomwastoochillyorsittingcomortably.

6.

The strong contrast in these photos shows

the glare actor rom the natural light


18/55

5 Visitorscommentsandratingsocomortconditionswerecorroboratedbythephysicalreadingstakenontheday(Table10,AppendixV).Indoortemperaturereadingsonthedayothequestionnaireweresurprisinglyhighandreachedapeako24.4CbymiddayindoorsonacoldMarch

day,eventhoughthemainheatingcontrolwassetto22C.Humidityreadingswererelativelylowinsidethebuilding,averagingaround30%,comparedtoanoutsidehumiditylevelo50%.Thiswouldaccountorasignicantpercentageovisitorsexperiencingtheairasbeingdry.Lightinglevelsinthebuildingwererelativelylowapartromintheupperlevelroomwhichwasfoodedwithlightromthe

largeskylight.Withitbeingasunnydayoutside,thecontrastinglowlevelsointernallightexacerbatedtheglareromthesouthacingwindows.Noiselevels,ontheotherhand,wereatanormalconversationallevelinmostpartsothebuildingapartromtheupper

levelspace.Thisareawasrelativelyquietdespiteconversationcarryingonbelow.

6 Visitorswerethenaskedtoconsiderthedegreetowhichtheyhadpersonalcontrolovertheircomortconditions(Table6,AppendixV).Nearlyhalelttheyhadabsolutelynocontrolovertheheatingornoiseconditions,with

aroundathirdeelingtheyhadnocontrolovercooling,ventilationandlighting.Interestingly,despitethevariouscomortissuesraised,theoverwhelmingmajorityousersstatedthatapersonaldegreeocontrolovercomortconditionswasnotimportant.Thissuggeststhateithertheyrelyonthestatodealwiththeseaspects,orthatotheraspectsothebuilding,suchastheviewsandwarmthowelcome,compensateortheseissues.An

interestingissuethatwastestedwiththequestionnairedatawasthedegreeotherelationshipbetweenthesenseocontrolthatthevisitorshadaboutthecomorteaturesothebuildingandtheirownsel-reportedratingsohealth,wellbeingandqualityolie(seesection6.).

7 Intermsobenchmarking,theDundeeMaggieCentreperormsexceptionallywellwithasignicantnumberovariablesagainstover50otherbuildingsintheUKthathavebeenevaluatedusingtheBUSquestionnaire(seetable11).

Despitetheissuesraisedinrelationtothecontroloheatingandotherareas,theratingsothesevariablesarenodierentromtheaveragebuilding.Theonlytwovariablesthatwouldappeartoallsignicantlybelowthebenchmarkaretherelativestillnessoairinthebuildingandtheapparentlyexcessiveamountonaturallight.Thelatterndingiscurious,giventhatanumberovisitorscommentedavourablyontheamountonatural

lightinthebuilding.

6.

The programmer and lack o cross ventilation

both contribute to the overheating

2

Associationor

Environmentally

ConsciousBuildersarticle

onLightweight.v.Heavyweight

construction.Vol.11,no.3

pp.30-34Winter2001-02


19/55

Conclusions:

8 Thereareanumberocomplexinteractingactorswhichmayaccountorthemildoverheatingothebuildingandrecommendationsarerelatedtotheseoruturebrienganddesignpurposes:

Open plan layout:

Theopenplanlayoutothebuildingmeansthattheusershavetoheatallthemainareastothesametemperature,regardlessounction.Inevitably,thewarmairwillriseandcausetheupperstoreyretreatareatobeevenwarmerthantheotherareasbelow.Thisisbestmitigatedby

adequateventilation.

Thermal mass, heating systems

and programmers:

Thereismuchdebateonthevirtuesolightweight.v.heavyweightconstruction11intheUKintermsoheatingstrategies.Lightweightconstructionisseenasbeingmoresuitableorquickresponseheatingsystems,whereasheavyweightconstructioncanworkwellwithaslowresponseheatingsystem,suchasunderfoorheating,inhelpingtoevenoutchangesintemperature.Intheory,theheatingsystemspeciedorthisbuildingwouldseemtoideallycomplimentthelargeamountothermalmasspresent.Inact,thesignicanttimelaginrespondingtotemperaturechangesaordedbytheheatingsystem(2hours)combinedwiththeslowresponseothethermalmassinthebuildinghasledtoadegreeoconusionbysta

attemptingtoheatandcoolthespacequicklyinresponsetorapidchangesinoccupancylevels.Thisisnothelpedbytherelativelycomplexityothemainunderfoorheatingprogrammer(HoneywellHometronicHCU30RemoteSetpointAdjuster)situatedbytheentrance,whichalsoperplexedsta.Theguidanceorsimplyoperatingtheprogrammeristwentyonepageslong,whichspeaksoritsel.Programmerswhicharerelatively

easytounderstandandoperatebynon-technicalstashouldbeselectedinpreerencetomorecomplexones.

Solar Gain and ventilation:

Thelackoadequateexternalshadingtothesouthernwindows,combinedwithinadequatecross-ventilation,pointstotheneedorcareuldesignwhenusingnaturalventilation,ioverheatingistobeavoided.Onesolutiontothisproblemwouldbetoensurethatthereisadequatecross-

ventilationprovidedthroughthelayoutoroomsandthattheneedorexternalsolarshadingistakenullyintoaccountthroughcareuldesignanalysis.Shadingneedstotakeaccountolow-levelaswellashighlevelsunpenetration.Thereareanumberomechanicalextractansinthebuildingtohelpwithventilation,buttheseareparticularlynoisyinthekitchenarea,makingstareluctanttousethemwhilepeoplearetrying

totalk.

User strategies or heating

and ventilating:

Itisclearromtheanalysisthatstaandusersarenotabletooptimisetheirheatingandventilationsystemsandhaveadoptedthecommonstrategyooverheatingthebuildingtoensurethatitdoesnotgettoocold.Excessheatmustthenbeventilatedoutothewindows.Duetothelow-levelplacementorestrictedwindow

openings,thereisabuildupoheatinthemainvolumeandusershaveresortedtoopeningdoorsinanattempttocompensateorthelackoventilationneededtoclearthisbuildup.Highlevelventilationpointswouldsolvethisissueinuturebuildings.

The need or user education:

Lackospecictrainingontheheatingandventilationcontrolsorusersattheoutsetinthisinnovativeproject,

andonanongoingbasisornewsta,mayalsohavecontributedtotheuseoinappropriatestrategiesorheatingandventilating.Userinductionisavitalaspectobuildingprocurementandmanagement.

6.

The windows are let open while the heating

is on due to its slow response to change

11

Associationor

Environmentally

ConsciousBuildersarticle

onLightweight.v.

Heavyweightconstruction

Vol.11,no.3pp.30-34

Winter2001-02


20/55

Choice o heating system:

Thesolerelianceonanunderfoorheatingsystemothetypespecied,whichisrelativelyunresponsivetochange,mustbequestionedoruturecentresothiskindunlessthereisanadequatetopupsystemandgoodventilationoptions.Theheatingsystemispredicatedonasteadystate

scenarioanddoesnotrespondquicklytotherapidchangesintemperaturewhichoccurwithvaryingnumbersousersandactivities.Theheatingmanualrecommendsatwohourlead-intimetoobtainthedesiredheatlevelromthesystem.Thestamustthereoreattempttopredicttemperaturesaheadotimeandthiscanleadtothesystemailingtoprovideadequatetemperatures,itheweatheroroccupancylevelchanges

suddenly.Thesupplementaryair-blownheatingsysteminthekitchenandgrouproomappearsnottobeusedtogreateect.Therelianceongasasaossiluel,withoutthebenetorenewableenergytechnologieswillinevitablyleadtoarelativelyhighcarbondioxideoutput.Thiscouldberelativelyeasilyaddresseditherequirementorrenewableenergywerebuiltintothebrieromtheoutset.

