Children’s hospitals are often cited as spaces that contribute to traumatic experiences of stress and fear in “little patients”. “The Little Patients” Association of Bonn worked to remove the negative effects of conventional hospital design at the Oldenburg Children’s Hospital through targeted improvements: clear signage, floor inlays, posters, pinboards, toys, creation of a room for those in mourning, furnishings, more windows and open spaces, etc. The goal of this empirical study, consisting of 59 patients (of 104), 65 medical employees (of 330) and 39 trained student observers, was to see how such alterations in hospital design can impact patients’ recovery, well-being, and create the sensation of visiting a “Children’s Hospital of the Future.” Patients, employees, and students filled out the “Koblenz´ Architecture Questionnaire”. The questionnaire’s “virtual walk-through” made the observers aware of specific aspects and gave them an overall impression of the building. A five-point rating scale, which ranged from +2 (very good) to 0 (average) to -2 (very poor), was applied to 112 items by patients and 171 items by observers. The methods of Building Performance Evaluation, the facet approach, descriptive measurements, t-tests, and regression analyses were used. The results of the study yielded conclusions about how to construct and remodel children’s hospitals. A system for evaluating the quality of hospitals was further developed. Patients and student observers characterized the Oldenburg Children’s Hospital as surprisingly successful and forward-looking. The possibility for parents to stay overnight, the “Bear Club,” the children’s library, and the chapel were especially recommended. Improvements to the building’s exterior, more privacy, and the availability of a ‘retreat’ for patients were still desired, and the operating room maintained its status as a “fear room”. Second Study: In the Children’s Clinic in Oldenburg (whose administration is considered to be experts in economic questions of hospital operation), a second study was carried out, in which 36 physicians and administration personnel -- a total of 50 individuals -- were asked the following questions: Which features of 1) the small rooms for children, 2) of specialty spaces, and 3) of the hospital as a whole are related to economic efficiency, and on what features these personnel base their judgment whether a feature is related to economic efficiency. Qualitative data about open questions, and quantitative results were collected through a Building Performance Evaluation and User Needs Analysis. The open answers relate to questions pertaining to the ten criteria for economic efficiency. (For example: “The building contributes to the realization of the goal of being a children’s hospital of the future”; “The building contributes to the earlier release of patients, because they are recovering faster”). The ten criteria are rank ordered according to their median values of having been judged to apply. The most applicable criteria were then rated, independently, by the chief administrative officer and his deputy according to their ‘felt’ annual cost impact. Using a stepped regression analysis (non-standard beta-coefficient), the relationships of variables for the three areas to the criteria associated with the highest costs were calculated. The costs of the variables with the highest effect on the applicable criteria can be stated. In this study for the children’s hospital in Oldenburg, ten criteria out of 148 items were found to be useful for measuring the efficiency of a children’s hospital. In part, these criteria can be connected with ‘countable’ data. In conclusion, apart from it positive effect on healing, child-friendly design gives children’s hospitals a competitive economic advantage over conventionally designed hospitals. “Quality architecture conveys an image of quality care.”