An illustration of the development of a strategy for evaluating the design of hospitals within a practice order network

This paper is part of on-going research that is investigating the potential of a practice theory perspective to understanding stakeholder evaluation of hospital design. Practice theory offers numerous affordances, especially to researchers and practitioners who seek alternatives to the problematic assumed universality of other 'traditional' theoretical perspectives. However there are several disagreements left unresolved in the literature about practice theory methodology that risk compromising its full potential. Drawing on Schatzki's notion of site ontology and illustrated by an on-going ethnographic study of the practice of evaluating the design of a major UK National Health Service (NHS) hospital, this paper seeks to contribute to resolving such disagreements by developing a strategy that generates a methodology for use with practice theory. The strategy is based on the premise of ontological salience and phenomenological congruence. Arguments for the mobilisation of a pluralistic portfolio of methodologies, methods and the synthesis of a pair of analytical devices ('design evaluation as practice' and 'design evaluation in practice') that emerged from the application of the strategy are explored. Dialogical reflexivity is foregrounded as a further and essential part of the strategy. The paper elucidates and enhances both the praxis and practices stimulated by current approaches to design evaluation. It raises important implications for the future development of UK Government policy to substantively improve the design quality of NHS healthcare building sand, in turn, improve patient healthcare outcomes.