Hospitals: for treatment or for healing?

The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them.
Contemporary methods and advances in treating disease can be supported by architecture which is sensitive to the contextual conditions of healing in health facilities. It is not the intention to supplant technology, but a question of supplementing the incredible advances that have been made in medicine in recent decades. The central premise is to minimize the negative effects of stress inducing environments based on research results. Which stress inducing factors? We can look around at some old hospitals and see they are noisy, confusing, ugly, monotonous, hard, cold, artificial, and dark; qualitative terms which can indicate what we shouldn’t be doing in hospitals.
Design factors which should be carefully considered include:
Light, as in daylight, artificial light, its color, its temperature, the level and quality of lighting and the effects of light on circadian rhythms. There is documented evidence in: users’ satisfaction, orientation, 24 hour rhythm of sleep, depression, admission length and mortality etc.
Sound, in order to keep decibel levels at 40db as recommended, reverberation times, type and quantity of equipment in terms of its noise and how it affects stress levels, acoustic screening to allow privacy and single wards. Documentation exists in; well-being of patients and staff, sleep disorders, pain distraction, confidentiality and privacy, levels of errors in hospitals.
Art and the use of color: Art can be context related so one should be aware whether it is in a private ward or the foyer and related to the experience of the patient. Art can be used as a stress reducing factor, pain distracter, and also to orientate and to provide landmarks in the hospital landscape.
Air, the use of natural ventilation as much as possible, complemented by mechanical ventilation in most cases, particularly in northern Europe; the emphasis should be on the reduction of unpleasant odors, filtering systems and infection control.
Movement & navigation: clarity of plan, clearly marking the main entrance, providing proper information and signage design, differentiated spatial references, e.g. internal landmarks, in order to lower stress in the navigation experience and wasted time of medical staff in providing directions.
Space in hospitals: space can be divided into personal, social and outdoor space.
Personal space: single rooms have been well documented in: admission length, mortality rates, comfort levels, sense of privacy, all users’ satisfaction. Social space: attention to spatial qualities, volume and interior design in terms of encouraging physical contact between users in wards, waiting areas and semi-private rooms. Outdoor space: Landscape and gardens are not enough in themselves; they should be visible, centrally or strategically placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say.
Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning, the design of water supply systems and filters, and particularly to materials and finishes. There’s a paradox here, on the one hand, while wanting to avoid a cold clinical atmosphere, floors, furniture fitting must not spread infections and bacteria.
Injuries and errors can be addressed and minimized through acoustics, lighting, and design of control stations, maneuvering areas and volumes. Special attention should be considered to furniture and fittings, again materials and types of equipment and its placing both in wards and other areas. All these factors are documented in terms of admission lengths, staff- sick-leave and work-related injuries.