Despite significant technological and scientific advances in healthcare provision and treatment in past decades, economies are struggling to address increasing costs while enhancing accessibility to quality health and care services. Globally, around 8.4% of gross domestic product (GDP) is spent on healthcare, with United States spending 17.4% of its GDP. There is, therefore, a growing interest in reducing healthcare costs and improving quality of care in terms of patients outcomes and their perception. Research has found strong association between physical environments and patient outcomes and staff and patient wellbeing. The acknowledgement of this link has led to the postulation of the idea of evidence based design (EBD) of healthcare facilities, in which design decisions are based on the evidence of the impact of environment on healthcare indicators. The key challenges for integrating EBD in healthcare design are the difficulty in disaggregating past research findings (i.e. evidence) from the context and the use of these findings, often hidden behind several behavioural and demographic variables or of the form of multi-dimensional indices, in design decision-making. Another recent development in healthcare is the patient-centred approach of care, in which patients perceptions and needs take the centre-stage in the planning and delivery of their care. Local and regional healthcare authorities are, therefore, interested in incorporating patients views in all aspects of care, including the design and operation of health and care facilities. Considering the gaps in knowledge, this research was aimed at investigating: users perception of physical environment indicators that had the potential for influencing their wellbeing and care outcomes, and the integration of their perception in the design of healthcare facilities through automated space layout planning. Perceptions of physical environment indicators were investigated using structured questionnaires among three user groups: inpatients, outpatients and healthcare providers. Resulting perception indicators were then used in a prototype automated space layout planning system, developed as part of this research, to aid the optimization process. The research has identified significant differences in perception between different user groups, in particular between males and females. Analyses of scaled responses indicate that environmental design (e.g. lighting and thermal comfort) and maintenance (e.g. cleanliness) related factors are more important to users than abstract architectural design factors (e.g. aesthetics). Accommodating the variation in perception would require individual approaches for the design of constituent spaces in a healthcare facility. With regard to the integration of user perception in design, the research demonstrates that qualitative indicators such as perception can be integrated in automated design frameworks and, therefore, design decisions can be based on a mix of quantitative and qualitative evidence. The application of automated layout planning system in the design of healthcare space layouts also demonstrates that computer-mediated systems and frameworks are a promising alternative to traditional manual design, if increasing number of design factors and objectives are to be reconciled for decision making.

In the hospital building, where patients seek medical treatment and hospital staff provide continuous support, creating a healing environment is an imperative. However, it appears that the ultimate aim to create a healing environment is not given due attention by healthcare designers. Patients’ negative experiences of the existing physical environment of a hospital building describing as depressing, confusing, dull, little natural light, stressful, noisy causing sleep deprivation, anxiety, isolation and physical restraint were noted in many studies of the built environment. Most of these criticisms are also experienced by the patients in the case studies of hospital buildings in Malaysia, particularly on thermal (too warm) and visual (glare) discomfort. Therefore, the term ‘Healing Architecture’ is adopted to invoke a sense of a continuous process; creating an environment physically healthy and psychologically appropriate for patients’ well-being. A majority of the literature on the healing environment has reached a consensus that the physical aspects of built environment could contribute indirectly to the health outcomes of patients and staff in a hospital building. These include shorter length of stay, reduced stress and increased patients’ satisfaction. Among the physical aspects, daylighting is considered one of the most influential factors to achieve visual comfort contributing to a healing environment. The thesis aims to explore daylighting performance of a four-bed ward by means of a parametric study of design variables in order to achieve the visual as well as thermal comfort in creating a healing environment. Conflicting issues of ‘physical to physical’ (e.g. daylight vs. solar heat gain) and ‘physical to psychological’ (e.g. daylight vs. undesirable glare) are analysed. With the theme of daylight and health, previous studies related to the factors of the physical environments in hospital buildings that influence health outcomes are reviewed. The physical factors affecting daylighting to achieve visual comfort are also analysed. Reviews of the project briefs of the completed public hospital buildings in Malaysia are also conducted and seven hospitals are selected as the case studies to investigate daylighting conditions of the existing four-bed ward environment. Triangulation by means of analyses through questionnaire, measurement and computer simulation is the method adopted for the investigation. Available simulation programs are reviewed for suitability and compatibility of the study. The simulation software (validated) used for the study is Integrated Environmental Solutions – Virtual Environment (IES–VE). Based on the qualitative and quantitative analyses, it can be concluded that visual comfort in the existing four-bed ward environments of public hospital buildings in Malaysia is not achieved. Factors contributing to the failure are that the conflicting priorities (i.e. ‘physical vs. physical’ and ‘physical vs. psychological’) were not analysed by healthcare designers when designing a window (size and position), there is clear evidence of glare and daylighting design failed to meet the daylight factor (DF) requirement of 1% at the (innermost) bed-head. The finding is that a healing environment in the four-bed ward is not achieved. The results of the analysis also confirmed that the key physical factors affecting daylighting in the hospital ward are orientation, window design (size and position), external shading device, glass transmittance and indoor surface reflectances. Parametric studies of daylighting design variables on the ‘base case’ unit are formulated in order to find the remedy as well as