9 Althoughtheoveralllevelonatural

lightingisclearlyappreciatedbyanumberovisitorsthroughtheircomments,asignicantnumberelttherewasaglareissueandtoomuchnaturallight.Thelatterndingisunusualinstudiesothiskindandmaybeattributabletovisitorsstateohealth.Itwarrantsurtherinvestigationinordertoestablishappropriatenaturallightlevelsinbuildingsorcancersuerers.Glarecouldbecausedbyexcessive

amountsounshadedlow-levelsunlightorromtheskylights.

10Thequalityodesignwouldseemtosuggestthatvisitorsalsohaveahighdegreeoorgivenessorlowercomortratings.Atthesametime,althoughthebuildingperormswellagainsttheBUSbenchmarkorallbuildingtypes,itshouldberememberedthatvisitorsusingthisbuildingdonotoccupy

itoranygreatlengthotimeandareinaparticularstateomindduetotheirhealthsituation.Boththeseactorsmaytendtoresultinmorepositivereportingthanusualandmaskunderlyingissuesgenerallyexperiencedbythosewhousethebuildingorgreaterperiodsotime.

F Sense o wellbeingand health

1 ThequestionnairecontainedtwoquestionstakenromtheEuropeanOrganisationortheRecognitionandTreatmentoCancerQualityoLieCoreQuestionnaire(30Itemversion).ThetwoquestionsadoptedromtheCoreQuestionnairewerechosenastheyassesssimpleglobalratingsbytherespondentthemselves(asopposedtotheclinician)otheirhealthandhealth-relatedquality

olie.Theratingsaregiveninresponseto7pointLikertscales.Theanswerstothesetwoquestionscanbecomparedtonumerousotherstudiesthathaveemployedtheseitemsintheirassessments.

2 Theoverallsel-reportedratingoglobalhealth(overpastweek)demonstratedthattheirviewwasmoderateonlyorthesevisitors.TypicallytheEORTCnormorcancersurvivorsorthisratingisaround75%(thatisthosescoring5to7onthe1-7ratingscale)andorthesampleincludedinthesurvey

weoundthatthispercentwas64.Thegeneralhealthratingthereorewassomewhatlessthanexpected.

3 Likewisethequalityolie(overthepastweek)ratingorthevisitorswas57%(i.e.scoring5,6or7)whichisalsolowerthanmighthavebeenexpectedincancersurvivors.

4 Overallqualityolieoverthepastweekwasoundtopositivelyrelate

signicantlytothelengthovisit(rs=0.45,p


21/55

5 Theywerethenaskedtoratethedegreetowhichtheyperceivedthebuildingitselimpactingontheirsenseowellbeingandhealth.

6 Althoughthestudydidnotaimtoproveadirectconnectionbetweendesignandhealthbenets,itwaseltimportanttoascertainwhether

ornotvisitorsthemselvesperceivedsuchalinkandwhetherthisrelatedinanywaytotheirperceivedqualityolieandhealthstatusatthetimeothequestionnaire.Threesetsoassociationswereinspectedandtheresultsarediscussedinthenextthreesections.

7 Correlationswerecalculatedbetweenthesel-reportedratingsoqualityolieandhealth(over

thepastweek),andtheperceptionotheeaturesothebuilding.Inadditiontheratingsorhowthebuildinginfuencedtheirwellbeingandhealthwerealsoinspected.Spearmanscorrelationcoecientswereadoptedastheindexoassociation.Statisticalassumptionssimplyrequiredtheratingstoberankorderscales,whichthisquestionnairedesignsatised.Henceinterpretationisstraightorward.Itwaspredicted

thatpositiveratingsothebuildingwouldbeassociatedwithsimilarpositiveratingsohealth.Onthewholethesepredictionswereconrmedormanyaspectsothebuildingandthevisitorsratingsotheirwellbeingandhealth(Table6,AppendixV).Onlyonecorrelationwasoundthatwasclosetosignicanceamongthequalityolieratingsandthatwastheassociationwiththeabilitytotalk

toothers.Hencethosewhoratedtheirqualityoliestronglyalsoeltthattheyregardedthebuildingwasamenableorconversationwithotherpeople.

8 Thelackourthersignicantcorrelationsbetweenthehealthandqualityolieratingsandtheotheraspectsothebuildingcanbeexplainedbythenatureothequestions.ThevisitorswereinvitedtogivetheirratingohealthandqualityolieOVERTHEPASTWEEK.Itwouldnotbesurprising

thatvisitorsreerringtotheirhealthstatusoveraweekwouldnotassociatestronglywiththeiropinionothebuildingduringtheirvisitonthedayothequestionnairecompletion.Insupportothisviewwerethestrongcorrelationsbetweenthehealthandwellbeingratingsandthebuildingeatureperceptions.Thequestionsonhealthandwellbeingarestatemeasuresaskingthevisitorto

oertheiropiniononhowtheyeltabouthowthebuildingwasinfuencingeithertheirhealthorwellbeingatthetimeoansweringthequestionnaire.Hencetherelationshipsbetweenthesetwostatequestionitemsandtheperceptionothebuildingeaturesshowsignicantrelationships.Howevertheinterpretationotheseassociationsisnotaltogetherstraightorward.

9 Onrstglance(Table7,AppendixV)itwouldappearthatpositiveperceptionsothebuildingeaturesarelinkedwithhigherratingsohealthandwellbeing.Thismaywellbethecaseespeciallyasthequestionsonwellbeingandhealthareinvitedwithreerenceinparticulartohowthebuildinginfuencestheirhealthandwellbeing.Itispossiblehoweverthatthepatternocausalitymaybe

thereverse.Thatis,thosevisitorswhoratedtheirhealthorwellbeingpositivelymayeelabletoratethebuildingenthusiastically.Specicpointsromtheindividualitemsworthnotingare:

a. Firstandlastingimpressionsothebuildingwerestronglypositivelyrelated.

b. Thevisitorsneedsbeingmetwithinthebuildingwasassociatedwiththeirperceptionsothebuildinginfuencingtheirhealthinapositivemanner.

c. Asignicantrelationshipwasoundwiththebuildingsettingthepersonateaseandaperceptionoastrongersel-reportedratingohealth.

d. Surprisinglytheinnerandouterviewswerenotsignicantlyassociatedwithratingsohealthorwellbeing.Thisresultappearstocontradictthemanypositive

commentsthatvisitorsmadetotheviews.Thisdiscrepancymaybeexplainedbytheactthattherangeovaluesorthequestionsconcerningtheperceptionoviewswassmall(i.e.positiveandveryewnegativeratings).Fromatechnicalpointoviewthisrestrictsthesizeothecorrelation.Inotherwordsthepositivedatacollectedontheperceptionoviewsmayhavepreventedastrongcorrelationwithhealthandwellbeing.Thisisan

areaorurtherinvestigation.

6.


22/55

10Thesecondsetoassociationsthatwasinspectedwasthecomortratingsothebuildingbythehealthandwellbeingratings(Table8,AppendixV).Wellbeingwasweaklyassociatedwiththecomortratings.Osignicancewasthe

associationonoiseexperiencedinsidethebuildingandthesenseowellbeingromthebuilding.Thatis,thosewhoratedtheirwellbeingpositivelyperceivedthenoiselevelastowardsthetoolittleendotheinteriornoiseratingscale.Allmeasuresooverallcomortsatisaction(namely:temperature,comort,noiselevelandlighting)werestronglycorrelatedwiththeratingohealth.

