Outdoor environments in healthcare settings: A quality evaluation tool for use in designing healthcare gardens

This article presents the first outline of a quality evaluation tool (QET) to be used in the process of designing outdoor environments in healthcare settings, e.g. healthcare gardens. Theory triangulation is used to integrate theories and evidence from selected research on people's health/well-being and the outdoor environment. The results first present the theoretical principles underlying the tool and justifying its practical construction. Then, 19 environmental qualities constituting the backbone of the practical tool are presented, including six qualities based on the need to be comfortable in the outdoor environment and 13 qualities based on the need for access to nature and surrounding life. Furthermore, this work presents suggestions of how the tool might include concepts dealing with how users can become involved in the design process, as well as general design guidelines corresponding to the various needs and wishes users may have. The paper ends with a discussion that, among other things, relates the QET to evidence-based design, salutogenesis and pathogenesis.