© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
38
F om use pe cep ion o a chi ec u e
Imp o ing a i al and wai ing spaces in p ima y heal hca e cen es
Nježić Ž., Budapes Uni e si y o Technology and Economics, Hunga y,
ORCID 0000-0002-5347-642X, zaklina.n[email p o ec ed]
Sch ammel Z., Budapes Uni e si y o Technology and Economics, Hunga y,
ORCID 0009-0000-9691-0727, sch ammel.zol [email protected]
Mandoki R.,Budapes Uni e si y o Technology and Economics, Hunga y,
ORCID 0000-0002-9470-6527, mandoki. ek[email p o ec ed]me.hu
Recei ed: 2024-03-21 | Accep ed: 2025-01-29 | Publica ion: 2025-05-11
Abs ac : This esea ch pape examines p ima y heal hca e acili ies in Mon eneg o, ocusing on
ou pa ien spaces - a i al in as uc u e, ou side spaces, and inside spaces. In Mon eneg o,
p ima y heal h cen es p o ide 80-85% o all heal h ca e se ices and a e designed o se e
pa ien s wi hin he de ined local communi y. In hese acili ies, he main aine o p ima y ca e is
a chosen doc o (GP), a pe son mos amilia wi h he pa ien 's condi ions and social backg ound.
Despi e he pe sonal se ice heal hca e cen es p o ide, he a chi ec u al exp essions o he buil
acili ies do no e lec he in ima e na u e o pe sonalisa ion o his se ice. By examining he
use expe ience and doing ield esea ch, we iden i ied se e al sho comings in hese acili ies'
ex e io and in e io quali y. Da a was ga he ed h ough a ques ionnai e in ol ing use s and ield
esea ch, encompassing la ge, medium, and small-sized heal hca e cen es. Pa icipan s ini ially
exp essed neu al pe cep ions o exis ing elemen s, bu when gi en he oppo uni y o choose,
hey became mo e inclined o sugges imp o emen s. The ield s udy iden i ied a he nega i e
a chi ec u al aspec s, including inconsis encies in pe o mance ac oss he acili ies. The design
p ima ily se es he unc ional equi emen s de e mined by he cu en capaci y, whe eas
conside a ions ega ding aes he ics and he use s' com o a e o en neglec ed. The indings
highligh he need o align a chi ec u al design wi h use p e e ences, emphasising he
signi icance o use -cen ic heal hca e acili y design in Mon eneg o and simila en i onmen s.
Keywo ds: heal hca e sys em, p ima y heal hca e cen es, ou pa ien spaces, pe sonalisa ion,
a chi ec u al epo , Mon eneg o.
1. In oduc ion
Mon eneg o p o ides heal hca e se ices on h ee le els. The i s le el is p ima y heal hca e,
p o ided by a gene al p ac i ione (GP) called a 'chosen doc o ' o a eam o doc o s in he heal h
cen e. The seconda y heal hca e le el p o ides special clinics and hospi al wa ds; he e ia y
le el suppo s i wi h sub-specialis clinics (Mon eneg o Minis y o Heal h, 2015). The majo i y
o heal hca e p o ide s a e public en i ies. The heal hca e ins i u ions can be in a s andalone
building o a designa ed space wi hin a esiden ial o mixed-use building wi h a sepa a e en ance
and exi . The o icial gaze e o Mon eneg o om 2008 s a ed ha all spaces o conduc ing
heal hca e ac i i ies mus o m a single uni and be comple ely physically sepa a ed om any
o he esiden ial o o ice spaces (Službeni lis C ne Go e, 2008).
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
39
The Mas e Plan o he De elopmen o he Heal h Sys em o he Yea s 2015–2020 highligh s
he impo ance o p ima y ca e in enhancing popula ion heal h and b inging down medical
expenses (Mon eneg o Minis y o Heal h, 2015). The p ima y poin o a pa ien 's access o he
heal hca e sys em is he chosen doc o (Mosca e al., 2022). Howe e , p ima y ca e is no being
used o i s ull po en ial (Wo ld Heal h O ganiza ion, 2020).
In Mon eneg o, he e a e 18 p ima y heal h ca e acili ies, which p o ide bo h p ima y ca e
se ices and addi ional se ices o e ed by suppo acili ies. Suppo ing se ices include
diagnos ic and p e en ion cen es, home isi s and pa ien anspo uni s, cen es o lung
diseases and ube culosis, men al heal h cen es, cen es o child en wi h special needs, dayca e
cen es, and p ima y-le el physical he apy uni s. In daily se ice deli e y, p ima y ca e se ings
di e om hospi al inpa ien se ings, whe e pa ien s a e ca ed o con inuously and equen ly
o longe pe iods. In con as , in p ima y se ice, pa ien s ecei e ea men almos immedia ely.
Many heal h p oblems can be esol ed en i ely in p ima y ca e, and pa ien s who equi e
seconda y ca e se ices a e i s e alua ed he e (Mo gan e al., 2021). Howe e , e en o
diseases ha may ecei e ea men in p ima y ca e, he cu en Mon eneg in p ima y-ca e
model and he chosen doc o s' paymen s uc u es encou age e e als o specialis se ices. This
model con as s wi h he go e nmen 's goal, which has exis ed since 2005, o o ganising p ima y
ca e o add ess up o 80-85% o he popula ion's heal hca e needs (Go e nmen o Mon eneg o,
2022a).
Mechanic (2004) s a es ha choosing a pe sonal doc o and ca e se ings, con inuous ca e, and
e ec i e communica ion con ibu e o us in heal hca e quali y. He poin s ou ha cen al o
pa ien s' us is how doc o s communica e and whe he hey seem ca ing. P ima y heal hca e
sa is ac ion could esul om good p ac ice o ganisa ion o good pe sonal ela ions wi h he GP
(Gabbo & Hogg, 2010). Neighbou hoods wi h mo e p ima y ca e physicians end o ha e
heal hie pa ien s, as g ea e access o p ima y ca e is associa ed wi h be e heal h ou comes.
The p ima y ca e physician can in luence unheal hy beha iou s o p e en diseases hanks o his
us ing ela ionship (K is e al., 2016). Ideally, indi iduals should connec wi h a p ima y ca e
physician when hey a e heal hy.
Besides he quali y o heal h se ices, he a chi ec u al design o heal hca e acili ies also impac s
pa ien sa is ac ion. The a mosphe e c ea ed by he physical en i onmen can p edic pa ien s'
sa is ac ion, hei in en ion o e u n, and hei willingness o ecommend a heal hca e p o ide
o o he s(Hu on & Richa dson, 1995). E idence sugges s ha ac o s unde he con ol o
a chi ec s can signi ican ly a ec pa ien sa is ac ion and in luence he quali y o li e, ea men
imes, medica ion le els, displayed agg ession, sleep pa e ns, and compliance wi h egimes,
among o he ac o s (Lawson, 2010).
