SHORT DESCRIPTION OF THE TOPIC/S – 150 words
Francesco
Healthcare design has a direct affect patient well-being and recovery. Studies show that poorly designed environments exacerbate patient anxiety and stress and diminish their healthcare experience whereas environments designed to support a patient’s wellbeing result in improved health outcomes[1]. For most of the past century healthcare architects and medical administrators concentrated on creating hospitals that would reduce infection risk exposure and succeed as platforms which are functional and efficient in delivering modern medical healthcare.[2] These traditional designs often produced environments that are considered starkly institutional, stressful and unsuited to the emotional needs of patients.[3] This has led towards Evidence Based architectural design[4] which refers to a process for creating hospitals and other healthcare facilities informed by the best available evidence to help improving safety, medical, staff and financial outcomes[5]. This project looks at understanding healthcare design currently and how it is evolving to better promote a positive and personal experience for every patient.
PROJECT BACKGROUND – 500 words
Francesco
Architecture touches us in every day of our lives in more ways than one. Sometimes its effect on us isn’t immediately apparent but can develop over time. This is more so true for healthcare architecture which can have a huge impact on patients and staff using and working in these facilities.
Throughout most of the past century healthcare design was focused around creating hospitals and other health facilities that would reduce infection risk exposure and excel in functionality and efficiency to be able to produce a high standard of care in a place that supported modern medical technology.[6] These traditional hospital designs produced environments that would now be considered starkly institutional, stressful, unsuited to the emotional needs of patients, and in some cases, detrimental to care quality.[7] Despite intense stress caused by illness and traumatising hospital experience, little attention was given to creating surroundings that calmed patients or otherwise addressed their psychological and social needs.[8] On the other side of this, improved design of a hospital environment can play a key role in reducing stress, making patients safer, promoting better outcomes and enabling staff to do their jobs more efficiently and with less strain.[9]
The World Health Organization stated in a determinants of health article “Whether people are healthy or not, is determined by their circumstances and environment. To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health …”.[10]
The British Medical Journal (BMJ) made the following comment: ‘Of course we must humanise hospitals’ [11](Bardon 1981)
There has been a large amount of research made in recent years that confirm that the conventional ways that hospitals are designed, in fact, heighten stress and anxiety[12], leading to a shift in Evidence Based Design (EBD) referring to a process of design based on the best evidence available.[13]
With this understanding and greater research being available, we are now, in recent years, seeing more and more healthcare facilities being designed and executed around this method of design. This is leading to far superior healthcare facilities in terms of patient well-being and staff efficiency and care. Some examples of this are the new Royal Children’s Hospital and the Maggie’s Centres located all around the world, which follow a model of design that answers all these issues to create a more personal and warming experience. Maggie’s programme of support has been shown to strengthen the physical and emotional wellbeing of people with cancer and their families and friends. The Department of Health has described our work as an example of best practice.[14]
AIMS – 150 words
Francesco
This research is intending to understand how and what impact architecture and the environments we create have on people in the healthcare system and where possible investigate how certain design decisions can change a person’s experience from negative to a positive one.
Although highly considered in a lot of ways, the traditional design of hospitals fails to address the psychological and social needs of its patients and staff[15] begging for more attention to be paid in the design of these facilities in regards to patient well-being and their mental state when they are exposed and experience these spaces.
This research will only scratch the surface of this issue but will hopefully create an understanding of the issues we face in hospital design and some methods which have been used to help create a greater experience of our healthcare system.
RESEARCH QUESTIONS – 200 words
Francesco
Architecture and the strategies used to design healthcare facilities can be used to improve the lives and health of patients. The World Health Organisation now defines health not as the absence of ill-health but as “a state of complete physical, mental and social well-being”[16] What role does architecture play in this change?
Health is no longer simply a question of access to medical treatment but it is determined by a range of factors related to the quality of our built environment.[17] The relationship between architecture and health has historically received little attention, beyond the design requirements of healthy buildings. This research is aiming to understand these design moves and determine what decisions of design make the greatest negative impact on patients?
“Hospital architecture has undergone a change in its functional focus, and hospitals are conceived as a set of spaces that attempt to give healthy experiences, rather than a space containing health. The goal is to improve internal processes in which various areas of the hospital participate, resulting in higher efficiency and better quality perceived by users”.[18]
In recent years we have been seeing medical care facilities are making a shift from monotonous spaces, committing to the interpretation of colour and light[19] and work has established a more holistic awareness of the role of architecture in health[20] which has shown can help people recover more quickly.[21] With this understanding, what design decisions have been made in recent projects to address this and does it truly have a great effect on patients?
METHOD – 200 words
Together
This particular research will require a lot of enquiries. Elements of this can be achieved through analysing textural information such as books and journals, as well as looking into other research based around these topics. In addition to this we thick a vast majority of our research may benefit from other modes of investigation and information through alternative sources. These may be in the form of interviews, videos and audio conversations which we hope can provide us with more specific information or perspectives.
Due to the similar nature of these projects which utilize and explore similar questions, we will most likely correlate and cross paths in our research. It would be advantageous to conduct our research in contact with each other, so we are able to share sources and materials, as well as comparing our understandings of information and modes of analysis as well if needed can potentially conduct interviews together. Saying this the overall themes of these two projects will differ and diverge in relation to our individual perspectives and interests as we develop or research and form our projects.
