Democratising hospital design: Reconfiguration of disciplinary power via M. Foucault’s theory

Abstract

Hospital interiors remained decisive sites where spatial form, materials, lighting, and acoustics
structured everyday conduct, making the democratisation of design a timely concern for healthcare quality and
dignity. The purpose of this study was to theorise and test a “democratisation design” logic that reconfigured
disciplinary power into emancipatory spatial practice. A mixed qualitative design method was employed that
combined literature synthesis, discourse analysis of briefs and standards, and comparative case studies of five
contemporary hospitals to evaluate spatial layout, material language, adjustable lighting, and participatory
navigation. How traditional interiors encoded hierarchy through radial zoning, cold hard finishes, uniform
high-illuminance lighting, and voice-controlled soundscapes was investigated; these configurations produced
routinised flows and asymmetric visibility. Decentralised layouts, nature-based materials, and circadian-tuneable
lighting were established to rebalance perception and privacy while sustaining hygiene and throughput. Dialogic
interfaces – open corridors, shared decision-making corners, and self-service information – were analysed and
were found to reduce information asymmetry, improve perceived control, and increase trust and satisfaction. The
findings were summarised as a four-part framework (movement, material, light, sound) showing where specific
interventions reinforced or redistributed power across entry, waiting, and treatment zones; across five cases,
queuing stress was reduced, wayfinding times were shortened, and staff coordination was supported without
increasing infection-control risk or compromising clinical workflows. The results could be used by healthcare
architects, engineers, and hospital managers to inform design guidelines and post-occupancy evaluations that
align safety and efficiency with agency, dignity, and participation in both new builds and phased renovations