Hospitals and Evidence-Based Design Part 3: Today's New Hospitals

Evidence-based design became a focus of study in the 1980s. This movement paired design choices with structured, formal scientific research. Rather than relying on anecdotal evidence of design choices, researchers systematically tracked data on patient outcomes. One study, for example, was able to demonstrate a reduction in the use of pain medications by patients in rooms with a view towards nature. 

Evidence-based design can focus on various aspects of hospital function. Decisions about design are influenced by what we know about human psychology and stress, medical treatments, infection control, financial considerations, efficiency, and human movement/traffic flow. Ultimately, the goal of evidence-based design is to improve patient outcomes, safety, and administration.

Scientific research, therefore, has been used to identify design elements that can improve patient outcomes. They have revealed that a window to the outdoors improves healing and decreases the amount of pain medications needed, that earth tones and natural colors reduce stress, that music and art can provide healthful distractions, and that isolation, which is important for infection control, can be mitigated by nurses stations spread throughout a medical unit.

Evidence-based design also reveals that material choices can impact patient outcomes. Non-skid flooring can reduce falls, hallways with railing can enable patients to get on their feet and walk the halls more easily, ventilation with proper filters can reduce airborne microbes, and preventive biocidal surfaces can kill bacteria missed by cleanings.

Research demonstrates that design choices in the following areas can improve patient outcomes:

As little as 3 minutes surrounded by nature can positively impact stress levels. Windows, gardens, aquariums, and even artwork can provide these benefits.

Patient choices:

Having choices means having control, an empowering experience for a patient whose very life is in the hands of strangers. Allowing patients to adjust lighting, temperature, music, volume and choose times for routine events such as meals and walks can provide an individual with just enough choice to feel they retain control over their environment. Designing technology that can be easily operated from the bed and hallways that support independence are key design choices.

Recreation:

Along with access to nature, access to positive distractions can help reduce stress and even reduce pain. Depending on the interests of the patient, these diversions can be artwork, music, multimedia programming, or even access to a pet/therapy dog. Bringing computers and internet access into patient rooms has helped this area dramatically.

Social support network:

For many patients, frequent access to supportive family and friends has a significant impact on healing and recovery. These visitors can be encourage to return through design choices in waiting and reception areas, patient rooms, and overnight accommodations.

Calming environment:

Hospitals are synonymous with sounds, lights, and an overall over-stimulating environment. Reducing these stressors has been shown to have great impact on patients well-being. Some design choices in this area including noise dampeners on alarms, pagers, and high-traffic areas, as well as setting times for dimming lights in all areas serving patients. Other aesthetic choices can create more calming environments such as earth tones on walls and surfaces, natural materials and less obvious technology and equipment.

One fairly recent (since the 1960s) hospital design element is the more consistent use of private rooms. The use of private rooms has allowed for many design choices that lead to better patient outcomes. First and foremost, they help reduce infection by not only separating potentially infected patients, but also providing easy access to handwashing stations and helping ensure that staff wash hands between patients. Private rooms allow some medical procedures and treatments to be performed without having to be moved, and allows the patient to create closer relationships with a more consistent nursing staff. 

The hospital design process is long, arduous, and complex process. It involves hospital trustees, city planning, architects, corporate sponsors, private donors, product manufacturers, and many other stakeholders. Thanks to this new area of research, this team now has access to evidence-backed design suggestions to consider as they design their healthcare facility.

Editor's Note: This post was originally published in January 2015 and has been updated for freshness, accuracy and comprehensiveness.