How Psychological Aspects of Healing Matter for Hospital Design


The design of hospitals changed in the 20th century, with hospitals moving from places of treatment of disease and injury to centers of health systems. Credit: Shutterstock

Long before COVID-19 raised public awareness of the importance of good ventilation, designers were concerned with how physical environments affect people’s well-being and mental health.

In the 20th century, the design of hospitals underwent a profound change. Hospitals were once places reserved for the treatment of illness and injury, or places strongly associated with death.

By the mid-twentieth century, due to medical and technological advances and the growth, development, and professionalization of diverse approaches to health care, hospitals had become centers of health systems. Nowadays, hospitals are not only places of treatment of diseases and ailments; they are also institutions for the promotion of physical and psychological health, and places of recovery and healing.

Today, patients expect more than just treatment. As the mandates and missions of hospitals have changed, so has the design of hospitals.

Healing environments

To design healing environments, significant advances have been made that support a patient’s recovery process. The healing environment concept places the patient at the center of hospital design and healthcare.

To this end, in addition to the clinical needs of patients, their psychological and mental needs must also be considered in the design process.

For example, empirical research has shown that natural daylight, contact with nature, and a pleasant indoor environment promote a sense of well-being that benefits patient recovery.

The physical aspects of hospital interior spaces can all contribute positively to the health and mindset of patients.

Patient perceptions of control

Design researcher Roger Ulrich conceptualizes how physical and social environments in healthcare settings can affect patient well-being, including stress reduction. He calls this theory “support design”.

According to this theory, all challenges and considerations for improving the health environment can be categorized into three broad branches: perceptions of control, social support, and positive distraction.

Each of these can be viewed as an opportunity to enhance a patient’s spatial experience.

To enable patients to perceive a sense of control in their environment, some studies have focused on the value of mapping and wayfinding during the planning phase of hospital design, which has the effect of more beneficial to help patients navigate independently.

How Psychological Aspects of Healing Matter for Hospital Design

A terrarium in the lobby of Rush University Medical Center in Chicago, seen here in 2014, provides both natural light and contact with nature. Credit: Shutterstock

Social supports

Access to social support reduces patients’ levels of psychological distress when present in treatment center environments. This can be facilitated by providing patients with access to private and quiet spaces, where they can discuss personal information or express their needs to family, friends and hospital staff.

For example, providing furniture that provides acoustic and visual privacy to patients in public spaces in hospitals can be an intervention to provide a sense of social support.

positive entertainment

Positive distraction is primarily anything that can grab a patient’s attention or interest, leading to a positive state of mind or mood.

Therefore, visual distractions such as televisions, reading material, indoor plants, views of nature, or works of art can contribute remarkably to a sense of well-being. Patients can access nature not only through windows with panoramic views, but also through paintings or artwork depicting nature in abstract or realistic styles.

Roles of patient, family and staff

Patients, families, caregivers and hospital managers can also help create a healing environment for patients.

For example, as positive distractions, patients can bring their own belongings into the hospital room, such as a small plant, pillow, and blanket, or their own reading materials or art supplies and of craftsmanship.

Families and staff can help create comfortable conditions and space for patients to hang their favorite artwork or pictures on the wall.

Design integrated into hospital protocols

With adequate resources, healthcare providers could have more tools to improve patient mindsets through small design ideas that can be incorporated into hospital protocols.

For example, installing a whiteboard on the patient room wall would allow families, patients and staff to draw figures of nature or write positive messages. To help reinforce a patient’s perception of control, hospital staff could draw a patient’s name on their room window with a smiley face to help them find their room.

To provide social support, hospital managers can provide free and easy access to Wi-Fi or telephone for patients in all areas of the hospital. Curtains or shades can be considered in public areas of hospitals, such as waiting rooms, to provide flexibility for patients who prefer to communicate privately with hospital staff or family members.

Include caregivers and patients in the design

While patients, staff, and families can independently help improve the patient’s spatial experience, designers must also include them in the design process.

As a result, designers and researchers can benefit from this design approach related to the role of caregivers, carers, and patients to improve healing environments in hospitals.

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