Rapid technological development and changing demands from a changing population call for
new ways of working in the healthcare sector. As the working environment should support
these new ways of working and be prepared for yet more changes, new strategies for facility
planning need to be studied.
Architects have a long tradition of working with end user involvement in the early stages of
building projects, but over the past ten years, a shift in focus or trend has been noticeable.
Over time, the purpose of end user involvement has moved from mere participation to codesigning,
making fuller use of user knowledge and experience.
This paper revisits seven healthcare building projects, now in various stages of realization but
initiated in 2007–2011 using a design-driven co-designing framework, involving end users in
the early stages of developing and designing their future environment.
The co-designing framework and its outcome are revisited and scrutinized here in light of four
factors presumed to influence the quality of the process and its outcome: representativity,
continuity, ownership, and innovation. Each case was mapped through archival studies,
observations, and interviews with involved architects, project managers, and users.
The intention is to deepen our understanding of the planning framework and the consequences
of user participation and co-designing by highlighting recurring factors connected to the
collaborative planning process and its outcome.
The findings indicate that the framework’s basic structure has proven stable and useful in
several projects and, although affected by external factors such as timing, politics, and
finance, still offers good conditions for involving end users in project development and
ownership creation, enabling the development of innovative ideas.

user involvement; co-designing; healthcare planning; participatory design; ownership; representativity; continuity; innovation