Stakeholder experiential knowledge as evidence in redesigning health-care facilities for improved usability

Purpose: Evidence-based design (EBD) is traditionally limited to using empirical research findings based on randomized controlled trials. The purpose of this study is to explore stakeholder experiential knowledge as alternate credible evidence in redesigning health-care facilities for improved usability. Design/methodology/approach: This research, based on critical participatory action research, involved a case study of redesign and post-occupancy evaluation (POE) of an emergency department (ED) at Holy Family Hospital, Techiman, Ghana. Observation, interviews and document analysis were used to collect data in the redesign and POE. The data was analyzed through directed content analysis. Findings: Findings indicate that the redesign interventions, generated from stakeholder experiential knowledge, led to improved effectiveness, efficiency and satisfaction in the ED. This presents stakeholder experiential knowledge as alternate credible evidence in EBD. Furthermore, the POE revealed that open and flexible spatial arrangement, zoning care areas according to severity, and providing staff-support amenities are some redesign interventions for improving ED usability. Practical implications: Compared to the hard and controlled nature of experimental research knowledge, the soft and fluid experiential knowledge of stakeholders could be more useful for health-care redesign process, especially in iteratively structuring design thinking and making choices. Originality/value: This paper contributes to theory by validating and illustrating stakeholder experiential knowledge as credible evidence for EBD. Practically, it provides strategies, based on POE findings, for designing EDs to improve usability.