1.1. Objec i es
The dominance o esea ch on inpa ien acili y en i onmen s and he lack o s udies on
ou pa ien o p ima y ca e acili ies in he heal hca e design li e a u e is no iceable (Wa son e
al., 2016). The e a e signi ican gaps in he li e a u e ega ding he ypes o ou pa ien o p ima y
ca e buildings and isi o s' iewpoin s wi hin he social spaces o heal hca e en i onmen s.
Resea ch abou use pe spec i es in hese se ings has been done sepa a ely o pa ien s
(Jo ano ić e al., 2022) and s a (Oandasan e al., 2009) o discussed om a combina ion o bo h
(Huisman e al., 2012).
The e is cu en ly no much esea ch ega ding he social con ex o heal hca e buildings and
hei design aspec s in Mon eneg o. While su eys ha e measu ed he use s' sa is ac ion wi h
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
40
se ices, none add essed he space quali y o hese se ices. This pape 's analysis s a s wi h
a eas o a i al whe e use s ge hei i s imp ession o he acili y. The esea ch deals wi h he
use s' imp ession o a i al and wai ing wi hin he acili y and examines whe he some design
elemen s a e pe cei ed di e en ly. By collec ing da a om pa ien s, s a , and accompanying
pe sons, his s udy can con ibu e o use s' sa is ac ion da abases wi h aspec s ha conside
sa is ac ion wi h he physical appea ance o he acili ies. Hospi al clinical p ac ices mainly ocus
on ea ing he illness a he han on a pa ien 's social, spi i ual, and psychological needs (Dilani,
2008). Heal hca e acili ies should p o ide a he apeu ic a mosphe e whe e o e all design
con ibu es o he healing p ocess a he han simply being a place o ca y ou he ea men
(Phi i, 2014). Quali y heal hca e a chi ec u e mus o e come p o i abili y p oblems wi hin he
public sec o o o e come hese sho comings and pe o m ho ough esea ch o he mos
a ou able ou comes.
2. Li e a u e Re iew
Hospi al clinical p ac ices mainly ocus on ea ing he illness a he han on a pa ien 's social,
spi i ual, and psychological needs (Dilani, 2008). Lawson (2010) emphasises he impo ance o
he pa ien 's expe ience and he need o c ea e healing places a he han machines o
ea men . Heal hca e acili ies should p o ide a he apeu ic a mosphe e whe e o e all design
con ibu es o he healing p ocess a he han simply being a place o ca y ou he ea men
(Phi i, 2014). To achie e hese objec i es, i is impo an o p io i ise quali y heal hca e
a chi ec u al design, ega dless o p o i abili y conce ns and public sec o inancing challenges.
2.1. Public sec o issues and lack o e idence-based esea ch
Since medicine some imes neglec s he signi icance o he physical en i onmen in pa ien well-
being, a chi ec u e lacks a p o ound adi ion o s udy o heal hca e acili ies. This o e sigh
makes he esea ch p ocess in heal hca e se ings especially demanding (De lin & A neill, 2003).
The s a ing esea ch poin o hese acili ies can be e idence-based design (EBD), which is done
du ing he design p ocess. I is ollowed by building pe o mance e alua ion (BPE), based on
analysing pos -occupancy e alua ion (POE) a e he acili y is in use.
P oblems associa ed wi h sponso s' and clien s' unding scena ios pe sis , as he amoun o
unding can de e mine g ea e design op ions and highe -quali y building execu ion(Ve de be e
al., 2014). The public sec o ypically has ewe design oppo uni ies han p i a e clien s, as public
p ocu emen s p io i ise he cos -e ec i e p o ision o p oduc s and se ices o public use o e
p o i (Palaneeswa an e al., 2003). Radulo ić, he di ec o o he Clinical Cen e o Mon eneg o,
s a ed ha he budge plan 2021 allowed he planning and execu ion o ou new heal hca e
capaci ies wi hin he exis ing heal hca e complex. The S a e Audi Ins i u ion announced he
cons uc ion o hese acili ies in 2011 h ough o icial epo s. Howe e , un il 2021, he e was
no alloca ed unding o hem, so he ealisa ion could no occu (Clinical Cen e o Mon eneg o,
2022). In July o 2022, he cons uc ion wo k s a ed o he men al heal h clinics (Go e nmen
o Mon eneg o, 2022c), while wo k on wo acili ies o in ec ious diseases and
de ma o ene ology clinics began in Oc obe o he same yea (Go e nmen o Mon eneg o,
2022b).
Ne e heless, no egula ions ensu e he building design quali y o heal hca e acili ies in
Mon eneg o. Resea ch may p o ide answe s ega ding he e ec s o design on he use s' heal h
and mood, imp o e he impo ance o he design p o ession, p o ide a be e e u n on
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
41
in es men , and—possibly mos impo an ly—c ea e op imal heal hca e en i onmen s o
pa ien s, amilies, and s a . S ill, in he case o publicly unded buildings, mos design guidelines
end o ocus on compliance wi h se e al minimum s anda ds. Public-sec o guidance
concen a es on he issue om he s a and ea men pe spec i e, o en lea ing he pa ien -
ocused imp essions behind (Zbo owsky & Bunke -Hellmich, 2010).
Joseph e al. (2014) desc ibe EBD as a h ee-s ep p ocess. Fi s , he design ac i i y employs
esea ch o make decisions and e alua e hei impac s. Second, a key componen o he EBD
p ocess is emphasising esea ch a he han elying solely on anecdo al e idence o bes
p ac ices. Las ly, i cen es all design decisions made h oughou he design p ocess on he needs
o pa ien s, s a , echnology, and o ganisa ional ou comes. Ano he issue o be add essed is he
exclusion o POE om con en ional a chi ec u al educa ion, possibly wi h he help o p o essional
p essu e (Hadj i & C ozie , 2009).
Acco ding o Al onsi e al. (2014)., unde s anding EBD esul s should be a 'manda o y s ep' o
any designe wo king on a heal hca e building design. S ill, i has no ye been widely applied o
heal hca e design globally. EBD is cu en ly widely u ilised and included in he p ocess by many
heal hca e designe s in he US. Howe e , in Mon eneg o, i is s ill no equi ed by egula ions.
