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Evaluating the design of hospitals within a practice order network

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journal contribution
posted on 03.09.2015, 13:49 by Dennis J. O'Keeffe, Derek ThomsonDerek Thomson, Andrew Dainty
Design evaluation is a complex and rich social practice that is organised and distinguished by its practical understandings, rules, general understandings and teleoaffective structures. This praxiographic study of a major National Health Service (NHS) hospital project uses practice theory to investigate the concept of design evaluation as ‘a practice’. By applying Theodore Schatzki’s site ontology, design evaluation practices are revealed to respond to dynamic teleoaffective structures that highlight the role of both practical intelligibility and the intertwined impact of external policy stipulations. Through this theoretical lens, fresh insight into the actuality of NHS hospital design evaluation praxis is provided that questions some of the axioms upon which such processes are assumed to operate. In particular, the appropriateness of the decontextualised and deterministic processes currently found in UK Government design policy is questioned. It is posited that an approach to design evaluation grounded in Schatzki's practice theory has greater potential to improve the design quality of NHS healthcare buildings that could, in turn, improve patient healthcare outcomes.



  • Architecture, Building and Civil Engineering

Published in

Construction Management and Economics


O'KEEFE, D.J., THOMSON, D.S. and DAINTY, A.R.J., 2015. Evaluating the design of hospitals within a practice order network. Construction Management and Economics, 3(5/6), pp.415-427.


© Taylor & Francis


AM (Accepted Manuscript)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Publication date



This is an Accepted Manuscript of an article published by Taylor & Francis in Construction Management and Economics on 15th Sept 2015, available online: http://dx.doi.org/10.1080/01446193.2015.1072639