Eric Legras … THEDOCTORFACTORY … Health & Wellness Strategic Marketing

Healing Environments: How simple design elements can promote recovery. by Aléxia Herms

By Korey Capozza for MSN Health & Fitness


Medically Reviewed By: Pat F. Bass III, M.D., M.S., M.P.H.

Enter most health care facilities today and you’re likely to find an aesthetic that might best be described as Eastern Bloc utilitarian—concrete facades and drab, institutional interiors. For patients and their families, spending time in these dark, cramped environments surrounded by strangers, austere equipment and unfamiliar sounds can add to the stress of coping with an illness or condition.

However, a new movement is challenging the status quo and pushing for health care design that promotes healing. The Center for Health Design, a research and advocacy organization in Concord, Calif., is leading the charge in this area. The goal? To improve health care delivery and patient experience through architecture and design.

“As the baby boomers age, they are going to ask for better hospital environments and expect to see features that make them more friendly and less institutional.” says Anjali Joseph, the center’s director of research.

Fortunately, improving the healing environment is surprisingly simpleseven small changes can dramatically improve the experience of patients on the mend. Chief among these is access to light, especially natural light, which can have a profound affect on mood.

For example, two studies—one of depressed patients and the other of heart attack patients—found that those housed in sunny rooms were discharged between two and four days earlier than those in darker rooms. And exposure to natural sunlight also appears to improve sleep: A study of nursing home patients found that those with afternoon exposure to light had more restful sleep at night.

Interestingly, light may play a role in perceived pain and medication use as well. A 2005 study of surgery patients treated in either the sunny side or dim side of a hospital found that those on the bright side experienced less stress, slightly less pain, and required 22 percent fewer pain medications.

Nature and the outdoors may also lift spirits and improve recovery. Laboratory and clinical studies have shown that viewing nature reduces stress and enhances a sense of control—a key aspect of wellness. Urban hospitals, often situated in the heart of the concrete jungle, rarely afford views of green space. But even a glimpse of tree tops, rather than parking lots or brick walls, can produce this effect.

“Patients want to feel in control of their health, to make their own choices while in a health care facility, and to not feel so dependent on staff for help,” says Cynthia Leibrock, a designer who has written several books on the topic including Design Details for Health (Wiley).

Indeed, inside the hospital, many patients feel powerless, especially when it comes to controlling noise. A cacophony of alarms, moaning patients, intercom messages and hallway chatter invade personal space and jangle nerves. Studies have shown that loud background noise increases staff stress, may lead to medical errors, and is a leading source of complaints by hospital patients and their visitors. According to the Center for Health Design, installing sound-absorbing ceiling tiles, providing single-patient bedrooms, and removing or reducing loud noise sources on hospital units can greatly reduce this cloying background din.

Blocking out noises that grate is one strategy; enhancing sounds that heal is a complimentary one. The sound of moving water, such as a fountain or waterfall, can relieve stress. So can soft music; however, given that one patient’s relaxation soundtrack may be Mozart while another’s might be Metallica, in-room stereo units rather than piped background music are the optimal solution.

Color too can impact mood, says Leibrock. And nothing screams institutional like “hospital green,” that non-descript minty hue favored by clinical facilities the world over. In fact, that particular color was selected by so many hospitals because it provides the best contrast with red allowing staff to see blood stains more clearly. But hospital green can evoke negative feelings in patients, and a monochromatic color scheme contributes to an institutional feel. Instead, warm, natural tones like sage and wood can foster a more inviting ambiance.

“You can use these details to set a mood, a relaxing, supportive, almost residential environment,” Leibrock says. Decorative elements like table lamps, carpets, window treatments, and wood furniture also help create this homelike atmosphere. But, Leibrock cautions, there’s a fine line between comfortable and unprofessional: “You don’t want it to look so much like home that [patients] start distrusting the quality of the environment.” Moreover, a homey environment shouldn’t come at the expense of hygiene. “It’s important to balance infection control with comfort and to find finishes that can be cleaned easily so that they don’t absorb pathogens,” agrees Joseph of the Center for Health Design.

Indeed, in spite of our best efforts, troublesome germs still lurk in health care facilities. And sometimes the best escape from these indoor pathogens—and the mechanical, highly controlled medical setting—is a retreat to the out of doors. Moreover, spending time in a more natural landscape has been shown to deliver several benefits: studies have shown that access to gardens reduces patients’ stress and provides a pleasant distraction from pain and discomfort.

With time organizations like the Center for Health Design hope that these key tenants of healing design will become the industry standard and that today’s stark, industrial environments give way to something more harmonious, calming, and natural—in short, places that heal.


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