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Stroke care units: evaluating the design quality and its impact on care and rehabilitation, safety, patient's health, and perception of the environment

The present study will explore how the quality of the design influences care and rehabilitation, safety and patient’s health in stroke units.

As a framework the Institute of Medicine, the International Classification of Functioning, Disability and Health, and stroke care evidence and guidelines will be used in order to study how the environment influences the health and care in newly built stroke units in Sweden. Lately team care, the patient’s possibility to be active and participate in the planning of her/his own care and rehabilitation have been identified as important factors for the patient’s health but is this reflected in the design of new healthcare environments e.g., a stroke unit?


The overall aim is to generate knowledge regarding the quality of the physical healthcare environment and the complex relationships between the quality of the environment of the care provided, health outcomes and the user’s perception of the design of the healthcare environment.

Specific aims

  • To describe and evaluate the quality of the physical environment in stroke care units
  • To explore facilitators and barriers of the physical healthcare environment in stroke units regarding:
  1. quality of the care and rehabilitation
  2. patient’s health
  3. patient safety
  4. patient’s participation in care-planning
  5. inter-disciplinary team work
  • To describe how the users (patients, significant others and staff) perceive the design of the stroke units.


The design is explorative, comparative, longitudinal with a case study approach, in which stroke units as an integrated whole will be studied. In depth understanding of how individuals act and interact in a context calls for a combination of methods that go beyond questionnaires. We will conduct a mixed-method study that combines quantitative and qualitative data. Questionnaires, interviews and observations will be used. Observations can capture the less tangible aspects of the process of care, gain insight into interactions between individuals, and groups, illustrate the setting, and capture context/process and information about influences of the physical environment.


The National School of Health Care Sciences, the Swedish Stroke Association, FORMAS

Principal Investigator

Marie Elf

Other researchers

Lena von Koch, Peter Fröst, Christina Sjöstrand

Doctoral students

Anna Anåker