Evaluating the design of hospitals within a practice order network

Abstract

Design evaluation is a complex and rich social practice that is organized and distinguished by its practical understandings, rules, general understandings and teleoaffective structures. This praxiographic study of a major National Health Service (NHS) hospital project uses practice theory to investigate the concept of design evaluation as ‘a practice’. By applying Theodore Schatzki’s site ontology, design evaluation practices are revealed to respond to dynamic teleoaffective structures that highlight the role of both practical intelligibility and the intertwined impact of external policy stipulations. Through this theoretical lens, fresh insight into the actuality of NHS hospital design evaluation praxis is provided that questions some of the axioms upon which such processes are assumed to operate. In particular, the appropriateness of the decontextualized and deterministic processes currently found in UK government design policy is questioned. It is posited that an approach to design evaluation grounded in Schatzki’s practice theory has greater potential to improve the design quality of NHS healthcare buildings that could, in turn, improve patient healthcare outcomes.