Design for all A.U.D.I.T. (Assessment Universal Design & Inclusion Tool). A tool to evaluate physical, sensory-cognitive and social quality in healthcare facilities.

BACKGROUND AND AIM: Universal Design (UD) is the design of environments equally accessible and usable to the wider range of people regardless their abilities or disabilities. Various studies highlight the lack of evaluation tools to support decision makers to enhance inclusive environments, especially complex constructions with various users as healthcare facilities. The research proposes a tool to evaluate the quality of building according to UD through a new set of objective indicators with a performance-based approach. METHODS: the tool has been developed through three main phases: 1. Analysis of the state of the art through a systematic literature review and workshops with stakeholders and experts; 2. Elaboration of the evaluation framework following the Multicriteria analysis methodology; 3. Application, to test and validate the tool in hospitals. RESULTS: the tool, named Design for All A.U.D.I.T., evaluates the level of UD analyzing Physical, Sensory-cognitive, and Social quality through a set of criteria specified by indicators and measurable requirements. The tool assesses the different healthcare environments through criteria and indicators to verify the level of appropriateness in terms of UD. The tool provides report with quantitative, qualitative and graphical information in plan of the facility status and design strategies. CONCLUSIONS: The study proposes an innovative evaluation system to determine the inclusion of hospitals, both for projects and for existing buildings. The flexible structure allows the tool to beapplied in different building typologies, currently adopted to identify hospital's weaknesses and setting priorities of intervention on inclusion.

Covid-19 emergency management and preparedness in cross-border territories. Collection of experiences, needs and public health strategies in the framework of interreg GESTI.S.CO. project.

BACKGROUND AND AIM: The Covid-19 pandemic highlighted management difficulties in neighboring territories. The aim of the paper is to report the needs of different stakeholders during, before and after Covid-19 emergency with specific regard to challenges faced by public administrators in confined territories. METHODS: In the framework of Interreg GESTI.S.CO. project the study has been designed with two methodological steps: i) a co-design workshop and ii) a web-based survey. The workshop includes both an audience interaction session and focus groups. Then, starting from the focus group results, the survey has been designed with 30 questions and submitted to the 227 municipalities located between Italy and Switzerland to understand the implementation of Public Health strategies in local emergency planning. RESULTS: The interactive session highlighted that most of the critical issues are related to the lack of communication and planning in Public Health policies. The survey highlighted that the local emergency plans rarely integrate a section on health emergencies (30% Italy and 50% Switzerland). Only 20% of the respondents dedicated a section for Covid-19 emergency management. Most of them did not activate initiatives to support mental health. 90% of the municipalities did not cooperate with the neighboring country, but half of them think that it would have been much more useful. The 55% of the Italian respondents are currently updating their emergency plan and will implement it with some Public Health input. CONCLUSIONS: The study provides insights that can support policy makers in improving their strategy in responding to future pandemic. (www.actabiomedica.it).

Communities, Sport, Inclusion. Strategies for Parish Complexes Social Reactivation Through Sport Practice Promotion.

The following contribution presents some findings deriving from the research project "Sport is Society" by Politecnico di Milano. The research reflects on the built heritage and its ability to be accessible and usable for different users with different needs in its structures and offer of services, focusing on sports activities and spaces. The study refers to collective ecclesiastical structures in the contemporary city. The research in this area demonstrates the possible degrees of innovation regarding the increase in the inclusiveness of private facilities with a public vocation, where sport represents a driver of social inclusion for the community. The research proposes advice to guarantee inclusive sports facilities for the community, highlighting the strict relationship between the inclusive city and the ecclesiastical heritage, as an emerging issue to be investigated and solved. Starting from its relevance and the potential of the structures to become a truly "accessible patrimony", the tool suggests strategies for policymakers and ecclesiastical administrations to make them become "open services" - usable and accessible by all - for and inside the urban community.

Developing Innovative Solutions for Universal Design in Healthcare and Other Sectors.

For over half a century, researchers have sought to better understand the needs of people with disabilities in the built environment, and for more than a quarter century, they have sought to understand the effectiveness of universal design (UD) on a wide range of people and populations. This research led to the creation of the innovative solutions for Universal Design (isUD) building certification program, which addresses knowledge gaps in the practitioner's field with UD criteria. The isUD focuses on commercial buildings but aims to expand to other sectors including healthcare and residential settings. The research and outcomes used in the development and evaluation of the isUD combined with lessons learned from implementation of the isUD program suggest a path forward to improve and expand the program. Several research studies have evaluated the effectiveness of UD standards. One study compared university residence halls, one of which was built using a draft version of UD standards using a guided tour and online surveys among other methods.[1] Another study used online surveys to compare a workplace built using the isUD with the former workspace.[2] Another study used in-person surveys to compare public right-of-way features pre- and post- design intervention.[3] Lastly, an innovative doctoral dissertation that proposes a new methodological tool to evaluate UD in healthcare settings [4-5] has been analyzed to inform the isUD's expansion into the healthcare sector. The results indicate there is value in using UD to address equal access to and use of facilities for people with and without disabilities, and people of diverse social, cultural, and economic backgrounds. Facilities built using UD standards and tools are more usable, comfortable, and satisfying for users. However, the results also indicate there is room for improvement to make the isUD tool more effective. These improvements will better enable expansion of the tool to be usable in settings with more specialized requirements. While UD is often effective at improving human performance, health and wellness, and social participation across some measures, and while tools that assist with UD implementation may further help achieve these outcomes, to gain widespread adoption across multiple sectors, such tools must be shown to be consistently effective in achieving UD outcomes across all measures. These improvements can help expand availability of UD to a wider, more diverse audience.