The c ucial pa o EBD is assessing how design decisions a ec ou comes. Resea ch linking
heal hca e acili y design o pa ien , s a , and amily ou comes is becoming mo e widely a ailable
(Joseph e al., 2014). Much o he esea ch a ailable in EBD is done h ough case s udies since i
can be challenging o gene alise heal hca e design case s udies beyond he indi idual se ing
whe e hey happen. Each heal hca e sys em, independen o i s scale, has i s o ganisa ional
s uc u e combining social laye s ha some imes ope a e independen ly, like nu sing and
physician cul u e o adminis a i e ision. Ensu ing ha o ganiza ions a e compa able o
unbiased esea ch o iden i ying simila o ganiza ions o s udy is a challenging ask, acco ding o
Zbo owsky and Bunke -Hellmich(2010).
E alua ing he building's design a e i has been buil and occupied, he las phase in he EBD
p ocess is c ucial because i adds o he body o knowledge and comple es he inno a ion cycle.
Pos -occupancy e alua ions (POE) ha e always p io i ised ga he ing use opinions and inpu
ega ding building pe o mance. Resea ch ega ding POE has la ely concen a ed on a building's
echnological pe o mance (Budaiwi e al., 2022; Eijkelenboom & Bluyssen, 2020; Ga cés e al.,
2022). By measu ing pa ien clinical ou comes, along wi h use sa is ac ion wi h he buil
en i onmen , he EBD me hod could s ongly in luence he pe o mance o heal hca e acili ies.
To e lec he quali y o a building's design and ou pu , P eise e al. (2009) pu use s a he cen e
o he design o a building by u ilising he e m pe o mance, which is less ambiguous and simple
o measu e. They used building pe o mance e alua ion (BPE) o measu e i he acili y e ec i ely
mee s a pe o mance a ge . Pos -occupancy e alua ion (POE) is conside ed a sub-p ocess o BPE
by hem. I is desc ibed as ' he ac o e alua ing buildings sys ema ically and igo ously a e hey
ha e been buil and occupied o some ime' (P eise e al., 2015).
While esea che s equen ly discuss EBD, p ac i ione s who play a signi ican ole in o ming he
buil en i onmen mus also ge in ol ed o achie e a posi i e u n in c ea ing buildings.
Un o una ely, mos new heal hca e acili ies in Mon eneg o do no implemen hese
me hodologies. Acco ding o Lawson (2010), designs mus imp o e ema kably o achie e a
be e s anda d o ca e. I is impo an o highligh he ole o a chi ec s engaging in POE o he
comple ed building despi e his app oach demanding a sys ema ic assessmen and in es men o
esou ces and ime (Samah e al., 2013). In conclusion, POE is a help ul ool o enhancing
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
42
s uc u es, aising use com o le els, and con olling expendi u es. Howe e , he cos ,
de ending p o essional e i o y, ime commi men , and skill equi emen s a e s ill ba ie s o he
b oad implemen a ion o POE (Vische , 2002).
2.2. Design aspec s and componen s
In heal hca e a chi ec u e, a no able ans o ma ion occu s as a chi ec s p io i ise humanis
alues and design p inciples, ocusing on pa ien s' social and psychosocial equi emen s while
enhancing hei expe ience wi hin he acili ies (Lyon, 2017). A chi ec u al ac o s like he
building's composi ion scale, dayligh ing, colou pale e, way inding ameni ies, s a , pa ien
ci cula ion pa e ns, aes he ic ambience, and o e all sui abili y o dissemina ing heal hca e a e
equen ly o e looked (Samah e al., 2013). Unde s andably, he p ima y conce ns ega ding
heal hca e se ices a e measu ing heal h ou comes, wo ke mo ale, p oduc i i y, and ca e
quali y. Howe e , ecognising how he physical en i onmen pe o ms in he a chi ec u al
aspec s can help s eng hen hei ela ionship.
Mon eneg o does no ha e a pa icula a chi ec u al guideline ega ding he design o heal hca e
acili ies. In Augus o 2023, he Minis y o Ecology, Spa ial Planning and U banism announced
he in e na ional compe i ion o he heal hca e cen e in Podgo ica. E en hough his is he
newes p oposed heal hca e building, he guidelines om he compe i ion b ie did no include
any equi emen s o he design quali y ega ding his speci ic acili y ca ego y (Minis y o
Ecology, 2023).
Howe e , se e al equi emen s exis in he gene al egula ions o p o iding p ima y ca e in
Mon eneg o. As s a ed in he O icial Gaze e o Mon eneg o, he ya d and access oads a ound
he building mus be pa ed o asphal ed, while o he a eas mus be co e ed wi h g ass; all ooms
o he heal h ca e acili y mus be ai y and li wi h na u al ligh o app op ia e a i icial ligh ; and
he wai ing oom mus con ain chai s o pa ien s, a hange , and a plas ic was ebaske (Službeni
lis C ne Go e, 2008).
Guidelines al eady implemen ed in o he coun ies can help b oaden he design knowledge.
Gene al design guidance o heal hca e buildings issued by he UK Go e nmen dis inguishes
policy and egula o y scope, mas e planning, and building design guidelines (Phi i, 2014).
Guidelines mainly deal wi h he a i al o he acili y, bo h ou side and inside. Ou side elemen s
include a canopy, b igh ligh ing, a well-li en ance, di ec ional in o ma ion, design su ace,
plan s, ex e nal sea ing, and an ex e nal appea ance ha is con iden and has a well-ca ed- o
look. Inside elemen s include ligh , spacious and ai y a mosphe e, sea ing dis ibu ion,
ecognisable ecep ion, easy way inding, plan s, and high s anda ds o gi e he o ganisa ion a
posi i e image.
The in e io en i onmen is he se ing ha helps c ea e a healing en i onmen and includes
elemen s such as a elaxing a mosphe e, gene al sa e y, sui able e gonomics, and he apeu ic
me hods (Ghazali & Abbas, 2012). These elemen s mus be adequa ely o ganised o a oid
con usion and diso ien a ion in he use 's pe cep ion.
3. Me hodology
As no ed, ew o icial equi emen s exis o he a chi ec u al design o heal hca e acili ies in
Mon eneg o. Based on his in o ma ion, i was hypo hesised ha he buildings would comply wi h
he egula ions bu no display addi ional design quali ies. The esea ch consis ed o wo phases
and used a mixed-me hod app oach. The i s s ep was a ques ionnai e conduc ed a he bigges
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
43
heal hca e cen e 'No a Va oš', which used a quan i a i e me hodology. Resul s om his pa
se ed as leads o he second pa , which ocused on he elemen s ha ecei ed he mos
signi ican imp essions. This pa included quali a i e analysis ield esea ch o h ee di e en
Podgo ica acili ies: a la ge, a medium, and a small-sized acili y. The assessmen ocused on
su ey elemen s, including a i al, ou side and inside spaces. Da a was collec ed by isi ing he
chosen heal hca e cen es, ga he ing g aphical ma e ial and making no es on he space design
and usage, which we e la e e alua ed.