to arrive at design guidelines. The Subang TRY weather data set is used and examined and found the two worst conditions days of the year: the hottest (day 60) and the cloudy (day 299). Evaluation criteria for measuring thermal as well as visual comfort are established to critically analyse the consequences of the variants in the permutations. A total of 186 simulations are run to appraise the comfort condition of the computer model of the four-bed ward environment. The simulation of daylighting conditions in a four-bed ward environment would take into consideration the magnitude of solar heat gain of one exposed wall (opaque wall and glass window) for the two selected worst days of the year and the ‘best’ orientation (other enclosing elements are taken as adiabatic). The results of the parametric study are analysed by adopting the process of elimination for the selection of variants. The variants of design variables that satisfy the evaluation criteria for comfort criteria set in the study are identified. Design recommendations are made and guidelines on how best to achieve visual comfort through daylighting design strategies in the hospital ward environment in the future are established. The findings arrive at two crucial conclusions in creating a healing environment. Firstly, visual comfort can be achieved through appropriate daylighting design.The second is that in order to achieve visual comfort in the four-bed ward environment there is a need to find a balance between the acceptable magnitude of solar heat gain and satisfying the requirement of daylighting (i.e. the acceptable limit of glare not exceeding a luminance ratio of 10 and 1% DF).

In the hospital building, where patients seek medical treatment and hospital staff provide continuous support, creating a healing environment is an imperative. However, it appears that the ultimate aim to create a healing environment is not given due attention by healthcare designers. Patients’ negative experiences of the existing physical environment of a hospital building describing as depressing, confusing, dull, little natural light, stressful, noisy causing sleep deprivation, anxiety, isolation and physical restraint were noted in many studies of the built environment. Most of these criticisms are also experienced by the patients in the case studies of hospital buildings in Malaysia, particularly on thermal (too warm) and visual (glare) discomfort. Therefore, the term ‘Healing Architecture’ is adopted to invoke a sense of a continuous process; creating an environment physically healthy and psychologically appropriate for patients’ well-being. A majority of the literature on the healing environment has reached a consensus that the physical aspects of built environment could contribute indirectly to the health outcomes of patients and staff in a hospital building. These include shorter length of stay, reduced stress and increased patients’ satisfaction. Among the physical aspects, daylighting is considered one of the most influential factors to achieve visual comfort contributing to a healing environment. The thesis aims to explore daylighting performance of a four-bed ward by means of a parametric study of design variables in order to achieve the visual as well as thermal comfort in creating a healing environment. Conflicting issues of ‘physical to physical’ (e.g. daylight vs. solar heat gain) and ‘physical to psychological’ (e.g. daylight vs. undesirable glare) are analysed. With the theme of daylight and health, previous studies related to the factors of the physical environments in hospital buildings that influence health outcomes are reviewed. The physical factors affecting daylighting to achieve visual comfort are also analysed. Reviews of the project briefs of the completed public hospital buildings in Malaysia are also conducted and seven hospitals are selected as the case studies to investigate daylighting conditions of the existing four-bed ward environment. Triangulation by means of analyses through questionnaire, measurement and computer simulation is the method adopted for the investigation. Available simulation programs are reviewed for suitability and compatibility of the study. The simulation software (validated) used for the study is Integrated Environmental Solutions – Virtual Environment (IES–VE). Based on the qualitative and quantitative analyses, it can be concluded that visual comfort in the existing four-bed ward environments of public hospital buildings in Malaysia is not achieved. Factors contributing to the failure are that the conflicting priorities (i.e. ‘physical vs. physical’ and ‘physical vs. psychological’) were not analysed by healthcare designers when designing a window (size and position), there is clear evidence of glare and daylighting design failed to meet the daylight factor (DF) requirement of 1% at the (innermost) bed-head. The finding is that a healing environment in the four-bed ward is not achieved. The results of the analysis also confirmed that the key physical factors affecting daylighting in the hospital ward are orientation, window design (size and position), external shading device, glass transmittance and indoor surface reflectances. Parametric studies of daylighting design variables on the ‘base case’ unit are formulated in order to find the remedy as well as to arrive at design guidelines. The Subang TRY weather data set is used and examined and found the two worst conditions days of the year: the hottest (day 60) and the cloudy (day 299). Evaluation criteria for measuring thermal as well as visual comfort are established to critically analyse the consequences of the variants in the permutations. A total of 186 simulations are run to appraise the comfort condition of the computer model of the four-bed ward environment. The simulation of daylighting conditions in a four-bed ward environment would take into consideration the magnitude of solar heat gain of one exposed wall (opaque wall and glass window) for the two selected worst days of the year and the ‘best’ orientation (other enclosing elements are taken as adiabatic). The results of the parametric study are analysed by adopting the process of elimination for the selection of variants. The variants of design variables that satisfy the evaluation criteria for comfort criteria set in the study are identified. Design recommendations are made and guidelines on how best to achieve visual comfort through daylighting design strategies in the hospital ward environment in the future are established. The findings arrive at two crucial conclusions in creating a healing environment. Firstly, visual comfort can be achieved through appropriate daylighting design.The second is that in order to achieve visual comfort in the four-bed ward environment there is a need to find a balance between the acceptable magnitude of solar heat gain and satisfying the requirement of daylighting (i.e. the acceptable limit of glare not exceeding a luminance ratio of 10 and 1% DF).

