Advancing indoor environmental quality (IEQ) in Indonesian hospital wards: an integrated importance performance analysis (IPA) and objective approach

Indoor Environmental Quality (IEQ) plays a critical role in user comfort and health, yet research in Indonesian hospitals has predominantly emphasized objective measurements, often neglecting users’ subjective perceptions. In contrast, global studies assessing IEQ performance using the Importance Performance Analysis (IPA) based on subjective user evaluations. This study addressed this gap by integrating traditional and alternative IPA methods with objective field measurements to assess 17 IEQ elements, covering thermal comfort, indoor air quality, visual comfort, acoustic comfort, and interior quality, in hospital wards. The research was conducted across three hospitals in Jakarta, Indonesia, aiming to identify and prioritize key areas for improvement. A mixed-methods research approach was employed, involving 178 participants (staff, patients, and visitors) in hospital wards. Gap analysis of users’ perception revealed significant performance gaps were identified in 13 out of 17 IEQ attributes. Traditional IPA identified temperature, noise level, natural light, and lighting control as high-priority concerns, alternative IPA expanded this list to 10 IEQ attributes. Both IPA matrices consistently indicated that natural elements, outside view, glare, and thermal control were low-priority. Conversely, space layout, speech privacy, and lighting intensity were found to exceed expectations. Objective measurements confirmed environmental deficiencies: indoor temperatures ranged from 23.4–27.6 °C (above the 22–23 °C Indonesia's standard), average CO₂ concentration reached 827 ppm (exceeding the 1 ppm national threshold), and PM₂.₅ levels averaged 93 μg/m³ (above the 25 μg/m³ limit). Ventilation was inadequate, several rooms failed to meet requirements for natural light access and occupancy density. Integrating objective data with alternative IPA enhances the precision of IEQ improvement prioritization. The combined approach identified nine critical IEQ aspects for improvement: temperature, noise level, natural lighting, air quality, cleanliness, lighting control, room size, air exchange, and air velocity, while humidity was generally satisfactory. Despite varying user roles, findings suggest a shared need for improved indoor comfort. This integrated method offers a more targeted and comprehensive framework for prioritizing IEQ enhancements in hospitals and other building types. This study advances healthcare facility design by combining subjective user perceptions with objective environmental data, offering a robust framework for IEQ assessment and improvement.