E hical app o al o he s udy was ob ained om he P ima y Heal h Ca e Cen e s o he Capi al
Ci y in Mon eneg o and he Budapes Uni e si y o Technology and Economics be o e any da a
collec ion happened.
Phase I
The ques ionnai e consis ed o 30 ques ions wi h a 7-poin seman ic di e en ial scale and a Like
scale. Ques ions conside ed speci ic pe sonal da a, imp essions abou he a i al a he cen e,
he ou side acili y appea ance, and he in e io wai ing zone. E e y pa icipan could exp ess
u he pe sonal expe iences ou side o he p ese ques ions. The ques ionnai e was conduc ed
in pe son, in he heal hca e cen e 'No a Va oš', while he online e sion was dis ibu ed o
people who could no ill i ou on he spo . This p inciple ensu ed ha all pa icipan s had he
mos ecen imp ession o he examined si e.
Age, gende , employmen , educa ion, and ole in he heal hca e cen e we e pa o he collec ed
pe sonal da a.
Ques ions conside ing elemen s o he buil en i onmen included:
• A i al spaces included anspo means, leng h o he ou e, wai ing ime, pa king lo , public
anspo , and co e ed a eas.
• Ou side spaces ocused on he o e all appea ance o he building, en ance, sea ing places
ou side, and ege a ion a ound he heal hca e acili y.
• Inside spaces we e he mos de ailed and conside ed design o he wai ing a ea, ecep ion,
a mosphe e, signage, way inding, sea ing a ea, na u al ligh ing, in e io plan s, and a wo k
and deco a ions.
A o al o 41 ca ego ies we e a ailable o pa icipan s o e alua e. Pa icipan s could use he 7-
poin seman ic di e en ial scale o exp ess hei pe cep ion o he elemen s by placing a ma k
along a scale ha spans be ween opposing pai s. This ma k ep esen ed a nume ical alue, om
-3 as en i ely nega i e o +3 as a comple ely posi i e adjec i e. The da a om pa ien s, s a , and
accompanying people was analysed using Jamo i s a is ical compu e so wa e.
Phase II
Th ee p ima y heal hca e cen es we e selec ed o he de ailed quali a i e analysis based on he
numbe o egis e ed pa ien s in he acili y. Table 1 shows e e y p ima y heal hca e cen e in
Podgo ica o ganised by he building cha ac e is ics and he pa ien capaci y.
The esea ch included h ee ins i u ions wi h a la ge, a medium, and a small pa ien coun . As
p e iously men ioned, a ques ionnai e was conduc ed in he la ges acili y' No a Va oš', which
has 25807 egis e ed pa ien s, so his ins i u ion was au oma ically selec ed o u he analysis.
The medium ca ego y included p ima y heal hca e cen es anging om 11714 pa ien s ('Konik')
o 16014 ('S a a Va oš'). E en hough he 'S a a Va oš' cen e was nume ically in he middle, i
was dis ega ded as i is physically iden ical o he No a Va oš building. Fo his eason, he 'Zla ica'
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
44
cen e, which had 13449 pa ien s, was selec ed. The 'Zabjelo' heal hca e cen e was chosen as
he smalles acili y, wi h 7280 egis e ed pa ien s.
Table 1. Ca ego isa ion o acili ies by he numbe o pa ien s (sou ce: Au ho s, 2023)
Size
Type
Pa ien
numbe
La ge acili ies
No a Va oš
Indi idual acili y
25807
Blok 5
Indi idual acili y
22849
Medium acili ies
S a a Va oš
Indi idual acili y
16014
Zla ica
Indi idual acili y
13449
S a i Ae od om
Indi idual acili y
11769
Konik
Indi idual acili y
11714
Small acili ies
Go nja Go ica
In mul ipu pose building
9373
S uden ski cen a
In mul ipu pose building
9202
Zabjelo
In esiden ial building
7280
We isi ed h ee ins i u ions, 'No a Va oš', 'Zla ica' and 'Zabjelo' in Feb ua y 2023, ollowing he
implemen a ion o he ini ial su ey. Pho og aphs, esea che ske ches, and no es on imp essions
we e collec ed. The s a could also desc ibe hei imp essions in an in o mal con e sa ion, albei
a he wo kplace. The ocus o he acili y isi s was on he elemen s included in he su ey.
Assessmen o he a i al included examining pa king acili ies, public anspo a ion op ions,
al e na i e modes o anspo a ion, and pedes ian access. En ance, o e all look, ou side
sea ing, co e ed a eas and ege a ion we e pa o he analysed ou side spaces. As o in e io
spaces, he e alua ion encompassed he ecep ion a ea, wai ing a ea, signage, sea ing
a angemen s, na u al ligh a ailabili y, indoo plan s' p esence, and a wo k display.
4. Resul s and Analysis
4.1. Phase I
A o al o 52 people pa icipa ed in he ques ionnai e. Female esponden s o med he majo i y,
66% o he sample. Howe e , he analysis showed no signi ican di e ences in he imp ession
esul s o he wo gende s. The majo i y o he pa icipan s (54%) we e using a ca as he means
o anspo a ion o he cen e, ollowed by aking a walk (28%), wi h he leas numbe o hem
aking a means o public anspo (14%) and a bike (4%). Only 8% needed 30-60 minu es o each
he acili y, while 14% ook less han i e minu es. Mos (38%) ook 5-15 minu es, ollowed by
36% whose each ime was 15-30 minu es.
As he sample was oo small o ob ain gene alisable esul s, he dis ibu ion o he esponses was
i egula o many pa ame e s examined h ough he ques ions. Va iables wi h egula
dis ibu ions a e p esen ed in Figu e 1.
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
45
Figu e 1. Ba plo s wi h he egula dis ibu ions (2023)
As depic ed in he ba plo s in Figu e 1, acco ding o he egula dis ibu ion o he answe s, he
g ea es a en ion was di ec ed owa ds he ex e io appea ance, signage, and way inding, which
cons i u ed he ini ial con ac wi h he ins i u ion and accessing se ices. Pa icipan s only
exp essed eac ions ega ding he ambience in ligh /da kness and cold/wa m h wi hin he
wai ing a ea and hei p e e ence o pleasan na u al ligh , in e io plan s, and a wo k. The
phase I esul s indica e a ela i ely neu al pe cep ion o he emaining ca ego ies wi hin he
heal hca e cen e whe e people spend hei ime. Howe e , Figu e 2 displays a s onge
inclina ion among esponden s o sugges imp o emen s in ce ain elemen s.
Based on he esul , Phase II ocused on e alua ing he acili ies' ex e io , i s ly, o e all look and
en ance, which ecei ed posi i e pe cep ions om Phase I. F om he in e io spaces, special
a en ion was paid o adequa e sea ing, signage, a wo k, and in e io plan s.