In the hospital building, where patients seek medical treatment and hospital staff provide continuous support, creating a healing environment is an imperative. However, it appears that the ultimate aim to create a healing environment is not given due attention by healthcare designers. Patients’ negative experiences of the existing physical environment of a hospital building describing as depressing, confusing, dull, little natural light, stressful, noisy causing sleep deprivation, anxiety, isolation and physical restraint were noted in many studies of the built environment. Most of these criticisms are also experienced by the patients in the case studies of hospital buildings in Malaysia, particularly on thermal (too warm) and visual (glare) discomfort. Therefore, the term ‘Healing Architecture’ is adopted to invoke a sense of a continuous process; creating an environment physically healthy and psychologically appropriate for patients’ well-being. A majority of the literature on the healing environment has reached a consensus that the physical aspects of built environment could contribute indirectly to the health outcomes of patients and staff in a hospital building. These include shorter length of stay, reduced stress and increased patients’ satisfaction. Among the physical aspects, daylighting is considered one of the most influential factors to achieve visual comfort contributing to a healing environment. The thesis aims to explore daylighting performance of a four-bed ward by means of a parametric study of design variables in order to achieve the visual as well as thermal comfort in creating a healing environment. Conflicting issues of ‘physical to physical’ (e.g. daylight vs. solar heat gain) and ‘physical to psychological’ (e.g. daylight vs. undesirable glare) are analysed. With the theme of daylight and health, previous studies related to the factors of the physical environments in hospital buildings that influence health outcomes are reviewed. The physical factors affecting daylighting to achieve visual comfort are also analysed. Reviews of the project briefs of the completed public hospital buildings in Malaysia are also conducted and seven hospitals are selected as the case studies to investigate daylighting conditions of the existing four-bed ward environment. Triangulation by means of analyses through questionnaire, measurement and computer simulation is the method adopted for the investigation. Available simulation programs are reviewed for suitability and compatibility of the study. The simulation software (validated) used for the study is Integrated Environmental Solutions – Virtual Environment (IES–VE). Based on the qualitative and quantitative analyses, it can be concluded that visual comfort in the existing four-bed ward environments of public hospital buildings in Malaysia is not achieved. Factors contributing to the failure are that the conflicting priorities (i.e. ‘physical vs. physical’ and ‘physical vs. psychological’) were not analysed by healthcare designers when designing a window (size and position), there is clear evidence of glare and daylighting design failed to meet the daylight factor (DF) requirement of 1% at the (innermost) bed-head. The finding is that a healing environment in the four-bed ward is not achieved. The results of the analysis also confirmed that the key physical factors affecting daylighting in the hospital ward are orientation, window design (size and position), external shading device, glass transmittance and indoor surface reflectances. Parametric studies of daylighting design variables on the ‘base case’ unit are formulated in order to find the remedy as well as to arrive at design guidelines. The Subang TRY weather data set is used and examined and found the two worst conditions days of the year: the hottest (day 60) and the cloudy (day 299). Evaluation criteria for measuring thermal as well as visual comfort are established to critically analyse the consequences of the variants in the permutations. A total of 186 simulations are run to appraise the comfort condition of the computer model of the four-bed ward environment. The simulation of daylighting conditions in a four-bed ward environment would take into consideration the magnitude of solar heat gain of one exposed wall (opaque wall and glass window) for the two selected worst days of the year and the ‘best’ orientation (other enclosing elements are taken as adiabatic). The results of the parametric study are analysed by adopting the process of elimination for the selection of variants. The variants of design variables that satisfy the evaluation criteria for comfort criteria set in the study are identified. Design recommendations are made and guidelines on how best to achieve visual comfort through daylighting design strategies in the hospital ward environment in the future are established. The findings arrive at two crucial conclusions in creating a healing environment. Firstly, visual comfort can be achieved through appropriate daylighting design.The second is that in order to achieve visual comfort in the four-bed ward environment there is a need to find a balance between the acceptable magnitude of solar heat gain and satisfying the requirement of daylighting (i.e. the acceptable limit of glare not exceeding a luminance ratio of 10 and 1% DF).

