The paper reports and reflects on an evaluation project at Malmö Nya Sjukhus, NSM, Sweden, where the relationship between healthcare performance objectives and indicators in the built environment have been studied. The starting point of the study was the outcomes in performance set by the hospital and a retrospective analysis of how these could be related to evaluation of the design of the new hospital. The paper discusses evaluation against a backdrop of existing studies on evaluations and with an argument that that there is a need for tools and methods to strengthen design work in general. The main argument is that it is valuable to evaluate the work processes in healthcare against spatial configurations in addition to studying effects of specific design features. Connecting healthcare process indicators to spatial design also envision several challenges and possibilities that are addressed in the paper. The study presented is mainly qualitative with and explorative approach.