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
46
Figu e 2. Elemen s o be imp o ed (2023)
Figu e 3. Elemen s o be included (sou ce: Au ho s, 2023)
The ecep ion a ea ga ne ed he highes imp essions; nea ly hal o he pa icipan s desi ed
imp o emen s. The sea ing ype and a angemen , along wi h he p esence o in e io plan s,
anked closely behind in e ms o use p e e ences. Educa ion con en , na u al ligh ing, and he
en ance zone ecei ed be ween 29% and 35% o pa icipan s who wished o enhancemen s. In
con as , only 12 pa icipan s o ed o imp o emen s in he en e ainmen con en , while a me e
i e indica ed a desi e o be e a i icial ligh ing, as pe he ques ionnai e esul s.
In addi ion, pa icipan s we e allowed o selec elemen s hey would like o ha e in he cen e,
ega dless o whe he hey al eady exis ed. O he esponden s, 22 exp essed a desi e o
in o ma i e lea le s, while 14 pa icipan s p e e ed a TV and co ee a ea. Fu he mo e, 13
esponden s wished o he inclusion o a ending machine, whe eas only nine pa icipan s
selec ed a play a ea as hei choice (Figu e 3).
4.2. Phase II
4.2.1. Heal hca e cen e 'No a Va oš' (A)
Heal hca e 'A' is a ees anding, g ound loo + one loo (GF+1) acili y in he inne ci y co e
(Figu e 4). In he immedia e icini y, esiden ial buildings ange om GF+0 o GF+3 loo s, and
public acili ies include an elemen a y school and a hea e. The building aces a seconda y oad,
p o iding access o all en ances. Ri e Ribnica lows behind he building, al hough he e is no
es ablished connec ion be ween hem.
A i al: Access o he building is possible o ehicula and pedes ian a ic om se e al
di ec ions, and he e a e wo public anspo bus s a ions wi hin a adius o 250 m. The
su ounding en i onmen is no designed o accommoda e cycling and o he al e na i e modes
o anspo a ion.
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
53
Ex ensi e ege a ion exis s on he si e, wi h p ima ily e e g een pe ennial species. The g eene y
makes a com o able and cosy neighbou hood a mosphe e. Landscape design lacks, wi h
unkemp g ass a eas and un immed b anches and plan s ha some imes obs uc passage.
Inside spaces: The ecep ion desk is igh be o e he en ance, whe e pa ien s di ec ly enqui e
abou hei isi (Figu e 11).
The desk esembles an o ice desk, wi h one side moun ed o he wall. The coun e 's heigh is
also a ound 120 cm, wi h no addi ional sepa a ion o he s a om he pa ien s. The middle
co ido di ides wo wai ing zones o wo doc o s in he shi . Speci ically, each has a nu se's
desk, so he e a e wo ecep ions in he acili y o each GP. The o he ecep ion also has an o ice
desk and no addi ional ba ie s (Figu e 12).
Figu e 11. Recep ion and wai ing a ea o he heal h cen e 'Zabjelo' (sou ce: Au ho s, 2023)
Figu e 12. Ske ch om he ield esea ch, acili y C (sou ce: Au ho s, 2023)
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
54
The ecep ions a e small, bu he c owd is a e, so i does no ge busy. Howe e , du ing he
pandemic, pa ien s we e old o wai ou side and we e called inside indi idually acco ding o he
queue.
The acili y has in o ma ion shee s on he walls and doo s, ma king each unc ion. Howe e , in
his space, many ad e ising ma e ials a e assigned.
The chai s a e in use bu a e a ely busy since only a ew pa ien s ha e appoin men s a a simila
ime. Dis ibu ion and o e lapping in he a he wai ing zone make wo sea s unusable. The
g oups cause he p oblem o insu icien space o accommoda e his speci ic ype o sea .
The e is no na u al ligh besides he su icien glass su ace on he exis ing doo . S a con i med
ha he lou es ne e unc ion due o echnical issues. This incon enience makes he need o
a i icial ligh cons an and lowe s he com o o he wo kplace. A wo k and plan s we e no
p esen in any o m in he in e io .
4.2.4. O e all acili ies pe o mance
A e he da a collec ion, acili y elemen s pe o mance was ca ego ised in h ee g oups: +
Posi i e; + - Neu al; - nega i e and displayed in Table 2.
Table 2 Facili ies pe o mance along he analysed aspec s (sou ce: Au ho s, 2023)
Facili ies
A - 'No a Va oš'
B - 'Zla ica'
C - 'Zabjelo'
A i al
Pa king
-
+
+ -
Public anspo a ion
+ -
+ -
+ -
Al e na i e anspo a ion
-
-
-
Pedes ian access
+ -
+ -
-
Ou side spaces
En ance
+ -
+ -
-
O e all look
+ -
+ -
-
Ou side Sea ing
+ -
+ -
-
Co e ed a eas
+ -
+
-
Vege a ion
+ -
-
+
Inside spaces
Recep ion
-
-
-
Wai ing a ea
+ -
-
-
Signage
+
+
+
Sea ing
+ -
+ -
-
Na u al ligh
+
-
-
Indoo plan s
-
-
-
A wo k
+ -
+ -
-
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
55
Elemen s ma ked as posi i e we e su icien in quan i y and well-designed o pe o m hei
unc ion. Neu al elemen s exis ed on si e and had ce ain quali ies bu showed laws such as
insu icien quan i y, mal unc ion, poo design, posi ion o se ice issues. Nega i e elemen s we e
ei he nonexis en , in insu icien quan i y, poo ly designed o comple ely mal unc ioning.
Al e na i e modes o anspo a ion, ecep ion and indoo plan s pe o med nega i ely in all
h ee acili ies. On he o he hand, signage was adequa ely p esen in each place. Inconsis ency
is no iceable, as each building pe o med di e en ly conside ing he emaining elemen s. O e all,
la ge acili y 'A' showed he bes , while he small acili y 'C' eco ded he lowes pe o mance
le el.
5. Discussion
Kea ns e al. (2020) sugges ed ha he ecep ionis and wai ing oom play c ucial oles in shaping
a pe son's ansi ion in o becoming a pa ien . By analysing Phase I, we go he imp essions om
he pa ien s and compa ed hem om he a chi ec 's pe spec i e h ough ield esea ch in Phase
II.
The p e iously men ioned si ua ion in Mon eneg o showed ha no communica ion was made
wi h he heal hca e use s ega ding a chi ec u al p e e ences, ollowed by he p oblems o mo e
p o ound design s udies and inancial sou ces. Phase I esul s sugges ha pa ien s i s ca ed
abou se ices and com o a he han he gene al look o he building and spaces.
