From Biophilic Quality Matrix Ratings to Candidate Design Interpretations: A Multi-Rater Study of Biophilic Integration in Three Singapore Hospital Environments

The Biophilic Quality Matrix (BQM) evaluates natural-element criteria in relation to intervention scales. This study applied its published 10 × 10 structure to examine document-supported biophilic integration in three completed Singapore hospital environments. Twenty-five trained raters independently assessed case-specific public documentation, organized under a common template, for all 100 C × S cells. Median ratings yielded hospital-specific BQM profiles for the three cases, and cross-hospital screening identified 67 shared candidate cells. Rater-level bootstrap analysis retained 47 high-stability cells at an inclusion-frequency cutoff of 0.95, and the study-defined high-priority rule further retained 18 cells with a median of 4 in at least two hospitals. Exploratory semantic organization of the retained cells distinguished criterion-anchored groups centered on plants, ecological systems, sunlight, and earthly materials from scale-anchored groups centered on direct use and on sensory perception and variability. The retained relationships were then traced across the three hospitals to documented spatial configurations, including pond–courtyard–bridge systems, water-and-plant respite gardens, planted terraces and roof gardens, landscape-facing building interfaces, and landscaped routes across the hospital campus. These spatial comparisons support candidate design interpretations for precedent analysis. The findings describe what the reviewed records support and do not establish measured environmental performance, realized user experience, restorative effects, or clinical outcomes.