Evaluating a Healthcare Rooftop Garden: Post-Occupancy Insights into Evidence-Based Design Processes and Governance Considerations

Therapeutic gardens are increasingly integrated into healthcare planning and design, supported by evidence showing that exposure to nature promotes health and well-being. As urbanisation and densification intensify, rooftop gardens offer a sustainable means of providing health-promoting green spaces in urban settings. This study aimed to deepen understanding of the EBD process behind a purpose-built rooftop garden at an urban Memory Clinic. It examined how the garden was experienced in terms of perceived successes and shortcomings and which design decisions or contextual factors were most influential. A POE was conducted through focus group interviews with healthcare professionals and an interview with the responsible landscape architect. Data were analysed using thematic analysis, producing five themes organised around three questions: How the garden turned out, why it turned out that way, and IF changes were desirable. Findings show that while the garden exceeded expectations regarding aesthetics, restorative qualities, and staff use, it was not used for patient-oriented therapeutic activities as intended. This divergence was linked less to physical design quality than to organisational change, the loss of key actors, insufficient documentation of design intentions, procurement disruptions, shifting clinical priorities, and maintenance arrangements. The study highlights “implementation drift” as a critical risk in EBD processes.