Vehicle in as uc u e in acili ies A and C was incompe en due o he lack o di ision, especially
o he cen e use s. On he o he hand, acili y B had su icien pa king lo s bu had p oblems
ega ding he pedes ian app oach.
En ances we e anked posi i e and clea by mos o he pa icipan s, sugges ing hei p ope
unc ioning. Field esea ch showed ha none o he acili ies ca ied he a chi ec u al alue o
he welcoming ou look o he en ance. Howe e , in o ma ion shee s and signage ha we e
p esen in a la ge numbe possibly played a ole in unde s anding he se ices in he acili y. E en
boa ds wi h i ele an in o ma ion can be help ul o he pa ien s and s a o na iga e he acili y
(Pa i e al., 2015).
Pa ien s did no ice he lack o indoo plan s and a wo k and ma ked bo h as desi able. In a simila
s udy, pa icipan s some imes iden i ied g een indoo plan s as p o iding posi i e dis ac ions
(Ayas e al., 2008). Addi ionally, a wo k can be calming and u he help wi h na iga ing he
acili y.
E en hough he use s in acili y A complimen ed na u al ligh , i was c i ical in B and C, wi h he
need o a i icial ligh du ing a majo pa o he day. Resea ch shows ha some use s like i when
he wai ing oom has ea u es connec ing i o he ou side wo ld and ha wai ing a eas wi h open
iews o access o he ou doo s a e highly alued (Kea ns e al., 2020). The au ho s explained ha
many pa ien s eel obliga ed o emain in he wai ing oom o secu e hei spo and a oid missing
appoin men s.
A simila si ua ion was obse ed inside all h ee acili ies. Pa ien s usually s ood be o e he GPs'
doo s and wai ed o hei u n, e en hough sea s we e nea by. Se e al pa icipan s men ioned
ha p o iding queue numbe s would diminish his eeling o missing an appoin men o being
called in p ope o de .
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
56
The s udy's indings may be limi ed by he ela i ely small sample size o esponden s who
pa icipa ed in Phase I, which could impac he gene alizabili y o he esul s o a b oade
popula ion. Addi ionally, examined heal hca e cen es may unde go eno a ions, eposi ioning,
o closu e o e ime. These changes could in luence he s udy's conclusions, as he spaces and
se ices o e ed a hese cen es may di e om hose ini ially assessed.
6. Conclusions
The esea ch de ailed in he pape highligh ed nume ous planning, o ganisa ional, and ope a ing
de iciencies ha hinde he humane design o p ima y heal hca e in as uc u e.
The esul s om Phase I and Phase II showed a disc epancy be ween he cu en a chi ec u al
design and he ela i e indi e ence o he use s who pa icipa ed in he ques ionnai e. The
esigned way in which people in need o healing ela e o he a chi ec u al quali y o he acili ies
p esen s a cul u al law a ising om he his o y o poli ical sys ems and is pa ly a consequence
o he designe s' modes y. The basis o de elopmen and p og ess is an ex ensi e educa ion,
whe e all g oups in ol ed in implemen a ion and use mus pa icipa e.
In o de o lea n he po en ial healing e ec s o he en i onmen , e e ence pilo p ojec s a e
necessa y, whe e all use s hemsel can expe ience he bene i s o a pu pose ully designed
healing en i onmen .
In mos coun ies, ins ead o he o e egula ed, unmo i a ed s a e o ganisa ions, p i a e
in es o s c ea e hese e e ence acili ies, which can only be a o ded by a small class o hose in
need, slowing down he quali a i e de elopmen o he in as uc u e in p ima y ca e. We
p opose se e al sugges ions ega ding he a chi ec u al decisions and quali ies ha a e no
p esen in he cu en guidelines:
• A i al in as uc u e should be adequa e and com o able o as many ypes o
anspo a ion as possible.
• Adequa e pa king o di e en ehicles should be p o ided and sepa a ed only o heal hca e
cen e use s.
• The acili y ou look should be designed acco ding o e idence-based design p inciples and
implemen local a chi ec u al alues and he al eady es ablished in e na ional guidelines.
• Na u al ligh , ege a ion, and a wo k c ea e a mo e com o able a mosphe e in he wai ing
oom and a e desi ed by he pa ien s. Na u al ligh should be p o ided as much as possible in
e e y oom ha se es pa ien s and s a .
• The ecep ion a ea should be imp o ed in consul a ion wi h he use s o make he wo k low
easie and mo e com o able o pa ien s and s a . Addi ionally, use p i acy could be mo e
p o ec ed wi h he p ope ecep ion design.
• Heal hca e cen es could implemen digi al communica ion sys ems so pa ien s can us he
ins i u ion and eel elaxed in he wai ing oom.
The Pos Occupancy E alua ion is necessa y because e en hough some ea u es mal unc ioned
o we e missing, hey needed o be adequa ely sol ed acco ding o he exis ing na ional
egula ions. Implemen a ion o POE in he u u e could be done by ga he ing egula eedback
om use s and employees and e iewing acili ies once hey’ e in use.
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
57
While ce ain ecommenda ions may appea s anda d, hey ha e no been implemen ed in mos
na ional heal hca e acili ies. The e o e, he esea ch e eals a consis en disconnec be ween
use needs and ac ual design p ac ices. To add ess his inconsis ency, a chi ec s, heal hca e
adminis a o s, and policymake s mus es ablish a collabo a i e app oach.
Fu u e esea ch di ec ions may in ol e de eloping e idence-based design guidelines speci ically
o heal hca e acili ies in Mon eneg o and simila con ex s. Such guidelines would p o ide
a chi ec s wi h a sys ema ic amewo k o in eg a ing use -cen e ed p inciples by es ablishing
con inuous imp o emen in heal hca e in as uc u e. Thus, his esea ch could p esen a s a ing
poin o e alua ing and enhancing heal hca e acili y design quali y in he u u e.
7. Bibliog aphy
Al onsi, E., Capolongo, S., & Bu oli, M. (2014). E idence Based Design and heal hca e: an
uncon en ional app oach o hospi al design. Annali Di Igiene : Medicina P e en i a e Di
Comuni a, 26(2), 137–143. h ps://doi.o g/10.7416/ai.2014.1968.
Ayas, E., Eklund, J., & Ishiha a, S. (2008). A ec i e design o wai ing a eas in p ima y heal hca e.
The TQM Jou nal, 20(4), 389–408. h ps://doi.o g/10.1108/17542730810881366.
Budaiwi, I. M., Mohammed, M. A., & Ha bi, H. A. (2022). Indoo en i onmen al quali y-based
space ca ego iza ion amewo k: he case o heal h-ca e acili ies. Jou nal o Facili ies
Managemen . h ps://doi.o g/10.1108/JFM-04-2022-0035.