Designing Hospitals Through the Lens of Universal Design. An Evaluation Tool to Enhance Inclusive Healthcare Facilities.

Various studies highlight a gap on reliable methods to measure the quality of projects and environments in terms of Universal Design (UD) and Design for All (DfA). In particular, healthcare facilities need decision support systems to improve the well-being of as many users as possible through a systematic approach. The present research proposes an evaluation tool to support designers and decision makers in the adoption of UD to develop healthcare facilities suitable for a wide range of users. Several methodologies have been adopted: an in-depth literature review on the current state of knowledge on UD evaluation, workshops and focus groups with both users and experts, and the analysis of four hospital case studies. The result was an evaluation framework built by using a Multi-criteria Analysis (MCA) methodology. The first version of the tool was applied to an American hospital and validated d in an Italian pilot case study. The research outlines a tool called Design for All A.U.D.I.T., able to evaluate Physical, Sensory-cognitive, and Social qualities based on a hierarchical framework with criteria and indicators based on UD and DfA. The framework evaluates the different areas of the hospital from outdoor to indoor spaces, allowing hospital administrators to act to improve the well-being of users according to the critical aspects of UD identified by the tool. The analysis provides a report of the facility status and design strategies to support designers for new projects or buildings renovations. The application shows that DfA A.U.D.I.T. can assess hospitals by examining both spatial qualities and DfA criteria. The tool could represent a decision support system in the national and international context, where many hospitals are not newly built. Further research will include application in different facilities and building typologies, aided by the flexible structure of the tool, which allows measurement of the environment's quality in terms of DfA and UD.

Evaluation Methodology for Inclusive Schools Environments. A Comparative Analysis Towards Goals and Strategies for Urban Design.

The paper deals with the issue of social inclusion in the scholastic environment where children begin to learn the set of rules that manage social life. The design of the spaces impact on people and becomes crucial to address a community behavioural change in terms of social inclusion. In line with Universal Design strategy, the paper presents a method developed for evaluating the degree of inclusion of primary schools' spaces, which consists of the definition of an evaluation matrix. The matrix makes possible to analyse quantitative-qualitative characteristics for each school and compare them objectively. It asses the level of accessibility and inclusion of the schools through four main categories (Outdoor space, Orientation, Movement, Spatial quality) and related criteria and indicators. The reliability of the evaluation matrix has been verified through its application in seven case studies (Italian and EU), and the analysis of one of them is described in the results. The present study proposes a basis to introduce a method able to support designing educational spaces that satisfy the needs of a wide range of users according to Universal Design strategy.

COVID-19 and Healthcare Facilities: a Decalogue of Design Strategies for Resilient Hospitals.

BACKGROUND AND AIM: The COVID-19 pandemic has upended the global healthcare systems. The surge in infections and sick critically ill patients has tested the resilience of healthcare infrastructures and facilities forcing organizations to quickly adapt and embrace emergency solutions. The paper proposes a decalogue of design strategies applicable both to new hospitals and to the refurbishment of existing hospitals. METHODS: The authors conducted observations at hospitals, during public health webinars and through experts working groups from March to May 2020. RESULTS: In this commentary, the authors present a list of strategies for creating critical care surge capacity and exploring design strategies for healthcare design for resilient hospital facilities. The strategies are organized into two tiers: I) design and II) operations. The (I) Design phase strategies are: 1) Strategic Site Location; 2) Typology Configuration; 3) Flexibility; 4) Functional program; 5) User-centerdness. The (II) Operation phase strategies are: 6) Healthcare network on the territory; 7) Patient safety; 8) HVAC and indoor air quality; 9) Innovative finishing materials and furniture; 10) Healthcare digital innovation. CONCLUSIONS: Hospitals, health care systems, and institutions urgently need to assess their resources, identify potential bottlenecks, and create strategies for increasing critical care surge capacity. The COVID-19 pandemic disrupted healthcare operations and accelerated the processes of innovation and transformation. The design and operational strategies can enable the achievement of resilient hospital facilities. Further multidisciplinary researches is needed  to validate the strategies empirically.

Towards a Universal Design Evaluation for Assessing the Performance of the Built Environment.

Universal Design is a recent and innovative strategy aimed at designing spaces that are as accessible and inclusive as possible. It considers the broadest range of users, and goes beyond the prescriptive approach of accessibility legislation. Theoretical research on this strategy is currently increasing, but the reliability of its principles remains limited in design practice and it struggles to guarantee performance-based knowledge to designers. Therefore, a practical evaluation method based on reliable performance criteria is required. The purpose of the research is to investigate which means, methods, and principles of Universal Design and Design for All are currently used to evaluate the accessibility and inclusion of the built environment. The paper describes a literature review aimed to select methodologies and reflect on instruments that are inherent to the thematic. The research's outcome is therefore the definition of both open issues and gaps in this field, which is based on the comparison of the studies analysed. In addition, the potential outlooks on the issue of Universal Design and Design for All evaluation are discussed. The current results provide a basis for further research on the development of evaluation and support tools for designers that are able to improve the accessibility and inclusion of the built environment, and the reliability of Universal Design performance criteria in design practice.