In the hospital building, where patients seek medical treatment and hospital staff provide continuous support, creating a healing environment is an imperative. However, it appears that the ultimate aim to create a healing environment is not given due attention by healthcare designers. Patients’ negative experiences of the existing physical environment of a hospital building describing as depressing, confusing, dull, little natural light, stressful, noisy causing sleep deprivation, anxiety, isolation and physical restraint were noted in many studies of the built environment. Most of these criticisms are also experienced by the patients in the case studies of hospital buildings in Malaysia, particularly on thermal (too warm) and visual (glare) discomfort. Therefore, the term ‘Healing Architecture’ is adopted to invoke a sense of a continuous process; creating an environment physically healthy and psychologically appropriate for patients’ well-being. A majority of the literature on the healing environment has reached a consensus that the physical aspects of built environment could contribute indirectly to the health outcomes of patients and staff in a hospital building. These include shorter length of stay, reduced stress and increased patients’ satisfaction. Among the physical aspects, daylighting is considered one of the most influential factors to achieve visual comfort contributing to a healing environment. The thesis aims to explore daylighting performance of a four-bed ward by means of a parametric study of design variables in order to achieve the visual as well as thermal comfort in creating a healing environment. Conflicting issues of ‘physical to physical’ (e.g. daylight vs. solar heat gain) and ‘physical to psychological’ (e.g. daylight vs. undesirable glare) are analysed. With the theme of daylight and health, previous studies related to the factors of the physical environments in hospital buildings that influence health outcomes are reviewed. The physical factors affecting daylighting to achieve visual comfort are also analysed. Reviews of the project briefs of the completed public hospital buildings in Malaysia are also conducted and seven hospitals are selected as the case studies to investigate daylighting conditions of the existing four-bed ward environment. Triangulation by means of analyses through questionnaire, measurement and computer simulation is the method adopted for the investigation. Available simulation programs are reviewed for suitability and compatibility of the study. The simulation software (validated) used for the study is Integrated Environmental Solutions – Virtual Environment (IES–VE). Based on the qualitative and quantitative analyses, it can be concluded that visual comfort in the existing four-bed ward environments of public hospital buildings in Malaysia is not achieved. Factors contributing to the failure are that the conflicting priorities (i.e. ‘physical vs. physical’ and ‘physical vs. psychological’) were not analysed by healthcare designers when designing a window (size and position), there is clear evidence of glare and daylighting design failed to meet the daylight factor (DF) requirement of 1% at the (innermost) bed-head. The finding is that a healing environment in the four-bed ward is not achieved. The results of the analysis also confirmed that the key physical factors affecting daylighting in the hospital ward are orientation, window design (size and position), external shading device, glass transmittance and indoor surface reflectances. Parametric studies of daylighting design variables on the ‘base case’ unit are formulated in order to find the remedy as well as to arrive at design guidelines. The Subang TRY weather data set is used and examined and found the two worst conditions days of the year: the hottest (day 60) and the cloudy (day 299). Evaluation criteria for measuring thermal as well as visual comfort are established to critically analyse the consequences of the variants in the permutations. A total of 186 simulations are run to appraise the comfort condition of the computer model of the four-bed ward environment. The simulation of daylighting conditions in a four-bed ward environment would take into consideration the magnitude of solar heat gain of one exposed wall (opaque wall and glass window) for the two selected worst days of the year and the ‘best’ orientation (other enclosing elements are taken as adiabatic). The results of the parametric study are analysed by adopting the process of elimination for the selection of variants. The variants of design variables that satisfy the evaluation criteria for comfort criteria set in the study are identified. Design recommendations are made and guidelines on how best to achieve visual comfort through daylighting design strategies in the hospital ward environment in the future are established. The findings arrive at two crucial conclusions in creating a healing environment. Firstly, visual comfort can be achieved through appropriate daylighting design.The second is that in order to achieve visual comfort in the four-bed ward environment there is a need to find a balance between the acceptable magnitude of solar heat gain and satisfying the requirement of daylighting (i.e. the acceptable limit of glare not exceeding a luminance ratio of 10 and 1% DF).

