Design of Inpatient Rehabilitation Facilities for Stroke Care: Results from the ENVIRONS Study (environments for Inpatient RehabilitatiON of Stroke Patients)

Background: Hospital building design can impact safety, clinical outcomes, economic performance, and emotional well-being of all users. The majority of healthcare design evidence comes from research in acute healthcare settings. Stroke rehabilitation differs from acute care in many ways, but there are no building design recommendations specific to this population. Aim: To explore how the built environment may best support efficiency, clinical outcomes, emotional well-being, and safety in inpatient stroke rehabilitation. Methods: ENVIRONS was a convergent mixed methods multiple-case study of two inpatient rehabilitation facilities in Victoria: 1) St George’s Health, SVHM, and 2) Bendigo Hospital. Data were collected on the design of the buildings and safety of staff and patients. Stroke inpatients participated in behavioural mapping, questionnaires, and “walk-through” semi-structured interviews to investigate their experience of the physical environment. Staff were also interviewed. The qualitative and quantitative data were collected in parallel, analysed separately, and then synthesised using convergent mixed methods to produce a multiple-case study report. Results: Twenty patients participated at St George’s (mean age 74 years, 40% female) and 13 at Bendigo (mean age 72 years, 46% female). Important elements for stroke rehabilitation design were identified, including access to communal spaces. Overarching themes included autonomy, access to spaces other than the patient room, opportunity for practice, and safety. Further results will be detailed. Conclusion: The ENVIRONS study used novel methods for investigating the unique relationship between the physical environment and stroke care. The results contribute new evidence to help optimise inpatient healthcare environments for people with stroke.