Needs realization management process (NRMP)
: a shift of Focus to need-centred healthcare service design & management in Jordan

  • Rawan Juma

Student thesis: Doctoral Thesis


Context - There is not much agreement among scholars as to what the term “needs” refers to in the context of healthcare. The ambiguity surrounding patient needs has had many negative implications for the application of theoretical findings of this research in practical healthcare settings. Given the magnitude of the evidence pointing towards a strong relationship between environmental design and patient needs and outcomes, it is essential to examine the degree to which environmental design in contemporary healthcare facilities contributes to the realization and satisfaction of patient needs.

Aims - The primary aim of this study is to explore the nature and extent to which the built environment can potentially affect patient needs and outcomes, evaluating the extent to which said environment could contribute to patients’ healing processes. The study culminates in the introduction of a new design decision and management framework, which is aimed at addressing the performance gap that currently exists in the field.

Design - The design of this study is observational in nature, drawing on researcher observations and empirical data to obtain the study’s findings. The study uses deductive and inductive approaches to analysing the data, using these approaches to conduct a confirmatory analysis of existing evidence.

Methods - A systematic review is used by the researcher to gather data from solid experimental and non-experimental sources of knowledge. These sources are used to develop a conceptual framework, which will serve to guide the development of two questionnaires, distributed to patients and clinical staff.

Sampling - The final sample population of the study constitutes 216 patients and 102 healthcare staff members at 6 Jordanian hospitals, located in Amman.

Findings - The findings of the study support earlier research findings establishing a strong link between the built environment and patient needs and outcomes. Three key design dimensions were explored: spatial, ambient, and functional, all of which were found to influence patient needs in certain key design categories, including lighting, flooring, acoustic quality, visual quality, indoor quality, and accessibility. Implications The study concludes with the development of a design decision and management framework centred around patient needs and outcomes.

Originality - This study provides a framework outlining a proposed approach to evaluating how healthcare design solutions should be applied in practice—a commonly neglected theme in the literature.
Date of AwardFeb 2021
Original languageEnglish
SupervisorSalam Al-Bizri (Supervisor) & Mark Gaterell (Supervisor)

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