In the hospital building, where patients seek medical treatment and hospital staff provide continuous support, creating a healing environment is an imperative. However, it appears that the ultimate aim to create a healing environment is not given due attention by healthcare designers. Patients’ negative experiences of the existing physical environment of a hospital building describing as depressing, confusing, dull, little natural light, stressful, noisy causing sleep deprivation, anxiety, isolation and physical restraint were noted in many studies of the built environment. Most of these criticisms are also experienced by the patients in the case studies of hospital buildings in Malaysia, particularly on thermal (too warm) and visual (glare) discomfort. Therefore, the term ‘Healing Architecture’ is adopted to invoke a sense of a continuous process; creating an environment physically healthy and psychologically appropriate for patients’ well-being. A majority of the literature on the healing environment has reached a consensus that the physical aspects of built environment could contribute indirectly to the health outcomes of patients and staff in a hospital building. These include shorter length of stay, reduced stress and increased patients’ satisfaction. Among the physical aspects, daylighting is considered one of the most influential factors to achieve visual comfort contributing to a healing environment. The thesis aims to explore daylighting performance of a four-bed ward by means of a parametric study of design variables in order to achieve the visual as well as thermal comfort in creating a healing environment. Conflicting issues of ‘physical to physical’ (e.g. daylight vs. solar heat gain) and ‘physical to psychological’ (e.g. daylight vs. undesirable glare) are analysed. With the theme of daylight and health, previous studies related to the factors of the physical environments in hospital buildings that influence health outcomes are reviewed. The physical factors affecting daylighting to achieve visual comfort are also analysed. Reviews of the project briefs of the completed public hospital buildings in Malaysia are also conducted and seven hospitals are selected as the case studies to investigate daylighting conditions of the existing four-bed ward environment. Triangulation by means of analyses through questionnaire, measurement and computer simulation is the method adopted for the investigation. Available simulation programs are reviewed for suitability and compatibility of the study. The simulation software (validated) used for the study is Integrated Environmental Solutions – Virtual Environment (IES–VE). Based on the qualitative and quantitative analyses, it can be concluded that visual comfort in the existing four-bed ward environments of public hospital buildings in Malaysia is not achieved. Factors contributing to the failure are that the conflicting priorities (i.e. ‘physical vs. physical’ and ‘physical vs. psychological’) were not analysed by healthcare designers when designing a window (size and position), there is clear evidence of glare and daylighting design failed to meet the daylight factor (DF) requirement of 1% at the (innermost) bed-head. The finding is that a healing environment in the four-bed ward is not achieved. The results of the analysis also confirmed that the key physical factors affecting daylighting in the hospital ward are orientation, window design (size and position), external shading device, glass transmittance and indoor surface reflectances. Parametric studies of daylighting design variables on the ‘base case’ unit are formulated in order to find the remedy as well as to arrive at design guidelines. The Subang TRY weather data set is used and examined and found the two worst conditions days of the year: the hottest (day 60) and the cloudy (day 299). Evaluation criteria for measuring thermal as well as visual comfort are established to critically analyse the consequences of the variants in the permutations. A total of 186 simulations are run to appraise the comfort condition of the computer model of the four-bed ward environment. The simulation of daylighting conditions in a four-bed ward environment would take into consideration the magnitude of solar heat gain of one exposed wall (opaque wall and glass window) for the two selected worst days of the year and the ‘best’ orientation (other enclosing elements are taken as adiabatic). The results of the parametric study are analysed by adopting the process of elimination for the selection of variants. The variants of design variables that satisfy the evaluation criteria for comfort criteria set in the study are identified. Design recommendations are made and guidelines on how best to achieve visual comfort through daylighting design strategies in the hospital ward environment in the future are established. The findings arrive at two crucial conclusions in creating a healing environment. Firstly, visual comfort can be achieved through appropriate daylighting design.The second is that in order to achieve visual comfort in the four-bed ward environment there is a need to find a balance between the acceptable magnitude of solar heat gain and satisfying the requirement of daylighting (i.e. the acceptable limit of glare not exceeding a luminance ratio of 10 and 1% DF).

In the hospital building, where patients seek medical treatment and hospital staff provide continuous support, creating a healing environment is an imperative. However, it appears that the ultimate aim to create a healing environment is not given due attention by healthcare designers. Patients’ negative experiences of the existing physical environment of a hospital building describing as depressing, confusing, dull, little natural light, stressful, noisy causing sleep deprivation, anxiety, isolation and physical restraint were noted in many studies of the built environment. Most of these criticisms are also experienced by the patients in the case studies of hospital buildings in Malaysia, particularly on thermal (too warm) and visual (glare) discomfort. Therefore, the term ‘Healing Architecture’ is adopted to invoke a sense of a continuous process; creating an environment physically healthy and psychologically appropriate for patients’ well-being. A majority of the literature on the healing environment has reached a consensus that the physical aspects of built environment could contribute indirectly to the health outcomes of patients and staff in a hospital building. These include shorter length of stay, reduced stress and increased patients’ satisfaction. Among the physical aspects, daylighting is considered one of the most influential factors to achieve visual comfort contributing to a healing environment. The thesis aims to explore daylighting performance of a four-bed ward by means of a parametric study of design variables in order to achieve the visual as well as thermal comfort in creating a healing environment. Conflicting issues of ‘physical to physical’ (e.g. daylight vs. solar heat gain) and ‘physical to psychological’ (e.g. daylight vs. undesirable glare) are analysed. With the theme of daylight and health, previous studies related to the factors of the physical environments in hospital buildings that influence health outcomes are reviewed. The physical factors affecting daylighting to achieve visual comfort are also analysed. Reviews of the project briefs of the completed public hospital buildings in Malaysia are also conducted and seven hospitals are selected as the case studies to investigate daylighting conditions of the existing four-bed ward environment. Triangulation by means of analyses through questionnaire, measurement and computer simulation is the method adopted for the investigation. Available simulation programs are reviewed for suitability and compatibility of the study. The simulation software (validated) used for the study is Integrated Environmental Solutions – Virtual Environment (IES–VE). Based on