We look into the effects of biophilic design practices in the healthcare sector, and marvel at the power of nature to heal…
When we think of hospitals, clinics or healthcare facilities, we automatically picture sterile, white spaces that may even be characterless. Healthcare design has traditionally focused on organisational efficiency and cleanliness. And any investment in new healthcare facilities leans heavily towards quality of equipment and the capacity of the space, with not too much thought given to the inherent design and how it affects a patient’s healing and recovery.
However, research into design and quality of patient care supports the assumptions that advocates of biophilic design have been making for quite some time now – there are substantial healing benefits to designing a space that brings nature into the built environment. Exposure to natural elements, or architectural elements that mimic nature, aids in the healing process of patients.
“Ever wonder why we feel so much more relaxed in a spa environment? Or more productive in an office?” asks Salwa Najafi, Interior Designer at Gensler. “Our environments are designed and curated to evoke a sense of feeling. Humans have an innate connection to nature and biophilia encourages wellbeing by promoting positive distractions. The mental and physical benefits of being in nature have to become an integral part of healthcare design. In fact, a successful healthcare environment is designed to mask the patient’s potential fear of machines with their love of nature.”
Above: Designed by Gensler, the Healing Garden courtyard and renovated lobby of North Scottsdale Hospital in Arizona, US, offers a restorative sensory experience symbolic of the natural cycles of life
Julijana Mitic, Associate at Perkins+Will, feels that it is absolutely necessary to incorporate biophilia into healthcare design projects. “Biophilic design principles propagate nature infused spaces that cultivate an atmosphere of rejuvenation, greatly enhancing patient wellbeing. It is practically designing for the senses.”
For the new Kings College Hospital in Dubai, recently completed by Perkins+Will, one of the ways this was accomplished was through art. “By offering calming, visual stimulation for the patient to focus on, we can reduce anxiety, making the healing process easier and possibly even faster,” says Julijana. “Furthermore, sounds from nature – birds singing, wind in the forest, and sea waves – can influence how you feel and how your body will respond to healing. These sounds can be introduced indoors through technology, and are great for naturally calming both mind and body, and improving overall wellbeing.”
One body of research even makes an argument for how artificial settings slow down the process of healing. Modern structures and built environments, composed largely of straight lines and right angles, create a load on the human mind that leads to a disconnect with the environment. In the case of a patient in recovery stage, the mind and body are aware of their physical presence in an artificial environment. Which means the body’s ‘fight-or-flight’ isn’t active, and we don’t see the need to heal and adapt quickly.
Above: The Kings College Hospital in Dubai, designed by Perkins+Will and scheduled to be operational in January 2019
Natural materials invoke comfort
Scottish painter, writer and landscape artist, Maggie Keswick, was a strong advocate of the importance of attending to the psychophysical wellbeing of patients. She shared views that are now accepted to be critical to healthcare design, that the aesthetic quality of a healthcare facility can help patients endure their illnesses.
The mind and body are aware of their physical presence in an artificial environment. Which means the body’s ‘fight-or-flight’ isn’t active, and we don’t see the need to heal and adapt quickly.
The presence of natural materials reinforces humans’ connection to nature, and improves the mind’s perception of the healing environment as welcoming and natural, thereby speeding the recovery process. Studies have shown that natural materials enhance visual comfort owing to how they absorb more light than they reflect. They also positively affect our olfactory senses, creativity, immune system and overall health.
“In my years with dwp, I worked on the Bumrungrad Hospital in Bangkok, the design of which leaned heavily into the biophilic school of thought,” says Kristina Zanic, Designer and Owner of Kristina Zanic Consultants. “At the time, this was considered quite revolutionary, and after this project, many hospitals in the city began to change their outlook to healthcare design, putting the focus back onto the healing process.”
The Bumrungrad features a Zen Garden in the central atrium, which doubles as a sanctuary for people to relax and immerse in the natural elements of stone, rock, wood and water. It is the focal point of the hospital building and can be seen from all twenty floors, as well as via cantilevered platforms that act as small lounges with optimum views. “In the outpatient facility and check-up area, the flow, in particular, was also important to ensure patients were directed smoothly from one point to another in a clockwise, circular direction,” says Kristina. “Images of green foliage, plants and flowers were introduced, together with natural wood and special surfaces, that met the health standards and criteria, to create a soothing and warm environment, and aid the healing process.”
The Danish Center for Proton Therapy, a WAN Future Projects Healthcare Award 2016 design winner, by Denmark based Link Arkitektur
Plants improve productivity and quality of care
It is not uncommon to see flowers around patient beds in a hospital, and for good reason too. Plants and flowers are a treat to the senses, and can greatly enhance the patient’s experience during recovery. Those benefits extend to doctors and staff as well. When the overall environment is one that promotes wellness and productivity of its inhabitants, it leads to better healthcare for patients. Rooms with plants (roses, in particular), natural ventilation, proper lighting, and natural elements that one can touch and feel, increase the medical staff’s productivity and organisational capability. According to a study, these biophilic design choices also boost the activity of the parasympathetic nervous system, thereby decreasing stress levels and encouraging a general sense of wellbeing. Not to mention they also help diffuse any ambient sound that can affect concentration or quality of sleep.
Maximising the use of natural light via skylights – Design for the Danish Center for Proton Therapy by Link Arkitektur
Spatial configurations affect patient and visitor experience
The layout of a healthcare facility, and the nature of the spaces within, can affect how patients and visitors view and experience them.
Research indicates that one of the ways this can be achieved is through the use of perspective in interior spaces, while at the same time conveying a sense of protection. Another tactic would be to simplify and organise. Despite the fact these facilities are inherently complex, there’s no reason for patients to be subjected to that level of information. Patients and medical staff alike should be able to perceive the spaces as clear and consistent. Examples here are effective orientation, wayfinding systems, or visual cues to provide direction.
Natural patterns induce subconscious responses
We recognise and process natural patterns far more easily than artificial ones. Scientists and researchers have theorised that we respond positively to these because most of them, particularly fractal structures, can be found within our bodies. These similarities create a sort of cognitive link, leading to an increased sense of comfort. According to a study by Nikos A. Salingaros, we react poorly to designs that deviate far from natural patterns – smooth, shiny objects or excessive use of minimal and straight lines in the built environment create alarm. The discomfort that arises from this occurs because these patterns contradict the natural patterns we are used to experiencing in nature.
