Architectural and Built Environment Determinants of Satisfaction in Selected Healthcare Facilities

Abstract

This study investigates the influence of architectural and built environment determinants on users’ satisfaction within selected Federal University Teaching Hospitals in Southwest Nigeria. The study is founded on the premise that the quality of healthcare environments significantly shapes patients’ experiences and perceptions of healthcare delivery. A descriptive mixed-methods approach was adopted, combining structured questionnaire surveys with semi-structured interviews and content analysis. Data were collected using a mixed-methods approach from 575 hospital users comprising 204 staff and 371 patients (242 out-patients and 129 in-patients), complemented with semi-structured interviews and direct observations across Lagos University Teaching Hospital (LUTH), University College Hospital (UCH), and Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC). The study examined users’ perceptions of key physical environment attributes, including spatial comfort, cleanliness, wayfinding systems, environmental quality, accessibility, and the availability of amenities. Quantitative findings revealed generally low levels of satisfaction with the hospital physical environment among both staff and patients. Among out-patients, 83.1% were dissatisfied with the availability of basic amenities, 79.3% reported difficulties with wayfinding, 78.5% expressed dissatisfaction with interior spatial comfort, and 76.0% were dissatisfied with signage and information points. However, cleanliness of treatment environments received relatively better ratings, with 35.5% of respondents expressing satisfaction. Qualitative interviews corroborated these findings, highlighting concerns about ageing infrastructure, inadequate maintenance, poor wayfinding systems, insufficient supporting facilities, and the need for renovation and modernization of hospital environments. Qualitative findings further revealed concerns regarding ageing infrastructure, inadequate maintenance, and insufficient supporting facilities across the hospitals. The study concludes that improvements in functional planning, environmental quality, infrastructure renewal, provision of essential amenities, and effective wayfinding systems are critical to enhancing users’ satisfaction and healthcare experiences in Nigerian teaching hospitals.