the qualitative and quantitative analyses, it can be concluded that visual comfort in the existing four-bed ward environments of public hospital buildings in Malaysia is not achieved. Factors contributing to the failure are that the conflicting priorities (i.e. ‘physical vs. physical’ and ‘physical vs. psychological’) were not analysed by healthcare designers when designing a window (size and position), there is clear evidence of glare and daylighting design failed to meet the daylight factor (DF) requirement of 1% at the (innermost) bed-head. The finding is that a healing environment in the four-bed ward is not achieved. The results of the analysis also confirmed that the key physical factors affecting daylighting in the hospital ward are orientation, window design (size and position), external shading device, glass transmittance and indoor surface reflectances. Parametric studies of daylighting design variables on the ‘base case’ unit are formulated in order to find the remedy as well as to arrive at design guidelines. The Subang TRY weather data set is used and examined and found the two worst conditions days of the year: the hottest (day 60) and the cloudy (day 299). Evaluation criteria for measuring thermal as well as visual comfort are established to critically analyse the consequences of the variants in the permutations. A total of 186 simulations are run to appraise the comfort condition of the computer model of the four-bed ward environment. The simulation of daylighting conditions in a four-bed ward environment would take into consideration the magnitude of solar heat gain of one exposed wall (opaque wall and glass window) for the two selected worst days of the year and the ‘best’ orientation (other enclosing elements are taken as adiabatic). The results of the parametric study are analysed by adopting the process of elimination for the selection of variants. The variants of design variables that satisfy the evaluation criteria for comfort criteria set in the study are identified. Design recommendations are made and guidelines on how best to achieve visual comfort through daylighting design strategies in the hospital ward environment in the future are established. The findings arrive at two crucial conclusions in creating a healing environment. Firstly, visual comfort can be achieved through appropriate daylighting design.The second is that in order to achieve visual comfort in the four-bed ward environment there is a need to find a balance between the acceptable magnitude of solar heat gain and satisfying the requirement of daylighting (i.e. the acceptable limit of glare not exceeding a luminance ratio of 10 and 1% DF).

In the hospital building, where patients seek medical treatment and hospital staff provide continuous support, creating a healing environment is an imperative. However, it appears that the ultimate aim to create a healing environment is not given due attention by healthcare designers. Patients’ negative experiences of the existing physical environment of a hospital building describing as depressing, confusing, dull, little natural light, stressful, noisy causing sleep deprivation, anxiety, isolation and physical restraint were noted in many studies of the built environment. Most of these criticisms are also experienced by the patients in the case studies of hospital buildings in Malaysia, particularly on thermal (too warm) and visual (glare) discomfort. Therefore, the term ‘Healing Architecture’ is adopted to invoke a sense of a continuous process; creating an environment physically healthy and psychologically appropriate for patients’ well-being. A majority of the literature on the healing environment has reached a consensus that the physical aspects of built environment could contribute indirectly to the health outcomes of patients and staff in a hospital building. These include shorter length of stay, reduced stress and increased patients’ satisfaction. Among the physical aspects, daylighting is considered one of the most influential factors to achieve visual comfort contributing to a healing environment. The thesis aims to explore daylighting performance of a four-bed ward by means of a parametric study of design variables in order to achieve the visual as well as thermal comfort in creating a healing environment. Conflicting issues of ‘physical to physical’ (e.g. daylight vs. solar heat gain) and ‘physical to psychological’ (e.g. daylight vs. undesirable glare) are analysed. With the theme of daylight and health, previous studies related to the factors of the physical environments in hospital buildings that influence health outcomes are reviewed. The physical factors affecting daylighting to achieve visual comfort are also analysed. Reviews of the project briefs of the completed public hospital buildings in Malaysia are also conducted and seven hospitals are selected as the case studies to investigate daylighting conditions of the existing four-bed ward environment. Triangulation by means of analyses through questionnaire, measurement and computer simulation is the method adopted for the investigation. Available simulation programs are reviewed for suitability and compatibility of the study. The simulation software (validated) used for the study is Integrated Environmental Solutions – Virtual Environment (IES–VE). Based on the qualitative and quantitative analyses, it can be concluded that visual comfort in the existing four-bed ward environments of public hospital buildings in Malaysia is not achieved. Factors contributing to the failure are that the conflicting priorities (i.e. ‘physical vs. physical’ and ‘physical vs. psychological’) were not analysed by healthcare designers when designing a window (size and position), there is clear evidence of glare and daylighting design failed to meet the daylight factor (DF) requirement of 1% at the (innermost) bed-head. The finding is that a healing environment in the four-bed ward is not achieved. The results of the analysis also confirmed that the key physical factors affecting daylighting in the hospital ward are orientation, window design (size and position), external shading device, glass transmittance and indoor surface reflectances. Parametric studies of daylighting design variables on the ‘base case’ unit are formulated in order to find the remedy as well as to arrive at design guidelines. The Subang TRY weather data set is used and examined and found the two worst conditions days of the year: the hottest (day 60) and the cloudy (day 299). Evaluation criteria for measuring thermal as well as visual comfort are established to critically analyse the consequences of the variants in the permutations. A total of 186 simulations are run to appraise the comfort condition of the computer model of the four-bed ward environment. The simulation of daylighting conditions in a four-bed ward environment would take into consideration the magnitude of solar heat gain of one exposed wall (opaque wall and glass window) for the two selected worst days of the year and the ‘best’ orientation (other enclosing elements are taken as adiabatic). The results of the parametric study are analysed by adopting the process of elimination for the selection of variants. The variants of design variables that satisfy the evaluation criteria for comfort criteria set in the study are identified. Design recommendations are made and guidelines on how best to achieve visual comfort through daylighting design strategies in the hospital ward environment in the future are established. The findings arrive at two crucial conclusions in creating a healing environment. Firstly, visual comfort can be achieved through appropriate daylighting design.The second is that in order to achieve visual comfort in the four-bed ward environment there is a need to find a balance between the acceptable magnitude of solar heat gain and satisfying the requirement of daylighting (i.e. the acceptable limit of glare not exceeding a luminance ratio of 10 and 1% DF).