11Oparticularinterestistherelationshipocontrolwithselperceptionohealth.Visitorswhoaresurvivingcancermayndtheabilitytoexertsomecontrolotheenvironmenttheyareincontactwithsatisyingandlieconrming,especiallywhenthediseaseitselmayhaveostered

theviewthattheirbodyhasbeenout-o-control.Alternatively,thepsychologicalliteratureontheeectsotheenvironmentontheindividualwhoiscompromisedthroughsevereillnessshowsthatwithincreasinglackounction,theenvironmentexertsgreatereectsontheindividualshealthstatus.Henceitwasimportanttotesttheassociationsbetweenthesenseocontrolthatthevisitorsindicated

andtheirperceptionohealth.12Signicantcorrelationswere

oundbetweentheselreportsowellbeinginthevisitorsandtheirperceptionocontrolothecoolingandventilation(Table9,AppendixV). It would appearthat i control was considered to

be available this had a positive

eect on wellbeing. Weakeectswerealsooundorlightingandheating.Onlyoneeect(andthis

wasweak)wasoundorcoolingcontrolandselperceivedhealth.

13Theactthattherewereconsistentpositiverelationshipsoundacrossthevariouscomorteatures,theircontrolandratingsowellbeingintroducesaascinatingareaostudy.Itcouldbearguedthattheseresultsreinorcetheviewthatmakinganenvironmenteasytoreadbyvirtueooering

systemstoallowchangingcomortparameterswillenhancewellbeingandpossiblyselreportedhealth.Thisinterpretationisspeculativebutwouldbeaascinatingareatoconrminaurtherinvestigationandcoulddevelopourunderstandingothisperson-environmentinteraction.

14Positivecommentsromvisitorsinrelationtohealthandwellbeing

included:

Feelings o calm

The building is a place where I have

moved rom ill-health to health by

visiting regularly

The building/space and light lend

themselves to people eeling welcome

and sae sae to explore difcult

issues.

6.

Positiveperceptionsothebuildingarelinked

withhealthandwellbeingbutwhichway?


23/55

Conclusions:

15GiventheaboveresultsanddiscussionthereareseveralissuesthatshouldbeconsideredinrelationtotheuturebrienganddesignoMaggiesCentresandpotentiallyothersimilartypologies.Itisclearromthestudythat

thereisapositivecorrelationbetweenmanydesignaspectsothebuildingandvisitorssenseohealthandwellbeingatthetime.Whatisnotcleariswhethervisitorssenseowellbeingandhealthisinfuencingtheirperceptionothebuildingsqualities,orwhetherthebuildingsqualitiesareaectingvisitorsperceptionotheirhealthandwellbeing.Additionalvisitorscommentswouldseemtosuggest

thelatter,butthisisnotprovenandisclearlyanareaorurtherinvestigation.

16Thendingsrelatinghealthandwellbeingtovisitorssenseocontroloverventilationandcoolingareimportantandsuggestthatgreaterattentionneedstobepaidtothedesignandspecicationoheating,ventilatingandcoolingcontrols,ivisitorssenseohealthandwellbeingaretobeurtherimproved.Whatisparticularlystriking,isthatwhilevisitorsconsciouslystatedthathavingadegreeocontrolintheseareaswasnotimportanttothem,thedegreeocontrolperceivedtobeavailableclearlyaectedtheirsenseowellbeingandhealth.Inotherwords,theymayliketoeelincontroloventilationandcooling(IcanalwaysopenawindowiIwantto),butwithoutnecessarily

havingtoresorttoactuallycontrollingthesethemselves.

17TheabilityorvisitorstobeabletocontroltheirenvironmenttiesincloselywiththeMaggiesCentresethosoempoweringpeopletobeabletoadapttotheirsurroundingsandtakecontrolratherthanbeingcontrolledaspassiverecipientsinacaresystem.

G Sta and volunteerperspective

1 Theinterviewguideorthestaandvolunteersdeliberatelyadoptedthesamequestionsasthevisitorquestionnaireorcomparativepurposes,butdivergedinrelationtothenatureoactivityinthebuilding(AppendixI).Manyotheresponsesechoviewsothevisitors.

2 OnlytwoMaggiesCancerCaringTrustulltimemembersostatookpartintheevaluation,inadditionthreesessionalworkersandonevolunteerwereincludedininterview.TheClientRepresentativewasnotincludedinthisinterviewprocessbutparticipatedinawalk-throughdiscussionatalaterstage.Allstalivedrelativelylocallyandalmostallcommutedtoworkbycarwithanaveragejourneytime20minutes.Mosthadworkedin

thebuildingortwototwoandhalyears.Theyhadveryvariableworkpatterns,withrelativelylittleuseoVDUsandtendedtobecontinuouslyonthemoveinthebuilding.

3 Asurprisingvarietyoimageswereassociatedwiththebuildingwiththebuildingbeingseenascontemporary,unique,welcomingandcalminaveinsimilartothe

visitorresponses.Thebuildingwasperceivedtobewellusedandinlotsodierentways.Generallythebuildingmetthestaneedsapartromsomekeyissueswhichareoutlinedintherestothissection.

4 Levelsoprivacywereperceivedtobegoodorvisitors,butnotsogoodorstawhoelttheydidnthaveaprivatespacetoescapeto.PartotheMaggiesCentresethos,however,istoensurethat

staarealwaysawareovisitors.Thisnecessarilyentailsstabeingvisiblemostothetime.Thelibrarywasnotseenasanidealplaceorconversationwithpeopleindistressasitwasdirectlyoppositetherontdoor.

5 Thelayoutothebuildingwaselttobewelcoming,easytounderstandandopen.Onememberostasuggestedthatthetherapy

andretreatroomsshouldbeknockedtogethertocreateamoreuseulspace,becausebothweretoosmallontheirown.Anothervolunteerwasunclearwhatthesesmallroomswereor.

6.

Theocemaylooklikeithasenoughspace...

...untiltheworkstationsareinuse.


24/55

6 Severalissuesinrelationtotheoceareawereidentied:visitorstendedtowanderintotheoce,notknowingquitewhatitwasor,thedeskareawasawkwardbecauseittendedtosuggesta

receptionpoint,whichitwasnotmeanttobe,andtheoceareawasperceivedtobeabitweirdnobodywasclearwhattheseatingatthebackotheocewasorandasaresultithadbeenadoptedasatemporarystorageplace.Itwassuggestedthattheocemightbebetterlocatedupstairs,butthiswasntnecessarilyperecteither,asstaneededtobeseenbyvisitors.Theocewasgenerally

elttobetoosmall,withnotenoughspaceorstorage.Oneintervieweesummedthisup:Icantbearthelackospaceintheocearea;thechairsaretoocloseandtherearenolingcabinetsandnostraightwalls.

7 Likethevisitors,allintervieweesverymuchappreciatedtheviewswithinthebuilding,withtheheightoroomsgivinganadditionalsenseospace.TheywereparticularlyondotheviewsacrosstheTayEstuarywithonecommentingthatIlovetheviewstheychangeall

thetimeandraisemyspirits.Theyneverceasetothetrees,tide,skyandcolourstheychangeallthetime.Arealjoy.Viewstothenorthothebuildingwereseentobenotsoimportantbutcouldbeimprovedpossiblywithtreescaping.

