Building Healthier Hospitals

Smarter hospital design could improve the recovery of patients.

Jan 20, 2015 6:00 AMNov 20, 2019 9:34 PM


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Most of us have been lost in a hospital. One study in a 600-bed hospital estimated that poor wayfaring cost over $220,000 a year. Much of this was due to the 4,500 hours of clinical time a year – approximately two full-time positions – that was spent giving directions to lost patients and even staff.

Signs at every junction and clear demarcations of different areas with visual cues such as different-colored floors or walls can help. Some of these principles have also been used for making wards dementia-friendly.

Photo Credits: CBCK / Shutterstock

Naturally lit rooms, which allow patients to see whether it’s day or night, have been linked to better sleep, less pain and less stress.

In one study patients in naturally lit rooms took fewer painkillers than those in darker rooms, leading to a 21 per cent reduction in medication costs.

Photo Credits: spotmatik / Shutterstock

Despite the available evidence, hospitals and clinics vary hugely in how much they take into account the design factors that we know are better for patient health. Many healthcare services are housed in buildings that do the exact opposite of what research suggests is helpful.

Roger Ulrich, the researcher who first compared natural and non-natural views in hospitals, firmly believes that good hospital design can save money.

“It’s clear that hospital design can help reduce pain and stress,” he says. “By carefully selecting, in evidence-based ways, certain important design upgrades when creating a new hospital, the design upgrades will cost more, e.g., single rooms, measures to reduce noise, but they pay back rather quickly by shortening stays and reducing other costs.”

[This gallery is adapted from a story that appeared on Mosaic. It has been edited to fit this format.]

Photo Credits: Stacey Newman / Shutterstock

Layouts need to be coherent enough for us to feel we that understand where we are and can interact easily and safely, but complex enough to give us a sense of exploration and mystery, a feeling that not all the space has been revealed at once.

The idea of mystery as a therapeutic element in hospital spaces seems counterintuitive: why would we want to make environments more complex? The idea comes partly from evolutionary theories that suggest we will stay interested and alert if we have a sense that there are elements of our environment left to discover. But we also need to be able to feel that we have somewhere safe we can retreat to or hide if necessary.

Research into buildings that make us recover better goes back to the 1980s, and has gathered momentum in recent years. Roger Ulrich, Professor of Architecture at Chalmers University of Technology in Sweden, was one of the first to research how hospital buildings can affect patients.

In 1984, Ulrich took advantage of a natural experiment created by a long hospital corridor, in which half the patients had a view of a brick wall and half a view of trees. The patients facing the natural view got better more quickly and reported less pain than those facing the wall. They asked for fewer painkillers and reported fewer minor complications like headaches or sickness.

Photo Credits: Craig Auckland / fotohaus

The Dyson Centre for Neonatal Care in Bath, England, shown here, is an example of a new and different type of healthcare design.

Deliberately distancing itself from the traditional hospital look, feel and smell, this and other places like it are drawing on a growing body of research that shows that buildings themselves can speed the recovery of patients, as well as boosting the health and happiness of the staff who work in them.

Photo Credits: Imageman / Shutterstock

Sleep is important. Poor quantity and quality of sleep can lead to increased stress, impaired immune function and difficulties with temperature regulation. Perhaps unsurprisingly, patients in quieter hospitals report that they sleep better.

A quieter environment is also associated with fewer patients returning to hospital after discharge, perhaps because of the additional benefits that sleep brings.

Photo Credits: Dmitry Pistrov / Shutterstock

Other studies have shown similar results. In one experiment, bedridden heart-surgery patients were given color pictures to look at after their operations. Patients looking at an open, well-lit and natural image of trees and water needed fewer painkillers than patients who had no picture or an abstract image.

Another study found that healthy volunteers sitting in a hospital had a higher pain threshold and better pain tolerance when they were watching a video of nature scenery than when they were watching a blank static screen.

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