Clinical Cen e o Mon eneg o. (2022). Di ek o ica KCCG: Za mjesec počinje izg adnja Klinike za
men alno zd a lje, a onda i no og objek a za još d ije klinike. h ps://kccg.me/ ijes i/
di ek o ica-kccg-za-mjesec-pocinje-izg adnja-klinike-za-men alno-zd a lje-a-onda-i-
no og-objek a-za-jos-d ije-klinike/
De lin, A. S., & A neill, A. B. (2003). Heal h Ca e En i onmen s and Pa ien Ou comes.
En i onmen and Beha io , 35(5),665–694. h ps://doi.o g/10.1177/0013916503255102
Dilani, A. (2008). Psychosocially suppo i e design: A salu ogenic app oach o he design o he
physical en i onmen . Design and Heal h Scien i ic Re iew, 1(2), 47–55.
h ps://www.b ikbase.o g/si es/de aul / iles/49Alan-Dilani-WCDH-2005.pd .
Eijkelenboom, A., & Bluyssen, P. M. (2020). P o iling ou pa ien s a based on hei sel - epo ed
com o and p e e ences o indoo en i onmen al quali y and social com o in six
hospi als. Building and En i onmen , 184, 107220. h ps://doi.o g/10.1016/j.builden .
2020.107220.
Gabbo , M., & Hogg, G. (1996). The glo y o s o ies: Using c i ical inciden s o unde s and se ice
e alua ion in he p ima y heal hca e con ex . Jou nal o Ma ke ing Managemen , 12(6),
493–503. h ps://doi.o g/10.1080/0267257X.1996.9964431.
Ga cés, H. O., Du án, C., Espinosa, E., Je ez, A., Palominos, F., Hinojosa, M., & Ca asco, R. (2022).
Moni o ing o The mal Com o and Ai Quali y o Sus ainable Ene gy Managemen
inside Hospi als Based on Online Analy ical P ocessing and he In e ne o Things.
In e na ional Jou nal o En i onmen al Resea ch and Public Heal h, 19(19), 12207.
h ps://doi.o g/10.3390/ije ph191912207.
Ghazali, R., & Abbas, M. Y. (2012). Quali y Physical En i onmen in Paedia ic Wa ds: Designe ’s
C ea ion Ve sus Use s’ Sa is ac ion. P ocedia - Social and Beha io al Sciences, 35, 221–
229. h ps://doi.o g/10.1016/j.sbsp o.2012.02.082.
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
58
Go e nmen o Mon eneg o. (2022a). O ganisa ion o heal h ca e. Minis y o Heal h.
h ps://www.go .me/en/a icle/o ganisa ion-o -heal h-ca e.
Go e nmen o Mon eneg o. (2022b). Počinje g adnja Klinike za in ek i ne boles i i
de ma o ene ologiju u Podgo ici. h ps://www.go .me/clanak/pocinje-g adnja-klinike-
za-in ek i ne-boles i-i-de ma o ene ologiju-u-podgo ici.
Go e nmen o Mon eneg o. (2022c). Saopš enje: Počinje g adnja Klinike za men alno zd a lje u
Podgo ici. h ps://www.go .me/clanak/saops enje-pocinje-g adnja-klinike-za-men alno-
zd a lje-u-podgo ici.
Hadj i, K., & C ozie , C. (2009). Pos -occupancy e alua ion: pu pose, bene i s and ba ie s.
Facili ies, 27(1/2), 21–33. h ps://doi.o g/10.1108/02632770910923063.
Huisman, E. R. C. M., Mo ales, E., an Hoo , J., & Ko , H. S. M. (2012). Healing en i onmen : A
e iew o he impac o physical en i onmen al ac o s on use s. Building and
En i onmen , 58, 70–80. h ps://doi.o g/10.1016/j.builden .2012.06.016.
Hu on, J. D., & Richa dson, L. D. (1995). Heal hscapes: The ole o he acili y and physical
en i onmen on consume a i udes, sa is ac ion, quali y assessmen s, and beha io s.
Heal h Ca e Managemen Re iew, 20(2), 48–61. h ps://doi.o g/10.1097/00004010-
199502020-00008.
Joseph, A., Quan, X., Kelle , A. B., Taylo , E., Nanda, U., & Hua, Y. (2014). Building a knowledge
base o e idence-based heal hca e acili y design h ough a pos -occupancy e alua ion
oolki . In elligen Buildings In e na ional, 6(3), 155–169. h ps://doi.o g/10.1080/
17508975.2014.903163.
Jo ano ić, N., Miglie a, E., Podlesek, A., Malekzadeh, A., Lasal ia, A., Campbell, J., & P iebe, S.
(2022). Impac o he hospi al buil en i onmen on ea men sa is ac ion o psychia ic
in-pa ien s. Psychological Medicine, 52(10), 1969–1980. h ps://doi.o g/10.1017/
S0033291720003815.
Kea ns, R. A., Neuwel , P. M., & Eggle on, K. (2020). Pe meable bounda ies? Pa ien pe spec i es
on space and ime in gene al p ac ice wai ing ooms. Heal h & Place, 63, 102347.
h ps://doi.o g/10.1016/j.heal hplace.2020.102347.
K is , A. H., Nease, D. E., K eps, G. L., O e holse , L., & McKenzie, M. (2016). Engaging Pa ien s in
P ima y and Special y Ca e. In Oncology In o ma ics (pp. 55–79). Else ie .
h ps://doi.o g/10.1016/B978-0-12-802115-6.00004-5.
Lawson, B. (2010). Healing a chi ec u e. A s & Heal h, 2(2), 95–108.
h ps://doi.o g/10.1080/17533010903488517.
Lyon, C. (2017). Humanis p inciples, sus ainable design and salu ogenics: A new o m o
heal hca e a chi ec u e. A chi ec u al Design, 87(2). h ps://api.seman icschola .o g/
Co pusID:114510036.
Mechanic, D. (2004). In my chosen doc o I us . BMJ, 329(7480), 1418–1419.
h ps://doi.o g/10.1136/BMJ.329.7480.1418.
Minis y o Ecology, S. P. and U. (2023). Compe i ion o he Concep ual A chi ec u al Design o
he P ima y Heal h Ca e Cen e in Ci y k a in Podgo ica. h ps://www.
a chi ec u alcompe i ions.me/en/de aljno/compe i ion- o - he-concep ual-a chi ec u a
l-design-o - he-p ima y-heal h-ca e-cen e-in-ci y-k a -in-podgo ica.
