Indoor Environmental Quality (IEQ) plays a critical role in user comfort and health

yet research in Indonesian hospitals has predominantly emphasized objective measurements

often neglecting users’ subjective perceptions. In contrast

global studies assessing IEQ performance using the Importance Performance Analysis (IPA) based on subjective user evaluations. This study addressed this gap by integrating traditional and alternative IPA methods with objective field measurements to assess 17 IEQ elements

covering thermal comfort

indoor air quality

visual comfort

acoustic comfort

and interior quality

in hospital wards. The research was conducted across three hospitals in Jakarta

Indonesia

aiming to identify and prioritize key areas for improvement. A mixed-methods research approach was employed

involving 178 participants (staff

patients

and visitors) in hospital wards. Gap analysis of users’ perception revealed significant performance gaps were identified in 13 out of 17 IEQ attributes. Traditional IPA identified temperature

noise level

natural light

and lighting control as high-priority concerns

alternative IPA expanded this list to 10 IEQ attributes. Both IPA matrices consistently indicated that natural elements

outside view

glare

and thermal control were low-priority. Conversely

space layout

speech privacy

and lighting intensity were found to exceed expectations. Objective measurements confirmed environmental deficiencies: indoor temperatures ranged from 23.4–27.6 °C (above the 22–23 °C Indonesia’s standard)

average CO₂ concentration reached 827 ppm (exceeding the 1 ppm national threshold)

and PM₂.₅ levels averaged 93 μg/m3 (above the 25 μg/m3 limit). Ventilation was inadequate

several rooms failed to meet requirements for natural light access and occupancy density. Integrating objective data with alternative IPA enhances the precision of IEQ improvement prioritization. The combined approach identified nine critical IEQ aspects for improvement: temperature

noise level

natural lighting

air quality

cleanliness

lighting control

room size

air exchange

and air velocity

while humidity was generally satisfactory. Despite varying user roles

findings suggest a shared need for improved indoor comfort. This integrated method offers a more targeted and comprehensive framework for prioritizing IEQ enhancements in hospitals and other building types. This study advances healthcare facility design by combining subjective user perceptions with objective environmental data

offering a robust framework for IEQ assessment and improvement.