8 Stacarriedoutaverywidevarietyoworkunctionswhichtheacilitiesgenerallyprovideor.Itwaseltthattheglasswindowin

themaindeskpartitiongavethewrongimpressionandthatpeopletendedtowaitattheentrancearea.Thisviewwasbackedupbythebehaviourovisitorsindependentlyobservedonthedayotheinterviews.Therewasasuggestionthatitmightbebettertohavethekitchenarearightnexttotheentrancetohelpencouragepeopletocomeintothebuilding.

9 Likethevisitors,intervieweesthoughtthatsomeotheurniturewasnotappropriate.Theseatingwaselttobetoolowanddidnthavearmrestsorpeopletohelpthemselvesupwith.Thechairswereseentobegoodlookingbutnotalwaysunctional.Theseating

inthecommonroomwasnotelttobeconducivetomeetingsandwasdesignedmoreorindividualrelaxation.Theoutwardlycurveddeskintheocewasoundtobeawkward.Itwaspointedoutthatthebuildingneedstocaterortheullspectrumoconditionsandpeopleandthatthereshouldbemorevarietyinthecrockeryprovided(olderpeoplemaypreeracupandsaucer,ratherthanamug).

10Thelackostoragespaceinthebuildingbroughtoutthestrongestreactionamongsta,whoendedupstoringthingsintheboilercupboard,creatingapotentialhealthandsaetyissue,andgenerallyspreadingitemsaroundthebuildingasdiscreetlyaspossible.

6.

Themaindeskandurniturewereelt

tobeinappropriateorvisitorsandsta

Althoughstoragewasaproblemstavery

muchappreciatedtherelaxingatmosphere

inthecentre


25/55

11Keythingswhichusuallyworkedwellortheintervieweesincluded:theatmosphereotheplaceandeelingorelaxation,thekitchenandspecicallythekitchentablewhichwereseentobethebestaspectsothebuilding,unctioningasanautomaticmeetingpointandbeingperectortalking.The

commonroomworkedwellorrelaxationclasses.

12Despitecertainissues,thebuildingdesignoverallwashighlyratedsuggestingthatitsoverridingqualitiesoutweightheissueswithasimilarorgivenessactoroperatingorstaandvolunteersasthatnotedorvisitors.

13Intervieweesviewsoncomort

alsoechoedthoseothevisitors.Themaincomortissueswereoverheating,inadequateventilationandsolarglareinthewinterromlowanglesunlightstreamingintothekitchenarea.Venetianblindsweresuggestedorthekitchentocounteractglareissues.Noisewasnotnormallyaproblemasstahadlearnedtolivewithitanditdidntgenerallyintererewiththeirwork.Therewasarealissueotherontdoorbanging,especiallywhenit

wasletopeninordertotryandventilatethebuilding.Thequalityonaturallightwasperceivedtobeverygooddespitetheissueosolarglareandthekitchenwaselttobethebrightestarea.Thecommonroomandsmallertherapyroomswereelttobeabitdark,bycomparison.Thebigspotlightsupstairswereelttobetoobrightandneededtobere-angled.

14Interviewees,incommonwithvisitors,elttheyhadlittlecontrolovercomortconditions,withvirtuallyno-oneunderstandinghowtheheatingworked,butrecognizedthatthebuildingwasslowtorespondtochangingconditions,whichledtooverheating.Thewindowventilationwaselttobe

inadequateandthemechanismsoropeningthemratherimpractical.Intervieweeshadresortedtoleavingtherontandbackdooropentotryandcreatecross-ventilation,butrecognizedthattherewaslittlecontroloverthismeansoventilation.Beingabletopersonallycontroltheheatingwasseentobemoreimportantthancontrollinglightingornoise.

15Despitethesignicantissueooverheatingandlackoocespace,staratedtheoverallcomortconditionsasbeingverygood,suggestingthatthey,likethevisitors,alsoorgavethebuildingsparticularcomortproblemsduetoitsoveralldesignquality.

16Intermsowellbeing,healthandproductivity,nooverallconclusioncouldbedrawnrominterviewees

perceptionsaboutwhetherornottheconditionsothebuildingactuallyaectthese,withtwosayingthattheconditionsimprovedboththeirwellbeingsenseohealthandproductivity,andthereststatingthatitmadenodierence.

Conclusions:

17Fromtheaboveitcanbeseenthattheviewsothestaandvolunteersareverysimilartothoseothevisitors.Additionalissuesraisedbystainclude:poorergonomicdesignintheoceareacombinedwithlackospace,

anambiguousreceptionarea,lackostorageandunamiliaritywiththeheatingcontrols.Itcanbeanticipatedrompreviouspostoccupancyevaluationstudiesthatthelongersomeonehasworkedinabuildingthemoretheybecomeawareoanydeciencies.Inthissense,itisvitalthatthebriengprocessandresultantbuildingdesigntakecareulaccountostarequirementsaswellastheneeds

otheusers.

18RecommendationsoruturebrienganddesignoMaggiesCentresarisingromtheinterviewndingsinclude:

a) therequirementordiscreetandfexiblestorageacilitiesrelatedtotheoce.Thesecouldbedesignedtolookdomestic,e.g.builtinshelvingandlingsystemswithdoorstocloseoviewsopaperwork.Baseunitscontaininglingacilitiesandotherstorageshouldbedesignedtobemoveabletoenableoceusetobereconguredasnecessaryaccordingtowhoisusingit.

b) therequirementoradequatespaceintheoceareaorallocestationstobeusedatthesametimeinecessary.

6.


26/55

c) separatingtheoceareaoromtheentrance,whilestillmaintainingadequatesightlines.Sightlinesneedtobecareullycheckedatdesignstage.

d) providingasound-proobutmoveablepartitionbetweenthesmallerretreatroomandtherapy

roomtoallowthesetobeopenedupormorefexibleuse.

H The building process

1 AnArchitectrepresentativewasinterviewedseparatelyusingquestionswhichrelatedspecicallytotheconstructionothebuilding,maintenance,managementandenergyeciencyinaseparate

TechnicalInterviewGuide(AppendixI).Theresultsotheinterviewwereanalysedinrelationtoacareulexaminationotheworkingdrawings,specicationsandheatingbillsorthebuildingtoprovideanoverallappraisalosustainability.AwalkthroughwiththeClientRepresentativewasusedtourtherclariyidentiedissues.Thebenetohindsightwasusedtoestablishwhat,iany,additionalchangesmightbemadetothe

uturebrieng,design,specicationandconstructionosmall-scalehealthcarebuildingssuchasMaggieCentres.

Construction process

2 Fromthelocalarchitectspointoview,therehadbeennoproblemsduringtheplanningstageandtheiconicstatusothebuildinghadverymuchhelpedinthisrespect.Theconstructionhadbeenequallystraightorwardapartromtheroo,

orwhichtheholdingodesignandconstructionworkshopsbeoregoingonsitehadeasedmatters.ThespecialisedangelhairnishtothestainlesssteelroohadtobecarriedoutintheUSAbecausenoonewoulddoitintheUK.Theconstructionprocesshadturnedouttobeslowerbutnotgreatlyso.Thebuildcontracthadbeenor12monthswhennormallyitwouldhavebeen6-8months.Therehad

beennoparticularproblemsduringthedeectstagebecausepeoplehadtakenarealprideinthejob.

Maintenance

3 Accordingtothelocalarchitectsandsta,ongoingmaintenancerequirementsorthebuildinghadbeenrelativelylowatthetimeothisstudyalthough,romrecordsanalysed,therehadbeenanumberocalloutsrelatingtothepoorperormanceotheheatingsystemandthenon-disabledw.c.AnymaintenancerequiredhadbeenarrangedonarelativelyinormalbasisbytheCentreHeadwiththeNHSestatesdepartment,thelocalarchitectsoragentsresponsibleormaintainingtheservices.

