A proposal for discursive methods of stakeholder involvement in healthcare project decision-making

Health is the state of complete wellbeing and not merely absence of disease (WHO 1948). The term healthcare facilities (synonymously used with healthcare buildings) is used here to refer to those structures in which health is restored or nurtured. The Sir Winston Churchill saying “we shape our buildings, thereafter they shape us” is increasingly being validated by empirical evidence. The built environment has been found to influence human behaviour (for example, Bordass and Leamann 1997), while recent research further indicates that healthcare facility design and built environments impact on patient wellbeing and staff performance (Lawson and Phiri 2003). This highlights the need to understand and manage the stakeholders in order to minimise negative impacts of healthcare buildings on the people (health and wellbeing) and to a greater extent the locality (urban sustainability). Building construction projects are generally divided into several stages representing different activities and levels of building completeness and use (Gambatese et al. 2007). The construction industry has been reported to often rush into projects without adequate understanding of the importance of the early phases (Emmitt 2007). It has also been known to make decisions predominantly based on the capital (initial) cost of a facility (Holti et al. 2000; Woodhead 2000). However, it is in the less-emphasised pre-design stages that fundamental decisions regarding major issues in the life cycle of the facility are made (Duerk 1993; Yu et al. 2007). This paper is based on pre-design activity. It attempts to portray the worth of spending more time in trying to engage with and understanding stakeholders as part of key planning activity. The paper also relates to how the social facet of sustainability can be utilised in decision support to enhance the other aspects of sustainable development especially in realising the functional value of a healthcare facility. The proposed ‘cooperative discourse’ and Value Management (VM) methodology, mainly workshop-based activities, heavily relies on the social aspect of communication. This may include hearing and listening, understanding and sharing of information as well as compromising positions [amongst the three aspects: economic, social and environmental] in order to achieve common good.