POE: What It Is and Why We Do It

From its inception, post-occupancy evaluation was intended to inform the creation of buildings that meet the needs of the people who live, work, learn, play and heal in them. At its core, POE was user-centered and focused on improving building performance and design. With these guiding principles in mind, POE is highly relevant in today’s healthcare industry where there is growing focus on patient-centered care, continuous quality improvement, the efficient delivery of care and the real connections between the built environment, patient satisfaction and reimbursement.

From a historical perspective, the emergence of the field of environment-behavior research marked the beginning of POE, when in the 1960s, social scientists, designers and planners were brought together by a shared concern about how buildings were affecting the well-being of occupants. The need for a tool that could offer a systematic approach to understanding the lack of fit between some buildings and intended users spurred the development and evolution of the POE.

Early POEs focused on assessing user satisfaction with the functionality, efficiency, comfort and aesthetics of buildings. More recently, the technical performance of building systems, energy use and sustainability have been added to the mix. POE data collection and research methods are becoming increasingly sophisticated with multi-method research designs that include baseline or benchmark measures in pre-existing facilities for comparison later to new or renovated facilities, control/comparison sites, new technologies to measure performance and a focus on evidence-based design.

POE Defined

An often cited definition of POE comes from Preiser, Rabinowitz and White (1988) who wrote:

“Post-occupancy evaluation is the process of evaluating buildings in a systematic and rigorous manner after they have been built and occupied for some time.”

Other definitions of POE have been offered by various writers and researchers, but each share a set of common characteristics, including the following:

• Employs specific methodology (including qualitative and/or quantitative data collection)
• Assesses buildings in use
• Focuses on the user experience
• Compares criteria/standards with actual building performance
• Seeks to improve the built environment by identifying both successes and shortcomings

POE Myth: Everyone knows what a POE is. The term is liberally used across the industry, but POE definition and practice has been extremely inconsistent. Any and all of the following have been routinely called POE: documentation of building outcomes (e.g., energy and water use), technical building system assessments, qualitative and/or quantitative assessment of user experience and/or behaviors in a facility, instrument measures of the ambient environment, and so on. In practice, these measures might be appropriately validated, or they might be made up on the fly by those conducting the POE, in which case risk of bias is a major concern. There’s great value to be had if we ask and describe what we actually mean when we say “POE.”

HDR’S Facility Performance Evaluation Process

HDR sees POE as one component of facility performance evaluation, which can occur at any point in a facility’s lifecycle, in order to inform an organization’s strategic capital planning processes and decisions.

Recognizing the benefits of facility evaluations for our clients, HDR typically conducts existing facility assessments and post-occupancy evaluations in conjunction with design projects. HDR also evaluates facility performance as part of the planning process, whether or not a specific design project has been identified, for clients with a range of facility types, sizes and stocks. The facility performance evaluation process may be deployed at any time to assess and/or compare facility performance, informing our clients’ planning decisions.

POE Myth: The best time to conduct a POE is some time after a new facility is completed and occupied It’s time to take the “post” out of POE and change the mindset that facility evaluations happen only after a new, renovated, or replacement building is occupied. Evaluation before a project begins, in an existing facility, allows documentation of outcome changes in the new facility later, to help owners understand the real impacts of capital investments. But, facility evaluation is also valuable beyond the bounds of a given design or building project. It is a strategic endeavor that can be conducted at any time in the building lifecycle. Formal evaluation can be used to comparatively assess facility performance, and may address the larger context of campuses and systems in light of organizational priorities and goals.

Facility performance evaluation captures perceptions and experiences of users in their environments as outcomes of the facility. In some cases where the evaluation is integrated with the design process for an architectural project, an evaluation informs design strategies for a new, replacement, or renovated facility, setting benchmarks for comparison. Then, in the new or renovated facility, usually 12 to 24 months after move-in, a POE is conducted. A major objective of the HDR facility evaluation approach with design projects is to provide seamless integration with the design process to make the overall experience as easy as possible for the client.

Engagement in facility performance evaluation enables organizations to:

• Identify and assess issues, perceptions, and outcomes in a representative sample of users in existing facilities
• Inform best decision-making for long-term strategic planning, master planning and/or specific design and construction projects
• Compare a new or renovated facility’s performance to the design guidelines and program intent, as well as to measures in a previous facility
• Identify elements of a facility that perform well, meet design intent and criteria or require further study
• Provide recommendations to improve performance and develop new or improved design criteria or policies
• Apply findings toward long-term optimal operation of a facility and to future projects

Facility evaluation provides a comprehensive perspective on the effects of design decisions and resulting building performance.

Facility performance evaluations at HDR generally engage a rigorous mixed-methods approach that includes, but is not limited to, quantitative surveys and qualitative focus groups with building occupants. An important goal in developing HDR’s process has been to create standard, yet flexible facility evaluation tools for application to inform clients about capital adequacy and needs. The use of standardized tools facilitates consistent capture of data across projects of like typology for valid benchmark comparisons of both spatial conditions, measures of effectiveness from the user perspective and other outcomes measured with validated scales.

HDR’s evaluation instruments include modules for measurement categories and constructs including the following:

Ambient Environment Comfort

• Acoustics: Frequency of noise interruptions and disturbances, and sources of noise
• Lighting: Lighting adequacy and control, glare control, access to natural daylight
• Temperature: Temperature comfort and control
• Indoor Air Quality: Air quality and circulation

Occupant Needs and Well-being

• Privacy: How well a facility supports both acoustical and visual privacy needs, specifically related to confidential conversations and information
• Nature and Outdoor Views: Visual and physical access to the outdoors
• Safety and Security: User perceptions of safety and security, availability of safe patient handling equipment in healthcare facilities

Functionality to Support Work

• Space/Supply Access and Storage: Adequacy of space to perform job functions, sufficiency and convenience of storage space and point of care supply access
• Technology: Adequacy of provisions for current technology in the design
• Flexibility: Design support of evolving work processes and technologies
• Staff Amenities: Availability and importance of amenities

Convenience/Ease of Use

• Signage and Wayfinding: Ease of use, effectiveness, difficulty in navigation to destinations, logical space arrangement
• Accessibility and Transportation: Adequacy of parking, pedestrian access, delivery vehicle access, transit

Work Outcomes

• Collaboration and communication
• Stress
• Job satisfaction

HDR’s facility performance evaluations are highly flexible and can be scaled up or down depending on the needed scope, and can be implemented in any setting. Additional data collection methods may also be desirable to delve more deeply into the impacts of specific design elements or strategies on particular outcomes.

Looking to the Future

Given the changing healthcare landscape, facility performance evaluation may be just the right tool for the time. In the healthcare industry, understanding user needs and building performance is more important than ever during these times of rapid evolution. Strategically-oriented facility performance evaluations can help healthcare providers and designers, alike, to better understand the impacts of facilities and how best to evolve facilities to support the new healthcare landscape.