Outdoor spaces in public healthcare institutions play a vital role in reducing patient stress and supporting healing. Well-maintained and well-designed open and green spaces around clinics have a positive effect on employee well-being and job satisfaction, improve patient experience, and even shorten hospitalization times. There are few open spaces in the largest hospital area in Slovenia, where University Medical Centre (UKC) Ljubljana and the Institute of Oncology Ljubljana are located. The proportion of green spaces on land owned by health institutions is only 13%, which is half of what is recommended by the Ministry of the Environment and Spatial Planning of the Republic of Slovenia.

A space tailored to patients and healthcare workers

Although health workers, patients and their relatives represent the main users of the outdoor space of clinics, they are rarely invited to participate in discussions about the space. Our research focused on their perspective. We wanted to know what their experience of the space is, what their needs are and how the space could be improved to better support the healing process. The user experience research included behaviour observation, online surveys, workshops, interviews, setting up test benches and collecting inputs at a planning stand.

The results show that users are well aware of the outdoor spaces and are able to precisely express what they need. The most frequently raised problems of the outdoor areas of the clinics by both patients and health professionals are the lack of seating and benches, insufficient number of bicycle racks, the lack of greenery and trees, and the poor signage and wayfinding system. Staff also miss well-designed spaces for socialising and see potential in atrium landscaping and greening of roofs. Patients point out that there are no waiting areas (for appointments and for pick-ups) in the clinics, they are also frustrated by obstacles on the pavements, and they miss places to relax and retreat to privacy.

Better outdoor spaces are possible today

Improving outdoor spaces doesn't have to be left to chance. Just a small square, an extra bench, a bright pavilion, a landscaped lawn and a tree can make a big difference to the experience of a space and mean a lot to users. We have applied the findings of our research to four typical public spaces in the area: a square, a street, a promenade and a riverbank. Proposals for the renovation of the square by the Emergency department, the Ljubljanica riverbank, the promenade to the main building of the UKC and a part of Zaloška Street. There are many similar spaces in the area which can be developed without major interventions in the traffic infrastructure.

Small measures for more welcoming spaces

Between 2022 and 2024, a series of temporary measures and small-scale interventions were carried out on the premises of the clinics. Benches, a covered waiting area, an exhibition, a pavilion redesign and a lighting intervention were implemented as immediate measures to improve the experience of outdoor areas with minimal financial resources. The overwhelmingly positive response from users and the management has made some of the measures permanent - such as the pavilion next to the main UKC building and the removal of VIP parking on the square by Zaloška Street.

The covered waiting area at Zaloška Street is a direct response to the lack of space needed by patients in the clinic area. The demountable structure made of metal and wood can accommodate more than 12 visitors at a time under a roof, sheltered from the rain and sun. The waiting area deliberately occupies space that - to the detriment of patients and everyone else who has to get around on foot - used to belong to cars. The square, which has large trees, was fenced off with planters, a chain, a billboard and blocked off by VIP cars, despite the fact that it is the most important orientation point in the area.

The Goal: An environment that supports the healing process

There is growing evidence that poor design of the outdoor environment is detrimental to wellbeing and can in some cases have negative psychological and physiological effects on users of healthcare services. Outdoor healthcare spaces should be recognized as essential self-care infrastructure requiring dedicated design, maintenance, and investment. Urban planners should ensure that these spaces are designed to accommodate the diverse needs of patients and health workers, fostering an environment that is navigable and accessible for individuals of all abilities. The aim of owners and maintainers should therefore be to create an environment that supports the healing process and increases the satisfaction of healthcare workers.