Health in Mind and Body to Design

“We are living in a post-industrial age. Hospitals are supposed to be places of healing and recovery, where the sick go to get well,” says Prof.Dilani, General Director of the International Academy for Design and Health (IADH), in Stockholm, Sweden. “In too many cases they are designed simply as factories for the treatment of disease. They are functional, of course, but do they promote a feeling of health and well-being for the patients and staff who use them?”

For surgical teams, lowering stress is a key wellness factor. In the pressurized conditions of the Operating Room, for example, Prof Dilani says stress can be eased by design features such as: providing windows with views, improving the lighting conditions, using LED* technology to change the color of the walls, introducing a selection of background music, adding pictures to the walls, or even having an aquarium or small atrium installed. Outside the Operating Room, rest and recuperation areas for staff to use between operations also help the mind to recover and cope with on-going periods of intense concentration.

Prof Dilani, points to research by the UK’s National Patient Safety Agency (NPSA) [1] which found that 60–80% of hospital accidents can be attributed to human error. “Without any facility to restore the mind, concentration suffers and it is then that accidents happen,” he says. “People become impatient and
irritated. As their capacity to concentrate diminishes, they become careless, less co-operative and less competent.”

From North America to Norway and Singapore, many new and re-developed hospitals around the world are now adopting ‘salutogenic’ design principles that promote a sense of well-being. Calming and stimulating features include landscaped gardens, the use of natural daylight and imaginative interior design, using color, art, running water and greenery. Prof Dilani adds: “The influence of a building’s design on patients and staff has both a clinical and an economic impact. Apart from providing restorative health, good salutogenic design can reduce the need for pain-relief with drugs and even improve staff recruitment and retention.”

As a simple example, he cites research by Dr Roger S Ulrich, Director of the Center for Health Systems and Design in Texas [2]. Surgery patients with a bedside window overlooking trees were found to have more favourable recovery courses than patients with a view overlooking a brick wall. They had shorter hospital stays, needed fewer doses of strong pain relief drugs and tended to have fewer minor post-surgical complications. “The healthcare sector should be setting an example in salutogenic design,” adds Prof Dilani. “Cost is not an issue. Experience shows that the design and construction costs of a new hospital correspond on average to just three years’ running costs. “

We estimate that good salutogenic design can bring annual savings of up to 20% in running costs, through factors such as improved staff productivity and retention, fewer sick days, reduced patient bed occupancy and a lower drugs bill. Adherence to salutogenic design principles can therefore help to pay back the total capital investment in a new hospital in about 15 years of operation. “For financial, as well as health reasons, it makes sense to design our hospitals as humanistic centres of wellbeing, rather than just facilities for the treatment of disease.”

References:
1. NPSA Safe Foundations Module – Principles of Human Error; 1994
2. Ulrich RS (1984). View through a window may influence recovery from surgery. Science, 224, 420-421.
* Light Emitting Diodes, extremely small light sources that can be programmed to change color.