An example of moments we think collaboration between the two of us will be beneficial is looking at case studies. One precedent project that we both intend to explore as a case study is the concept and design behind “Maggie’s centres” and how they have managed to change and revolutionise cancer care for patients. In addition, another key precedent worth investigating is the Royal Children’s Hospital in Melbourne. This hospital is an exemplar of change, and patient-centeredness. It demonstrates the difference between hospitals that are empathetic and considerate towards patients as opposed to hospitals that have less of a “patient-centred” approach. Obviously, all hospitals have large considerations towards health, sanitation and so much more, however this research requires further analysis to explore the factor of the mental effect of hospitals on patients and what changes have been addressed to count for this.
STRUCTURE/OUTCOMES – 150 words
Francesco
The intended outcome of this research project is to generate an essay or report that outlines and creates an understanding of how healthcare architecture can continue to be developed in an attempt to create a greater positive environment for patients. To help with understanding, aiming at a creative audience, the text will also be followed by diagrams or drawings.
The report will mainly attempt at analysing past and current healthcare examples to help outline the issues and how those issues are trying or have been addressed in later projects and creating a comparative investigation of these. In addition, the text will be backed up with a visual queue being either photo or diagram to help create a better understanding and simplify with is being said.
SIGNIFICANCE – 250 words
Francesco
With a rapidly growing and an incredibly important issue such as mental health, this project is a very significant topic looking to address to help create an understanding of the impact architecture can have on people, especially those in hospital which would most likely be one of the most vulnerable times in their life.
We are slowly seeing a shift from the traditional hospital design which research shows their conventional ways in which these hospitals were designed towards actually heighten stress and diminish satisfaction with care[22], to now where we see a few recent facilities that have a more considered approach to patient well-being and a greater positive experience of their environment.
With this change it is important to understand how our design decisions can affect people and what considerations can be made to best promote a positive and personal experience in our healthcare system with a particular look into case studies such as the new Royal Children’s Hospital or the countless Maggie’s Centres around the world that do a good job at promoting this.
LIMITATIONS – 100 words
Francesco
Due to the specific nature of this project which is focusing on healthcare institutions, some foreseeable complications that may arise in regards to the execution of this research project could be an influx of generalised information that we might be collecting. This kind of information calls for us to interpret and we run the risk of potentially understanding any information we collect incorrectly. In addition to this, dealing with such a complex issue such as patient well-being and mental health, which is different case by case, we may be limited by contradicting case studies. In this case, opposing findings will make it hard for us to effectively develop a concrete solution to this issue.
[1] Willis, D. “Designing for Wellbeing: Realizing Benefits for Patients through Best Practice Hospital Design” University of Melbourne
[2] Wagenaar, C. “The architecture of Hospitals” Rotterdam, NAi Publishers, 2006 V-31
[3] Wagenaar, C. “The architecture of Hospitals” Rotterdam, NAi Publishers, 2006 V-31
[4] Hamilton, D. K “The four levels of Evidence Based Design practice.” Healthcare Design 11 (November) 2003: 19-26
[5] Ulrich, R. S “Evidence Based Design to enhance patient safety”, The Environment for Care, London, 2004 V-31
[6] Ulrich, R. S “Evidence Based Design to enhance patient safety”, The Environment for Care, London, 2004 V-31
[7] Ulrich, R. S “Evidence Based Design to enhance patient safety”, The Environment for Care, London, 2004 V-31
[8] Ulrich, R. S “Evidence Based Design to enhance patient safety”, The Environment for Care, London, 2004 V-31
[9] Ulrich, R. S “The Role of the Physical Environment in the Hospital on the 21st Century”, The Robert Wood Johnson Foundation, 2004, 69
[10] “Health Impact Assessment (HIA):The determinants of health” World Health Organization. 2016, https://www.who.int/hia/evidence/doh/en/
[11] Bardon, D. “No Place Like Home?” British Medical Journal Volume 282, 1981, 2052. [Google Scholar]
[12] Ulrich, R. S “Evidence Based Design to enhance patient safety”, The Environment for Care, London, 2004 V-31
[13] Hamilton, D. K “The four levels of Evidence Based Design practice.” Healthcare Design 11 (November) 2003: 19-26
[14] “About Maggie’s : Why Maggies’ Works” Maggie’s Centres, https://www.maggiescentres.org/about-maggies/
[15] Ulrich, R. S “Evidence Based Design to enhance patient safety”, The Environment for Care, London, 2004 V-31
[16] WHO. (2001). Fifty-fourth World Health Assembly. Geneva: World Health Organization.
[17] CABE. (2009). Sustainable places for health and Well-being. London: Commission for Architecture and the Built Environment.
[18] “How can hospital architecture impact the lives of patients?”, José Antonio Mezquita, https://blog.ferrovial.com/en/2019/01/hospital-architecture-impact-lives-patients/
[19] “How can hospital architecture impact the lives of patients?”, José Antonio Mezquita, https://blog.ferrovial.com/en/2019/01/hospital-architecture-impact-lives-patients/
[20] “Architecture of Wellbeing and health”, Daylight, http://thedaylightsite.com/architecture-for-well-being-and-health/
[21] “How can hospital architecture impact the lives of patients?”, José Antonio Mezquita, https://blog.ferrovial.com/en/2019/01/hospital-architecture-impact-lives-patients/
[22] Ulrich, R. S “Evidence Based Design to enhance patient safety”, The Environment for Care, London, 2004. V-31