4 Thehoodedeectotheroohadhelpedtosheltersomeotheexposedtimber,althoughitwasthoughtthattheexternaltimberonthesouth/southwestwoulddeteriorateunlessitisregularlymaintained.Theexternaltimberseatingwillbeneedparticularattentioninthisregard.ThedesignarchitectshadspeciedaverticalgrainimportedDouglasFiroraestheticreasons,evenalthoughthelocalarchitectshadrecommendedamoredurable

hardwoodbecauseothesevererainallinScotland.

5 Wallingareaswhichweresubjecttosignicantwearthroughurnitureabrasionandhandprintshadbeen

repaintedandwerelikelytoneedrepaintingrelativelyrequently.

6 Generallythenishestothebuildingwereelttobeogoodquality,apartromtheexternaltimber,anditwasanticipatedthatthehighercapitalcostandinvestmentinbetterqualitymaterialsshouldresultinlessmaintenance.

6.

Theexposedsotwoodtimberonthe

southsideothebuildingwillneed

maintenance


27/55

7 Atowerwillberequiredtochangetheinternallighting,anditwasrecommendedbythearchitectsthatthelow-energylightbulbswerereplacedallinonegowhentherstonegoes.Acherrypickerwillbeneededtoservicetheroobecauseoitsparticulardesign.Thearchitectdidnoteelthat

maintenanceexpenditureonthebuildinghadbeenexcessivetodate.

8 Itshouldbeaddedthatnoliecyclecostinghadbeenspecicallycarriedoutonthisdevelopmentatthedesignstagetominimiseuturemaintenancecosts.

Management

9 Accordingtothelocalarchitect,theperormanceothebuildinghadgenerallyullledthebrierequirementsapartromtheocearea,wheretheergonomicswerenotthoughttobeoperable.TheocedidnotcomplywiththeDisabilityDiscriminationAct,becauseitwasnotpossibleorawheelchairusertoworkintheoce.Itwouldbepossible,however,orawheelchairusertobe

accommodatedelsewhere,giventhefexibilityothebuilding.

10Thebuildingwasperceivedtobeveryfexibleinusebythelocalarchitect,whopointedoutthatalaptopacilityhadrecentlybeenaddedtothekitchentableareatoenablepeopletouseITwhilehavingacupotea.Itwassuggestedthattherewaslotsoopportunityorthiskindofexibility.

Storageareas,however,wereelttoberelativelyunprovidedorandthelocalarchitectssuggestedthattheclientwillneedtore-examinetherequirementorthis.

11Generally,althoughthebuildingwaselttoworkwellandhadacompletelackoinstitutionaleeling,thelocalarchitectsuggestedthatthebriewasnotcomprehensiveenough.

Neverthelessthedesignwasratedbyhimasprettyclosetoexcellent.

12ThewalkthroughrevealedthatsightlinesromthePCinormationstationandthekitchenareastotheentrancedoorwereblockedtoadegree,leadingtostahavingtopositionthemselvescareullyatalltimestoensurethattheycouldhear/seevisitorsarriving.Thiswas,however,viewedpositively

asitensuredthatstaremainedattentivetoallpartsothebuilding.

Energy efciency

13Theprimarymeansoheatingthebuildingwasbyunderfoorheatingusingadomestic30kWcombinationgasboilerorthegroundfoorwetsystemandelectricityortheupperfoorunderfoorheating.A6.6kW

woodstove-eectgasreprovidedadditionalheatingtotheupperlevelareaabovethelibrary.Thewetsystemwasdesignedtoberunataconstanttemperaturesettingoaround18Cwithlocalisedheatingelementsinthekitchenareaandlargegrouproomtotopthisupasrequired.Theunderfoorheatingwassplituptoeightdierentzonesrelatingtodierentpartsothebuilding,eachwitha

separatethermostat.Thesecouldonlybeadjustedbyoneortwodegrees,however,romthemainprogrammesetting.Thelocalarchitectwasnotconvincedbythecontrolmechanismorthelocalisedheatingelementandatthetimeothisstudytheheatingcoilitselappearedtobemalunctioning.

6.


28/55

14Serviceengineersreportsnotedseveraltimesthattheheatingprogrammerwasonthewrongsettingsandhadtobereset.Therehadalsobeensomepastproblemswiththeheaterunderthebenchunitinthekitchenandintheocearea.Itisquiteclearromtheengineersreportsthat

staregularlyreportedproblemswiththeheatingwhichwerelargelyrelatedtothecomplexityotheprogrammer.Theauthoralsoobservedthecomplexityousingtheprogrammerduringthewalkthrough.

15Thelocalarchitectobservedthattherewasconsiderablesolargaininthebuildingasnotedalsobyusers.Onedesignsuggestionhad

beentouserittedglassorthelargeskylightovertheconcretefoorinthecentreothebuildingtopreventexcessiveheatbuildup,butthedesignarchitectshadbeenadamantthattheusersshouldbeabletoseetheskyjustasitwas.Thelocalarchitectalsostressedtheneedtocontinuouslyeducatethestaonhowtousetheheatingsystemduetotheinevitableturnoveropersonnel.

16Thebuildingwasdesignedtobenaturallyventilatedapartromareaswithnooutsidewall,whichwereservedbymechanicalventilation.Thelocalarchitectrecognisedthattheshapeandvolumeothemainspacestogetherwithnaturalventilationonlyoccurringthroughthelow-levelsashwindows,was

notaltogetherhelpulinthisregard.Itwassuggestedthatarapidextractsystemcombinedwithheatrecoverymayhelptoovercomeanyventilationoroverheatingissues.

17Thelevelsoinsulationinstalled(60mmRockwoolHPintheexternalwalls,35mmrigidinsulationinthefoor,and80mmFoamglassintheroo)werethoughttobeinexcessothebuildingregulationsatthe

timeandthelocalarchitecteltthatthebuildingshouldbeverygoodintermsoenergyeciency.Bestpracticeinthisareawouldhoweversuggestdoublingtheselevelsoinsulationinutureprojectsinordertoreducecarbondioxideemissionstoasustainableratewhichwillmitigateclimatechangeinuture12.

18Evidenceontherunningcostsromuelbillsobtainedoraullyear(Table12,AppendixV)indicatesthat,despitetheheatingcontrolissuesidentied,theenergyusewaswellwithinthegovernmentenergytargeto35-55GJ/100cu.mornewbuildingsintheNHSEstate(2001-10),cominginat29.4

GJ/100cu.m.Energyrunningcostswere64perweekor286kwh/m2.Totalcarbonemissionsorthebuildingwere4.4tonnesortheyear.

6.12

Stevenson,F.andWilliams,N.

(2000)SustainableHousing

DesignGuideorScotland

p.36


29/55

Overall sustainability

19 AnappraisalotheoverallsustainabilityotheDundeeMaggieCentrebuildinginvolvedanassessmentoanumberointerrelatedareas:resourceuse,pollution,biodiversity,healthyenvironments,peopleand

communitiesandthebuildingprocessitseldrawingontheheadingsinTable13 13.Thelimitationothisstudydidnotpermitaullassessmenttobemade,andwhatollowsisabrieoverviewollowingscrutinyothedrawingsandspecicationtogetherwithvisitstothebuildingandinterviewswithvariousparties.

