Infection Control and Biophillic Design: Can Both Be Achieved?

Anyone familiar with hospitals knows that design impacts operations. How people - both healthcare workers and patients - move through the space affects how well they can do their jobs, how quickly patients can receive treatments, and how visitors can know where to go. More specifically, there are two areas of hospital design that can impact patient outcomes. Spaces can be designed to reduce exposure to dangerous pathogens which could lead to hospital associated infections (HAIs) and spaces can be designed to bring nature inside in order to help the healing process. Both design goals are important, trending issues in design. But can a designer meet the needs of both infection control and biophillic design at the same time?

Biophilic design is the evidence-based theory that exposure to nature can have positive psychological, physiological, and cognitive impacts on patients, healthcare workers, and guests. Studies have shown that access to nature can lower heart rates and diastolic blood pressure, reduce the release of stress hormones (such as cortisol) into the bloodstream, relax muscles, and keep the mind more actively engaged. These positive impacts can lead to quicker healing, greater mood stability, and a more positive work environment.

We have covered the many ways design can impact infection control in our past posts (here, here, and here). As a quick summary, the patient area should have as few surface reservoirs where bacteria can persist and be transferred to hands and equipment. It should be easy to clean, with cleaning supplies handy, and be well ventilated. Where possible, surfaces should help reduce bioburden, including self-sanitizing surfaces and single-use devices. Overall, pathogens should be kept out as much as possible, and destroyed quickly if they reach a surface.

Now let's consider the implementation of biophilic design. Typically this would mean the use of indoor plants, water features, and organic materials such as wood or natural fibers. Unfortunately, these design elements are incompatible with infection control. One spoonful of soil contains trillions of bacteria cells. Water features provide reservoirs for any number of pathogens, including Legionnaire's disease. Organic materials, including wood, bamboo, paper, leather, wool, and cotton, all provide ample opportunities for bacteria to attach and persist - the materials are porous as well as hard to clean with hospital-grade disinfectants. This seems to not leave much room for biophilic design in healthcare environments.

Thankfully, there are indirect ways to introduce nature into the patient's environment without introducing pathogens or bacterial reservoirs. Images of nature, especially moving images that cycle through weather or day/night, can provide many of the same benefits of a living plant or "green wall." Natural colors from earth-toned palettes are calming, and combined with naturalistic shapes (horizons, flowing lines, natural geometries), create a warm and inviting space. Instead of wood and other porous materials, surfaces can be made from safe materials but shaped into natural textures to provide visual and tactile interest. The shapes and patterns do not have to be actual depictions of natural objects (leaves, trees, waterfalls, flowers), they can simply evoke nature through "controlled variability," that is, large-scale patterns that are organized yet complex.

The ideal design element would check both the infection control and biophilic boxes: Something that could both help prevent HAIs while also providing a healing, natural environment. One such product is the self-sanitizing, copper-infused surface, EOS^cu. It looks like stone yet is warm to the touch, providing a natural look and an inviting feel. It is infused with copper, a natural, non-toxic biocide that destroys >99.9% of harmful bacteria in under two hours, including resistant strains. Its earth-toned palette meshes well with any biophilic design, while also providing EPA-registered protection to patients, healthcare workers and visitors. 

Are there other products or design elements that you use to both control the spread of infection and provide a healing, natural environment? We would love to hear about them in the comments below!