In the hospital building, where patients seek medical treatment and hospital staff provide continuous support, creating a healing environment is an imperative. However, it appears that the ultimate aim to create a healing environment is not given due attention by healthcare designers. Patients’ negative experiences of the existing physical environment of a hospital building describing as depressing, confusing, dull, little natural light, stressful, noisy causing sleep deprivation, anxiety, isolation and physical restraint were noted in many studies of the built environment. Most of these criticisms are also experienced by the patients in the case studies of hospital buildings in Malaysia, particularly on thermal (too warm) and visual (glare) discomfort. Therefore, the term ‘Healing Architecture’ is adopted to invoke a sense of a continuous process; creating an environment physically healthy and psychologically appropriate for patients’ well-being. A majority of the literature on the healing environment has reached a consensus that the physical aspects of built environment could contribute indirectly to the health outcomes of patients and staff in a hospital building. These include shorter length of stay, reduced stress and increased patients’ satisfaction. Among the physical aspects, daylighting is considered one of the most influential factors to achieve visual comfort contributing to a healing environment. The thesis aims to explore daylighting performance of a four-bed ward by means of a parametric study of design variables in order to achieve the visual as well as thermal comfort in creating a healing environment. Conflicting issues of ‘physical to physical’ (e.g. daylight vs. solar heat gain) and ‘physical to psychological’ (e.g. daylight vs. undesirable glare) are analysed. With the theme of daylight and health, previous studies related to the factors of the physical environments in hospital buildings that influence health outcomes are reviewed. The physical factors affecting daylighting to achieve visual comfort are also analysed. Reviews of the project briefs of the completed public hospital buildings in Malaysia are also conducted and seven hospitals are selected as the case studies to investigate daylighting conditions of the existing four-bed ward environment. Triangulation by means of analyses through questionnaire, measurement and computer simulation is the method adopted for the investigation. Available simulation programs are reviewed for suitability and compatibility of the study. The simulation software (validated) used for the study is Integrated Environmental Solutions – Virtual Environment (IES–VE). Based on the qualitative and quantitative analyses, it can be concluded that visual comfort in the existing four-bed ward environments of public hospital buildings in Malaysia is not achieved. Factors contributing to the failure are that the conflicting priorities (i.e. ‘physical vs. physical’ and ‘physical vs. psychological’) were not analysed by healthcare designers when designing a window (size and position), there is clear evidence of glare and daylighting design failed to meet the daylight factor (DF) requirement of 1% at the (innermost) bed-head. The finding is that a healing environment in the four-bed ward is not achieved. The results of the analysis also confirmed that the key physical factors affecting daylighting in the hospital ward are orientation, window design (size and position), external shading device, glass transmittance and indoor surface reflectances. Parametric studies of daylighting design variables on the ‘base case’ unit are formulated in order to find the remedy as well as to arrive at design guidelines. The Subang TRY weather data set is used and examined and found the two worst conditions days of the year: the hottest (day 60) and the cloudy (day 299). Evaluation criteria for measuring thermal as well as visual comfort are established to critically analyse the consequences of the variants in the permutations. A total of 186 simulations are run to appraise the comfort condition of the computer model of the four-bed ward environment. The simulation of daylighting conditions in a four-bed ward environment would take into consideration the magnitude of solar heat gain of one exposed wall (opaque wall and glass window) for the two selected worst days of the year and the ‘best’ orientation (other enclosing elements are taken as adiabatic). The results of the parametric study are analysed by adopting the process of elimination for the selection of variants. The variants of design variables that satisfy the evaluation criteria for comfort criteria set in the study are identified. Design recommendations are made and guidelines on how best to achieve visual comfort through daylighting design strategies in the hospital ward environment in the future are established. The findings arrive at two crucial conclusions in creating a healing environment. Firstly, visual comfort can be achieved through appropriate daylighting design.The second is that in order to achieve visual comfort in the four-bed ward environment there is a need to find a balance between the acceptable magnitude of solar heat gain and satisfying the requirement of daylighting (i.e. the acceptable limit of glare not exceeding a luminance ratio of 10 and 1% DF).