20 Resource Use:

Thedesignothebuildingitselhasreducedenvironmentalimpactthroughtheextensiveuseorenewabletimberinthestructuralraming,windows,doorsandcladding.Howeveritshouldbenotedthatthereislikelytohavebeenasignicantamountoembodiedenergytiedupinthetransportationocertainelements,suchasthesteelcladdingortheroo,whichhadtobetransportedtotheUSandbackagainornishing,andthetimberstructuralbeamswhichweremanuacturedinFinland.Theextensiveuseobuildingproductsandmaterialsbondedtogetherbystrongadhesiveswillmakeitdiculttorecyclethesecomponentsattheendotheirlie,althoughthemaintimberelementscouldintheorybere-used.

21 Pollution and Biodiversity: Almostalluserswerecommutingbycar,arelativelypollution-intensiveormotransport,despiteaccessiblepublictransportacilitiesonsite.ThesolutiontothisliesbeyondthecontrolotheMaggiesCentres,possiblyintheormolesspollutingcars.Thematerialsandproductsusedinthebuildingwererelativelystandardandnoparticularattempthadbeenmadetospeciylowpollutantsbeyondregulatory

practice.Biodiversityonthesiteremainedrelativelyunaectedbecausethesiteitselhadnoparticularmerittostartwith.Althoughnoattemptshadbeenmadetoenhancebiodiversitytodate,thepotentialisoeredthroughuturelandscapinginitiatives.

22 Healthy Environment:

Therehadbeensignicantemphasisoncreatingahealthyenvironmentwithinthebuildingthroughthespecicationolow-emissionpaintandvarnishnishes,theextensiveuseonaturalmaterialsinsidethebuilding,theuseonaturalventilationanddaylight.Therewas,however,noparticularrequirementinthebrietominimisetoxicityortooptimisehumiditylevels,bothowhichhelppreventallergicreactions14.Neverthelesstheperceptionbyuserswasthattheairqualityinthebuildingwasrelativelygood,possiblyduetothegenerousvolumesprovidedbythedesignwhichprovidedadegreeobueringintermsoairquality.

6.13

Halliday,S.P.andStevenson,

F.(2004)Sustainable

Constructionandthe

RegulatoryFramework:

AThinkPiece,GaiaResearch,

Edinburgh,http://www.

gaiagroup.org/Research/IDS/

suc-con-reg/index.html

14

Berge,B(2000)Ecology

obuildingmaterials.

ArchitecturalPress,Oxord.

Thisbookextensively

describestheproperties

ovariousconstruction

materialsandishelpulor

specicationpurposes.

Thedesignothebuildinghas

reducedenvironmentalimpact

throughtheuseotimber


30/55

23 People and Communities:

TheoutstandingdesignqualityothebuildinghadgreatlybenetedthelocalcommunityintermsoraisingDundeesproleasacity,althoughthedirectbenetstothelocalconstructionandmanuacturingeconomywererelativelyminimalgiventhatmost

productsorthebuildinghadbeenimportedtotheregion.Therewerenolocallabourclausesspeciedinthecontractassuch,tohelppromotethelocaleconomy.

24 Building Process:

Thebuildingprocessdidnotutiliseanyparticularsustainabilitytoolsorbenchmarksandpostoccupancyevaluationwasnotspeciedaspartothebriengprocessassuch.Therewas,however,extensivepre-evaluationothedesignwiththeclientbodyandaverycloseandcontinuousrelationshipwiththearchitect.Futureexpansionoserviceshadbeenconsideredandratherthanexpandthebuilding,theclientwouldconsiderbuildinganotherbuildinginstead.Future-proongthebuildingintermsouturelegislativerequirementsorupgradingelementswasdiculttoanticipateandpotentially

expensive.Althoughthebriespecicallyrequiredthatthebuildingshouldeconomicaltomaintain,therewasnobrieorthearchitectorcontractortoprovidesustainablemethodsoconstructionthatminimisedwaste,energyuseandaddressedclimatechangebeyondstatutoryrequirements.

Conclusions:

a) Design issues:

1 Thedomesticnatureothedesignresultedinarelativelystraightorwardconstructionprocessapartromtheroo.Thecontractlengthwasslightlylonger

thanorabuildingoasimilarsize,butthedierenceisrelativelyinsignicant.

2 Intermsomaintenance,itisimportanttotakeaccountothelocalclimatewhendesigningandspeciyingexternaltimberelements.Largefattimbersuraces,suchastheseatingonthejettyshouldbeavoidedaswaterwillsitontheseandleadtoprematuredecay.

3 Althoughtheprovisionoanenvironmentallysustainabledevelopmentwasnotaprimaryaimotheoriginalproject,thedesignhasaddressedtheseonanumberolevelsincludinggoodlevelsodaylighting,passivesolargainanddurability.Ithasalsominimisedenvironmentalimpacttoadegreethroughthespecicationorelativelylowembodiedenergytimberorprimaryandsecondaryelementsothedevelopment.Incorporatingthebriengrequirementsrelatedtoresourceuse,pollution,biodiversity,healthyenvironments,peopleandcommunitiesandthebuildingprocess,wouldimproveperormanceinalltheseareas.

4 ThereisalsoscopeorutureMaggiesCentrestoreducecarbondioxideemissionstoamoresustainablelevel,orrelativelylittleextracapitaloutlay,byintroducingquickwinstothebriewhichrecognisethecostconstraintsoanorganisationdependentonundraising.Theseinclude:

increasedlotinsulation useomaterialsandproductswith

recyclateinthem wasteminimisationprocedures

duringconstruction minimaluseotimbertreatments categoryAboilers.

b) User related issues:

5 Themaintenanceandrunningothe

buildingisrelativelytraightorwardapartromtheheatingsystem.Atpresentmaintenanceiscarriedoutonarelativelyinormalbasis.ItmaybeuseulortheMaggiesCentres,atthisstageodevelopmentasanorganisation,toconsideremployingapermanentbuildingsmanagerortheirstock,whowouldbeablehelpstaunderstandproblemsrelatedtoheating,ventilationandgeneralmaintenanceandensurecontinuing

inductionornewstaunamiliarwithhowtoruntheirbuilding.Thispersoncouldalsobechargedwithcyclicalmaintenanceplanningandbroughtinonthebriengprocessornewprojectsinordertoprovidetechnicaleedbackonproposedspecicationsrelatedtotheactualrequirementsousers.

6.


31/55

1 ThelimitedscopeothisshortstudypresentsasnapshototheDundeeMaggiesCentreandcannotseektoreplicateaullmonitoringexerciseoveralongerperiodotime.

2 Themethodologyadoptedhashowever,revealedagreatdeal

obothsubjectiveandactualinormationwhichhasprovidedarichpictureohowwellthebuildingisperormingandcouldbereplicatedoruturebuildings.

3 Theresultsothesmallpilotsurveyindicatethatthebuildinghassuccessullyachievedtheollowingobjectivesothebrie:

ahighlyeectivedesignconcept

inrelationtotheMaggiesCentrescaremodel veryhighusersatisactionoverall,

withacilitiesprovidingacalmandriendlyspaceandanappropriatedegreeoprivacy

highlevelooverallcomort usersperceptionoincreased

healthandwellbeingduetovisitingthebuilding

particularappreciationotheviewsoutothebuilding

lowlevelomaintenancerequired

4 Thebuildinghasbeenlesssuccessulinachievingtheollowingobjectives:

fexibleocespacewhichisseparateyetvisibleromwelcomearea

adequatestorageacilitiesortheoceareaandotheractivities

thermalcomort

5 Evidenceontherunningcostsromuelbillsobtainedoraullyear(Table12,AppendixV)indicatesthat,despitetheheatingcontrolissuesidentied,theenergyusewaswellwithinthegovernmentenergytargeto35-55GJ/100cu.mornewbuildingsintheNHSEstate(2001-10),cominginat29.4

GJ/100cu.m.Energyrunningcostswere64perweekor286kwh/m2.Totalcarbonemissionsorthebuildingwere4.4tonnesortheyear.