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
59
Mon eneg o Minis y o Heal h. (2015). Mas e plan o he de elopmen o heal h sys em in
Mon eneg o 2015-2020. h ps://ex ane .who.in /coun yplanningcycles/si es/de aul /
iles/public_ ile_ ep/MNE_Mon eneg o_Mas e -Plan-o - he-De elopmen -o -Heal h-
Sys em_2015-2020.pd .
Mo gan, S., Pullon, S., McKinlay, E., Ga e , S., Kennedy, J., & Wa son, B. (2021). Collabo a i e
Ca e in P ima y Ca e: The In luence o P ac ice In e io A chi ec u e on In o mal Face- o-
Face Communica ion—An Obse a ional S udy. HERD: Heal h En i onmen s Resea ch &
Design Jou nal, 14(1), 190–209. h ps://doi.o g/10.1177/1937586720939665.
Mosca, I., Te zic, N., & Tille, F. (2022). Heal h sys ems in ac ion: Mon eneg o.
h ps://eu oheal hobse a o y.who.in /publica ions/i/heal h-sys ems-in-ac ion-
mon eneg o-2022.
Oandasan, I. F., Go lib Conn, L., Linga d, L., Ka im, A., Jakubo icz, D., Whi ehead, C., Mille , K.-L.,
Kennie, N., & Ree es, S. (2009). The impac o space and ime on in e p o essional
eamwo k in Canadian p ima y heal h ca e se ings: implica ions o heal h ca e e o m.
P ima y Heal h Ca e Resea ch & De elopmen , 10(02), 151. h ps://api.
seman icschola .o g/Co pusID:70569580
Palaneeswa an, E., Kuma aswamy, M., & Ng, T. (2003). Ta ge ing op imum alue in public sec o
p ojec s h ough “bes alue”- ocused con ac o selec ion. Enginee ing, Cons uc ion
and A chi ec u al Managemen , 10(6), 418–431. h ps://doi.o g/10.1108/096999803105
09390.
Pa i, D., Ha ey, T. E., Willis, D. A., & Pa i, S. (2015). Iden i ying Elemen s o he Heal h Ca e
En i onmen Tha Con ibu e o Way inding. HERD: Heal h En i onmen s Resea ch &
Design Jou nal, 8(3), 44–67. h ps://doi.o g/10.1177/1937586714568864.
Phi i, M. (2014). Heal h Building No e 00-01 Gene al design guidance o heal hca e buildings.
h ps://www.england.nhs.uk/wp-con en /uploads/2021/05/HBN_00-01-2.pd .
P eise , W. F. E., Ve de be , S., & Ba is o, D. (2009). ASSESSMENT OF HEALTH CENTER
PERFORMANCE: TOWARD THE DEVELOPMENT OF DESIGN GUIDELINES. A chne -IJAR,
3(3), 21–44. h ps://www.a chne .o g/publica ions/5292.
P eise , W. F. E., Whi e, E., & Rabinowi z, H. (2015). Pos -Occupancy E alua ion (Rou ledge
Re i als). Rou ledge. h ps://doi.o g/10.4324/9781315713519.
Samah, Z. A., Ib ahim, N., & Ami , J. S. (2013). T ansla ing Quali y Ca e Fac o s o Quali y Space:
Design C i e ia o Ou pa ien Facili y. P ocedia - Social and Beha io al Sciences, 105,
265–272. h ps://doi.o g/10.1016/j.sbsp o.2013.11.028.
Službeni lis C ne Go e. (2008). Službeni lis C ne Go e. Službeni Lis C ne Go e, 10.
h p://sluzbenilis .me/.
Ve de be , S., Jiang, S., Hughes, G., & Xiao, Y. (2014). The e ol ing ole o e idence-based esea ch
in heal hca e acili y design compe i ions. F on ie s o A chi ec u al Resea ch, 3(3), 238–
249. h ps://doi.o g/10.1016/j. oa .2013.12.001.
Vische , J. (2002). Pos -Occupancy E alua ion: A Mul i ace ed Tool o Building Imp o emen . In
Lea ning om Ou Buildings (p. 23). Na ional Academies P ess. h ps://doi.o g/10.17226/
10288
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
60
Wa son, K. J., E ans, J., Ka onen, A., & Whi ley, T. (2016). Re-concei ing building design quali y:
A e iew o building use s in hei social con ex . Indoo and Buil En i onmen , 25(3),
509–523. h ps://doi.o g/10.1177/1420326X14557550.
Wo ld Heal h O ganiza ion. (2020). Eu opean P og amme o Wo k 2020-2025: Uni ed Ac ion o
Be e Heal h. h ps://i is.who.in /bi s eam/handle/10665/339209/WHO-EURO-2021-
1919-41670-56993-eng.pd .
Zbo owsky, T., & Bunke -Hellmich, L. (2010). In eg a ing Heal hca e Design Resea ch in o
P ac ice: Se ing a New S anda d o P ac ice. HERD: Heal h En i onmen s Resea ch &
Design Jou nal, 4(1), 115-130. h ps://doi.o g/10.1177/193758671000400108.
© Jou nal o Accessibili y and Design o All (JACCES), Volume 15, Issue 1, 2025, ISSN: 2013-7087
DOI: h ps://doi.o g/10.17411/jacces. 15i1.530
61
How o ci e his a icle
Nježić Ž., Sch ammel Z., Mandoki R. (2025). F om use pe cep ion o a chi ec u e. Imp o ing
a i al and wai ing spaces in p ima y heal hca e cen es. Jou nal o Accessibili y and Design o
All, 15(1), 38–60. h ps://doi.o g/10.17411/jacces. 15i1.530
© Jou nal o Accessibili y and Design o All (JACCES), ISSN 2013-7087, is published by he Uni e si a Poli ècnica de
Ca alunya, Ba celona Tech, wi h he sponso ship o he ONCE Founda ion o Coope a ion and Social Inclusion o
People wi h Disabili ies. This issue is ee o cha ge and a ailable in elec onic o ma .
This wo k is licensed unde an A ibu ion-
Non-Comme cial 4.0 In e na ional C ea i e
Commons License. Reade s a e allowed o
ead, download, copy, edis ibu e, p in ,
sea ch, o link o he ull ex s o he a icles
o use hem o any o he law ul pu pose,
gi ing app op ia e c edi . I mus no be
used o comme cial pu poses. To see he
comple e license con en s, please isi
h p://c ea i ecommons.o g/licenses/by-nc/4.0/.
JACCES is commi ed o p o iding accessible
publica ions o all, ega dless o echnology
o abili y. The p esen documen g an s
i al accessibili y since i applies o WCAG 2.2
and PDF/UA ecommenda ions. The
e alua ion ool used has been Adobe
Ac oba ® Accessibili y Checke . I you
encoun e p oblems accessing he con en
o his documen , you can con ac us a
jacces@ca ac.upc.edu.
