‘Complete the HEAT’: An Evidence-based Hospital Environment Audit Tool (HEAT)

Ms Jess Barry1, Ms Kathryn  Squires1, Ms Paulene Mackell1, Associate Professor Frances Batchelor1, Mr Andre Catrice2, Ms Amy Parker1, Ms Nicole Doran2

1National Ageing Research Institute (NARI), Parkville, Melbourne, Australia, 2The Department of Health, Victoria (DH)

Background: Functional decline is a leading complication of hospitalisation in older people. While environmental auditing of hospitals is an effective way of understanding the barriers and facilitators to optimising function for older patients, this process is often reliant on external consultants which can be time-consuming and costly.

Objective: To create an online, evidence-based tool that allows clinicians to audit their hospital environment and implement practical strategies to best meet the needs of older people.

Methods: Development of the audit tool was supported by the following:

  • Literature review
  • Benchmarking/trials against existing environmental audit tools
  • Consultation with older people, clinicians, engineers, architects and peak body representatives
  • Content development/online design
  • Pilot of functionality, format and usefulness


Results: The new Hospital Environment Audit Tool (HEAT) enables clinicians to audit their hospital environment without requiring any training: www2.health.vic.gov.au/hospitals-and-health-services/patient-care/older-people/environment. It consists of 19 questionnaires across 5 sections that can be completed together or individually using a computer, handheld device or hard copy version. An action plan template is also available to document the progress of any recommendations suggested by the audit. Pilot evaluation from 8 Victorian Health Services found that the HEAT was easy to use and provided a basis for implementing environmental improvements to optimise the care of older people in hospital.

Conclusion: The HEAT is an evidence-based tool that encourages clinicians to consider how the hospital environment affects an older person’s mobility, independence, wellbeing and health outcomes. With this resource freely available online, it’s time to ‘Complete the HEAT’!


Jess Barry is a Research Assistant within the Clinical Gerontology Division at the National Ageing Research Institute (NARI). Her research at NARI focuses on investigating the needs and priorities for older people regarding their health and wellbeing and exploring acute models of public health care for this population.

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