6 Thehighlevelooverallusersatisactionvalidatesadesignapproachwhichhasplacedanemphasisonthequalityandgeneroussizeointernalspaces.Goodqualityinternaldesign

alsogivesthebuildingahighorgivenessactorinrelationtocomortissuesconcerningoverheating,humidity,ventilationandglare.

7 ThereareanumberoissuesarisingromtheevaluationinthelightotheoriginalbrieanddevelopedproposalwhichshouldbeinvestigatedurthertohelpimprovethedesignqualityoMaggiesCentresandothersmall

scalehealthcarebuildings:

Design Issues:

a) largeareasosouthacingglazingcanleadtooverheating,unlessadequateexternalsolarshadingandventilationmeasuresaretaken

b) thesizeotheoceshouldtakeaccountotheneedorfexibility,

storageandadequatecirculation

c) thespecicationotheunderfoorheatingsystemneedsanadequateandinstantaneoustop-upsysteminthelightothefuctuatingnumberswhichuseaMaggiesCentre.

d) thespecicationanddesignowindowsmustalloworadequateventilationathighlevelandshouldbedesignedtoalloweasyopening

byoneindividual

e) adequatecrossventilationisneededbetweenroomsithissizeobuildingistobenaturallyventilated

) thepossibilityoprovidingasound-proomoveablepartitionbetweenthesmallerretreatroomandtherapyroomtoallowormorefexibleuse.

7. Conclusions andRecommendations


32/55

User-related issues:

a) userinductionshouldbeaninherenteatureoanynewbuildingandneedstobecontinuous,especiallyinrelationtoheatingandventilationcontrols,toavoidpotentialmisunderstanding

b) complexheatingprogrammersshouldbeavoidedthedesignteamneedtoensuretheyaresimpletounderstandwithnounnecessaryoptionsorsettings

c) thepositionotheoceshouldbeconsideredcareullyinrelationtostarequirementsaswellasuserrequirements,andavoidbeingseenasareceptionarea.Thekitchenshouldideallyleadimmediatelyo

themainentrance,astheprimarysocialspace,toavoidrsttimevisitorshoveringattheentrance

d) theuseochairswithoutarmrestsoradequatebacksupportorconversationalmodeisnotrecommendedorambulantdisabledusers

e) thereisaneedorincreasedcarparkingprovisionatpeaktimes.

8 Positiveoutcomesthatshouldbeadoptedromthebuildingdesigninuturebriengincludetheuseo:

Design principles:

a) emphasisonexternalviewsonatureromthebuilding,whicharenaturalanduplitingorusers

b) relativelygenerousspacestandards

andvolumecombinedwithacareullydesignedabundanceo

naturallighting,whichallowsairtoremainresh

c) theuseohighqualitymaterialsandnishestominimisemaintenancecostsandincreasedurability

d) theuseotimberorboththeprimaryandsecondaryelementsoconstructiontominimiseenvironmentalimpact.

User-related principles:

a) openplanlayout,whichwhileprovidingasenseowelcomealsomakescirculationandinternalmanagementrelativelyeasy

b) thegenerousarmhousekitchenastheprimarysocialspace,whichisthekeytothesuccessotheMaggiesCentre

c) theinclusionoavarietyodierenttypesospaceswhichallowdierentactivitiestooccurinthem.

9 ThereareanumberoareaswherethebriengprocessortheMaggiesCentrescouldbestrengthenedinordertoimprovetheoverallperormanceotheirbuildings,includingtherequirementor:

a) simpletounderstandandeasytouseheatingsystems,controlsandprogrammerswhichcanrespondtorapidlychangingoccupancylevels

b) low-noisemechanicalventilationequipmentinuserenvironmentswhichdontintererewithquietconversation

c) adequatesolarshadingandprovisionocross-ventilation

d) specicstorageareasandacilitiestobemoreclearlyidentiedorsystemorremovingitems

e) adequatecirculationinoceareas

) sustainabledesignandspecicationwhichdrawsonquick

winswithincostconstraints.

10ASWOTanalysisbasedonthestudyndingstoestablishtheoveralleciencyothedesignanduturestrategiesinrelationtotheinitialprojectobjectivesisshownoverlea.

7.


33/55

Strengths

successuldesignconceptinrelationtoMaggieCentrecaremodel

qualitativenatureodesignbrie

outstandingscenicviewsrombuilding

qualityandabundanceonaturallight

openplanlayout

welcomingandengagingkitchenarea

fexibilityodesignordierentuses

staethos

7.

Weaknesses

inadequateventilationdesignandlackosolarshadingleadingtooverheating

poorthermalcomortconditionsduetounderfoorheatingsystemandthermalmasswhichcannotrespond

quicklytorapidchangesinuseractivitiesandnumbers.

complicatedheatingprogrammer

unergonomicchairsandseating

relativelyundevelopedbriengdocumentationandeedbackproceduresorprojects

Opportunities

addmoveablesolarshadingtosouthacingkitchenwindowstoreduceglare

remodelocearea

continuoususerinductiontohelpunderstandthebuildingsheatingandventilationandcontrolitbetter.

improveddesignbrietotakeaccountoidentieddesign,sust-ainability,andmaintenanceissues

employmentobuildingsmanagertoprovidestrategicsupport

Threats

stadissatisactionwithworkingconditionsinocearea

uturelegislativerequirementsinrelationtosustainabledesign

increasingenergybillsorossiluels

longtermmaintenanceoexposedtimber

11Theollowingaspectspresentopportunitiesorurtherresearch:

awiderstudyoallMaggieCentresusingaurtherrenementothemethodologyestablishedinthispilotstudytoascertainspecicoutcomesandresearchquestionswhichexaminekeydesigneatures

inrelationtousersperceptionhealthandwellbeing.

awiderstudyotherelationshipbetweenusersabilitytocontroltheirenvironmentandtheirperceivedstateohealthandwellbeing.

thedesignoventilationandheatingstrategiesinrelationtothepresence,orabsence,othermal

massinsmall-scalehealthcarebuildingsandtheeectthishasonenergyeciencyandcomort

SWOT analysis o DundeeMaggies Centre


34/55

AssociationorEnvironmentallyConsciousBuildersarticleonLightweight.v.Heavyweightconstruction,Vol.11,no.3pp.30-34Winter2001-02

Berge,B(2000)Ecologyobuildingmaterials.ArchitecturalPress,Oxord.

BuildingandResearchInormation,Vol29,Number2,March-April2001SpecialIssueonPost-occupancyEvaluation

BuildingandResearchInormation,Vol33,Number4,September2005

Burt-ODea,K.(2005)DesignImpactStudy.Plan&Projectpartners,EuropeanHealthPropertyNetwork.

DepartmentotheEnvironment,TransportandtheRegions(2000)BuildingaBetterQualityoLie:AStrategyormoreSustainableConstruction,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)TheArchitecturalHealthcareBuildingandItsEectsonPatientHealthOutcomes,UniversityoSheeld

Roa,S,Fuentes,MandThomas,S.(2001).Ecohouse:ADesignGuide,ArchitecturalPress,Oxord.

