The shift towards evidence based design has focused increasing attention on the role that design plays in enhancing healthcare outcomes for users in specific healthcare contexts. The purpose of this study was to explore occupational and physical therapy practitioners’ use of outdoor environments, in the context of patient treatment in rehabilitation facilities. A multimethod approach, with cluster sampling by climate region, was used to survey therapy supervisory personnel, and to interview occupational and physical therapy staff working within Inpatient Rehabilitation Facilities across the United States. The outdoor environments were valued as a resource for patient treatment related to four themes: the affordances provided for goal facilitation; the psychosocial benefits perceived; meaningful participation opportunities for patients; and patient satisfaction. The factors reported most frequently influencing the use of the outdoor environment for patient treatment were related to features supporting goal facilitation, shade provision, location, and patient length of stay. This study provides a new perspective on the unique characteristics of a rehabilitation environment, which calls for careful consideration of design features so that the need for challenging opportunities is balanced with the needs of those with the least abilities. The use of outdoor spaces by therapy practitioners is significant in that it can allow patients to have additional exposure to the natural environment while providing contextually relevant and meaningful opportunities to address therapeutic goals. In addition, as a billable service, the use by therapy staff may assist in enhancing the value of these spaces.
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