The present study aimed to analyse the hospital´s management system as performed by the hospital staff and the relationship between management and environmental improvement projects in common spaces.<br> Today, hospitals are expected to provide patient-centred medical care and high quality environments in their health care spaces. New hospital construction incorporates large common space areas such as day rooms, waiting rooms, corridors, and lobbies. However, the hospital staff has the difficult task of improving and maintaining the spatial and environmental conditions, such installing adequate furniture or artworks. Thus, after the building is completed, the environments turn into untidy and gradually desolated spaces due to an unclear management and maintenance system.<br> This study focused on exploring all common spaces in one hospital in Tsukuba city, Japan. It considered these spaces not only as complementary to medical care, but also areas in which the medical and home environments meet. As part of the research methodology, interviews with hospital staff were conducted to understand how they manage and care for the environmental elements found in common spaces.<br> Section 2 introduces a description of each common space found in different areas of the hospital. First, the public access areas included waiting rooms for outpatients and exams, and areas outside the ward for connection purpose (i.e. corridors connecting two buildings). Second, the areas without public access included non-waiting rooms (corridors, corridors with waiting areas, lobbies) for outpatients and exams, and areas inside the ward for patients (corridor, day rooms).<br> Section 3 identifies the maintenance management system as a particular environmental element for staff. As a result, there were two systems for the management of common spaces. The first system was the management of all environmental elements by specific staff that was exclusive to common space maintenance. In the second system, individual staff members were not responsible for maintaining spaces, which created disorder in common areas. The former involved areas without public access and the latter involved the public access areas. Therefore, both management systems for common spaces coexisted on the same floor and thus lack continuity.<br> Section 4 describes the environmental improvement projects that have influenced the management system. Three spatial renovation projects were accomplished through a number of meetings and workshops with hospital staff to discuss the environmental problems and design concepts. Therefore, the hospital staff maintained order and cleanliness in the common spaces following the renovation. The signboard renovation project was launched to provide continuity in plural common spaces under different management systems. The staff did not participate in the process, hence they had no understanding of the new sign and colouring system concept. As such, the signboard renovation project had no influence on maintenance.<br> Consequently, the hospital has problems in several areas with their hospital staff-driven management system. However, environmental improvement projects have influenced the hospital staff's perception and management to maintain order and cleanliness in the common space environments. Accordingly, there are three provisions for the management and improved environment of common spaces: 1) create the concept of each common space managed jointly with hospital staff; 2) remove problems in the management system; and 3) create a design rule to integrate several management systems and share with hospital staff.