Stevenson,F.andWilliams,N.(2000),SustainableHousingDesignGuideorScotland,TheStationeryOce,Norwich

Stevenson,F.(2005)Environmentalarchitectureandthehealthbuilding;thematerialityperspective,FourthDoorReview,Nos.7,pp.38-42

Wagenaar,C.(ed.)(2006),TheArchitectureoHospitals,NAiPublishers,Rotterdam

AEDETEvolution:DesignEvaluationToolkit,NHSEstatesDept,Londonhttp://knowledge.nhsestates.gov.uk

ASPECT:StaandPatientEnvironmentCalibrationToolkit,NHSEstatesDept,Londonhttp://knowledge.nhsestates.gov.uk

NHSEnvironmentalAssessmentTool(NEAT),NHSEstatesDept,Londonhttp://www.dh.gov.uk

8. Bibliography


35/55

Appendix 1User Interview Guide

Sta Interview PromptSheet or Questions

Interviewer:

IamcarryingoutthisinterviewaspartoastudytohelpwithutureplanninganddesignoMaggieCentres.Theinormationcollectedwillbetreatedascompletelycondential.Thenal

reportothestudywillusesummariesotheinormationandnotrevealtheidentitiesoanyindividuals.Anynotesontheinterviewwillbedestroyedattheendothestudy.

Theinterviewwilllastaboutanhouranditwouldbehelpuliyoucouldanswerasmanyquestionsasyoucan.

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.Whatimagedoyoueelthebuildingprojects?

11.Howwouldyoudescribethelevelsoprivacyitprovides?

prompts

-oryourwork-orvisitors

12.Howdoyoundthelayoutothebuilding?

prompts

-howeasytounderstand-howpractical

13.Howwelldothinkthespaceisusedinthebuildingasawhole?

14.Doesthebuildingasawholemeetyourneeds?

15.Howwouldyoudescribetheviewsinsideothebuilding?

16.Howwouldyoudescribetheviewsromtheinsidetotheoutside

othebuilding?

17.Whatdoyouthinkothestoragearrangementsinthebuilding?

prompts

-oryourwork

18.Allthingsconsidered,howdoratethebuildingdesignoverall?

C Your Work Requirements

19.Pleasebriefydescribetheworkthatyoucarryoutinthisbuilding

20.Specicallyorthepurposeoyourwork,howwelldotheacilitiesmeetyourneeds?

21.Canyougiveexamplesothingswhichcanhindereectiveworking?

22.Canyougiveexamplesothingswhichusuallyworkwell?

23.Howdoyouratetheusabilityotheurnitureprovidedatyourdeskornormalworkarea?

24.Doyouhaveenoughspaceatyour

deskornormalworkarea?

D Comort

25.Howwouldyoudescribethecomortconditionsinthebuilding?

prompts:

-temperature-airquality

26.Howwouldyoudescribenoiseinthebuilding?

prompts:

-noiseromotherpeople-othernoiserominside-noiseromoutside

27.Howwouldyoudescribethequalityolightinginthebuilding?

prompts

-lightingoverall-naturallight

-glareromsunandsky-articiallight-glareromlights


36/55

E Personal Control

28.Howmuchcontroldoyoupersonallyhaveovertheollowingaspectsothebuildingduringyourvisit?

-heating-cooling

-ventilation-lighting-noise

29.Howimportantisittobeabletocontroltheseactors?

30.Allthingsconsidered,howwouldyouratetheoverallcomortothebuildingenvironment?

31.Isyouroverallwellbeingincreased

ordecreasedbytheenvironmentalconditionsinthisbuilding?

32.Doyoueelthatthebuildingaectsyourhealthbymakingyoueelmoreorlesshealthy?

33.Doyouthinkyourproductivityatworkisdecreasedorincreasedbytheenvironmentalconditionsinthisbuilding?

34.Anyotherscomments?


37/55

Thankyouoragreeingtotakepartinthisinterview,whichshouldtakeabout45minutes.CanIassureyouthatnorecordsotheinterviewwillbekeptwithyournameonthem.IwillbetapingthisinterviewbutthetapewillbedestroyedonceIhavemadeanonymousnotes.Canyoupleasetrytoanswerallquestionsasullyas

youcan.

Background:

1.Howotenhaveyouvisitedthebuilding(onceitwascomplete)

2.Whatwasyourinvolvementwiththebuilding?

Section A: Perormance Aspects

3.Howdoyouthinkthedevelopmenthasmeasureduptotheoriginalexpectationsothebrie?

Probes

-layout-useospace-viewsinside-viewsoutside-fexibility-privacy

Appendix IITechnical Interview Guide

Section B: Construction

4.Wasconstructioneasierormoredicultcomparedtostandardsmallscalepalliativecaredesign?

Probes

-structure-superstructure

-oundations-services-ttings-nishes

5.Wasconstructionasterorslowercomparedtostandardsmallscalepalliativecaredesign?

Probes

-structure-superstructure-oundations-services-ttings-nishes

6.Werethereanyproblemsduringtheplanningstageothescheme?

7.Werethereanyproblemsduringtheconstructionstageothescheme?

8.Werethereanyproblemsduringthedeectsstageothescheme?

9.Howeasyisthebuildingtomaintainandclean?

Probes

-maintenancediculties-cleaningdiculties-liecyclesormaterials,nishes

10.Whatimprovementswouldyoumaketothebuildingintermsoconstructioninhindsight?

Section C: Heating, Ventilation

and Lighting

11.Howisthebuildingmeanttobeheated?

Probes

-whenduringday/season-usingwhat

12.Howwellhastheheatingsysteminthebuildingperormed?

Probes

-comortlevels-temperaturesinallseasons-easeouse-responsiveness-qualityoheat-anyproblems

13.Howisthebuildingmeanttobeventilated?

Probes

-whenduringday/season-usingwhat

14.Howwellhastheventilationstrategyinthebuildingperormed?

Probes

-comortlevels-easeouse

-responsiveness-airquality-anyproblems

15.Howisthebuildingmeanttobelit?probes-natural-articial

16.Howwellhasthelightingstrategyperormed?

17.Howenergyecientisthebuildinginyourview?

18.Whatimprovementswouldyoumaketotheheating,ventilationorlightinginhindsightiany?


38/55

Section D: Flexibility

19.Howfexibleisthebuildinginaccommodatinguserneeds?

probes

useoroomsworkspaceacousticprivacy

20.Howwelldoyouthinkthebuildingcouldaccommodateutureuserneeds?

probes

-storage-disability-growinguse-workspace/IT

21.Whatimprovementswouldyoumaketotheschemeintermsofexibilityinhindsightiany?

Section E: General

22.Pleasegiveexamplesothingsaboutthebuildingwhichworkwell?

23.Pleasegiveexamplesothingsaboutthebuildingwhichhinderitseectiveoperation?

24.Inonewordwhatimagedoyoueelthebuildingprojects?

25.Allthingsconsidered,howdoyouratethedesignoverall?

26.Arethereanyothercommentsyoudliketomake?


39/55

Appendix IIIDrawings plans/sections/elevations

Ground Plan


40/55

Section looking North

Section looking North

Appendix III


41/55

Appendix IVBenchmarking or uel costs

Table x: Energy/ C02 Benchmarking or 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

Dundee

Maggies Centre 785 286 0.07 29.4


42/55

Appendix VTables

1: User Demographics (Questionnaire)

Parameters

Age Over30yrs=97% Under30yrs= 3%

Sex Female=69% Male= 29%

Status Sueringromcancer=71% Carer= 29%

Travel mode Car=82% Walk= 9%

Nos. o visits 5timesormore=73% rsttime= 12%

Length o

Documents

Post Occupancy Evaluation Maggiecentre