Trust, Participation and Hospital Design Two Approaches One Result.

Paper in proceeding, 2005

This paper is based on a study of the change and design process for the surgery and radiology building at Örebro University Hospital, Sweden. The basis for the process is the tradition in the County of Örebro to carry out projects in close co-operation with the users as well as aiming for high quality buildings. Traditionally building design projects were set up in a close co-operation between core business representatives and the real estate department. The building project utilized this cooperative approach. In the study of the process, two approaches to the co-operation were identified. One (1) trust based process and one (2) participation based process. The trust-based process is characterized by having a respected leader, or a small group, with a strong support among staff that enables them to act for others. The participation-based process is characterized by a larger number of active participants representing all tasks, often in working groups dealing with sub tasks in the design process, and a need to get feed back before any decision is made. It was found that both of the two processes worked well and that the result is considered as a usable building. This finding is compared with a finding from another study where the issue of discrepancies between client’s goals and the outcome, is discussed. The paper discusses the two approaches, how they relate to client’s goals and how these affected the process and what can be learnt for future change and design processes.