The transfer of information between the different phases of construction projects is limited, which complicates the quality assurance of configurations. Functional requirements on the building configuration are often ambiguous and lack measurable acceptance criteria. Vaguely described criteria provide an insufficient basis for the design and verification acceptance values. The contractor is often the first to consider the feasibility just before or during the production phase. However, feasibility including production methods should be considered with the establishment of each design solutions. Costs or time consequences are often the basis for change decisions, while the investigations of the impact on the building configuration and functionality are insufficient. A continuous flow of information with functional requirements as a controlling factor is required to control configurations. Functionality that ensure high quality patient care are essential in health care facilities, therefore the control of the configurations are particularly important. This licentiate thesis shows how configuration information in healthcare construction projects can ensure necessary building functionality. The following information areas are identified as necessary for control of configurations: function, verification, design solution, production and change control. All information is related and changes in one area affect the others, directly or indirectly during construction projects. The studies that are the basis of this licentiate thesis show that the management of configuration information was deficient in healthcare construction projects, especially regarding availability and interconnectivity. In addition, the information was not available at the right time during the construction process, which impaired configuration control. For example, verification methods were not available until the end of production. This precluded verification of intended functionality through large parts of the construction project. Detailed change information from digital models of buildings can significantly improve control of configurations, but this requires standardisation of input data. In the manufacturing industry, configuration management is practised to ensure that products fulfil the required functions throughout their entire lifecycle. Development of new technologies, such as digital processes and industrialised construction, require that construction projects develop working processes similar to those of the manufacturing industry. The risk of unnecessary rework with subsequent cost increases, delays and environmental impact decrease with increased control of the configuration. In construction projects, systematic management of configuration information can ensure delivery of healthcare facilities with intended functionality. / Överföringen av information mellan de olika faserna i byggprojekt är ofta begränsad, vilket försvårar kvalitetssäkring av utformningen. De funktionella kraven på byggnadens utformning är ofta tvetydiga och saknar mätbara acceptanskriterier. Det ger en otillräcklig grund för projekteringslösningarnas och verifieringsmetodernas acceptansvärden. Möjligheten att färdigställa en utformning övervägs ofta av entreprenören precis före eller under produktionsfasen, men bör säkerställas för varje projekteringslösning. Beslut gällande ändringar baseras ofta på kostnads- eller tidskonsekvenser, medan utredningar av hur byggnaders utformning och påverkas är otillräcklig. Ett kontinuerligt informationsflöde med funktionella krav som styrande faktor krävs för att kontrollera utformning. Kvaliteten på patientvården måste säkerställas i vårdbyggnader, därför blir kontroll av utformningen är särskilt viktig. Denna licentiatuppsats visar hur utformningsinformation i vårdbyggnadsprojekt kan säkerställa anläggningens funktionalitet. Följande informationsområden identifieras som nödvändiga för kontroll av utformningen: funktion, verifiering, designlösning, produktion och ändringskontroll. Information gällande utformningen av en byggnadsdel är relaterad och ändringar inom ett område påverkar de andra, direkt eller indirekt under ett byggprojekt. Studierna som ligger till grund för denna licentiatuppsats visar att det finns brister inom alla områden av utformningsinformation, speciellt gällande tillgänglighet och sammankoppling. Kontroll av utformningen försvårades dessutom av att informationen inte var tillgänglig vid rätt tidpunkt under byggprocessen. Verifieringsmetoder fanns till exempel inte tillgängliga förrän i slutet av produktionen. Det försvårar säkerställandet av avsedda utformning genom stora delar av projektet. Detaljerad information från digitala byggnadsmodeller kan förbättra kontrollen av vårdbyggnaders utformning, men det kräver standardisering av indata. Tillverkningsindustrin utövar konfigurationsledning för att säkerställa att produkters utformning motsvarar kravställda funktioner genom hela deras livscykel. Utvecklingen av nya tekniker, såsom digitala processer och industriell produktion, kräver att byggprojekt utvecklar arbetsprocesser som liknar de i tillverkningsindustrin. Risken för onödiga omarbetningar med efterföljande kostnadsökningar, förseningar och miljöpåverkan minskar med ökad utformningskontroll. Systematisk hantering av utformningsinformation i vårdbyggnadsprojekt kan säkerställa att leveransen uppfyller avsedd funktionalitet. / <p>QC 20201002</p>