Care workers deserve a better workplace

Doctoral research by AnneMarie Eijkelenboom

Against the background of growing healthcare needs, a shortage of hospital staff and above-average sick leave, insight into the health and comfort of hospital staff is of the utmost importance. The physical environment is a factor in this regard. This is a simple fact, but conditions are determined by the complex interplay between a multitude of personal, work and building characteristics. AnneMarie Eijkelenboom, architect at EGM, focuses on the well-being of hospital workers in her PhD research, which she recently completed at Delft University of Technology.


Science and real-life experiences

The best way to disentangle the jumble of factors that influence the well-being of care workers is to view them from various angles. To this end, AnneMarie Eijkelenboom assessed previous studies, compiled an inventory of building characteristics, and interviewed hospital workers about the spaces in which they work. Some 556 employees of policlinics in six Dutch hospitals took part by answering over 100 questions. Armed with extensive checklists, the research team then inspected the locations, cleaning protocols, technical areas and 127 workspaces in the policlinics. The findings were analysed in 2019 and 2020.


Inclusive well-being during pandemic

The doctoral research was undertaken during a remarkable period: before and during the Covid-19 pandemic, the first cases of which were detected in the Netherlands in February 2020. A representative selection of workers was therefore extensively interviewed in the autumn of 2020 about the impact of the pandemic on outpatient areas. These participants submitted photographs of their workspaces in advance and discussed them during the interviews. They explained their experiences and preferences with regard to issues such as light, air, sound, privacy, interaction, and the influence of the pandemic on these. For example, care workers were more concerned about indoor air quality because of a heightened awareness of the spatial limitations for fresh air in their place of work. The ability to understand patients had also worsened because of the introduction of screens at reception desks, the use of face masks, and the need to maintain social distancing. Moreover, the decrease in live contact during the pandemic meant that workers missed pleasure in their work and the information and signals they would normally derive from body language and physical examinations.


One size fits all?

Workers do not always react in the same way to environmental factors. For some, daylight in the workplace is very important, while others want fresh air most of all. Therefore, in order to do justice to the different preferences expressed by care workers, the research team created profiles that grouped workers with similar comfort preferences. This revealed that groups with similar preferences differ from other groups in terms of health (complaints, sick leave), workplace characteristics (length of stay, number of people at the room) or activities (physical examination of patients, concentrated office work). For example, care workers who view control of ventilation as very important showed higher levels of sick leave and complaints. Those who work frequently in different spaces, such as reception areas, consultation rooms and treatment rooms, value patient privacy over quiet workspaces. In this way, the profiles of groups of workers with similar profiles differ from one another. These profiles are key to creating customized designs that meet the individual preferences of many care workers.


Congratulations, also as a fellow architect. I think I am doing this also on behalf of all architects. It is an extremely complicated subject that we must integrate well into the profession of architect. Your research certainly contributes to this. Thank you for that!

Professor ir. M.F. Asselbergs, TU Delft doctoral committee during his congratulations


Plenty of room for improvement

The findings of the study also reveal that there is plenty of room for improvement. Satisfaction with comfort levels in consultation and treatment rooms is higher than in office spaces (front and back offices). People who mostly work in office spaces are generally less satisfied with the temperature, air quality, privacy and quietness. That means that the design of outpatient areas also needs careful consideration of the comfort levels in office spaces. The most common building-related complaints are dry eyes and headaches. Analysis has revealed the relationship between such complaints and building characteristics determined by the design brief, spatial design, building services and maintenance. An integral design process is therefore essential in order to reduce complaints.

Moreover, it is vital that such health complaints are addressed in the design process in hospitals, in order to create a (more) healthy working environment for their staff.



This is the first extensive scholarly study into the comfort and health of workers in outpatient areas in hospitals. The research reveals that it makes sense to look specifically at individual departments, such as outpatient areas or intensive care units. Spatial characteristics, length of stay, activities and accompanying comfort levels differ so much between departments that a general conclusion does no justice to individual situations and needs.

In the current social and economic situation, it was and is important to improve insight into the experience and needs of care workers. They have now been examined and analysed, and recommendations have been made. EGM will draw on these insights to improve the well-being of care workers through spatial design. That is sorely needed.


If you want to find out more about this study, or what it might specifically mean for your organization, please contact AnneMarie Eijkelenboom for a personal interview:, or 078 - 6330 660.