The built and natural environments complement one another in medical environs.
By Kenneth W. Betz, Senior Editor
Patients’ experiences and expectations of what a hospital should be have undergone dramatic changes. Central to those changes is the concept of person-centered health and the acknowledgement of the important role of both the built and natural environment in health, wellbeing, and healing. Hospitals that have incorporated this principle have seen patient satisfaction scores improve substantially.
It’s a trend that has been growing over for several decades. In 1984, Roger Ulrich, then a visiting professor at Center for Healthcare Architecture at Chalmers Univ. of Technology, Gothenburg, Sweden, wrote a seminal paper that used clinical data to show that patients with “tree views” versus “wall views” had shorter postoperative hospital stays, fewer negative evaluations, and slightly lower scores for postsurgical complications.
Thirty years on, the Univ. of Arizona Institute on Place, Wellbeing, and Performance (UA IPWP), Tucson, “seeks to redefine human health to fully encompass the role of the built and green environment in health and wellbeing, through research, education, practice, and policy change,” according to its website.
The UA IPWP is an interdisciplinary institute at the Univ. of Arizona (UA), Tucson, that links expertise of the UA College of Medicine, Tucson; the Arizona Center for Integrative Medicine (AzCIM), Tucson; and the UA College of Architecture, Planning, and Landscape Architecture, Tucson, “actualizing the university’s commitment to a vision of human health that fully encompasses the role of the built and natural environment in health, wellbeing, and healing.”
The World Health Organization (WHO) defines health as “a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity.” Similarly, healthcare environments today increasingly seek to encompass the complete patient experience—physical, mental, and social—through the built environment. The projects on the following pages seek to do this through connections with nature and other design features that speak to more than just patients’ and visitors’ physical convenience.
Outdoor Care Retreats Offer Respite
In the peaceful ambience of the forests only a short walk from two of Norway’s largest hospitals, Oslo-based architectural firm Snøhetta designed secluded wooden shelters to make hospitalization easier for patients and their families. The Outdoor Care Retreats offer visitors a physical and psychological respite from stringent treatment regiments and the isolation that often follows long-term hospitalization.
Leaning towards the lush forest and the trickling Sognsvann creek, the Outdoor Care Retreat is located several hundred feet from the entrance of Norway’s largest hospital, Oslo Univ. Hospital, Rikshospitalet. Its sister building is situated in the deciduous woodland by Sørlandet Hospital, Kristiansand, in the south of Norway, between oak trees and birch, overlooking a nearby pond. Originally developed in collaboration with the Department of Psychosomatics and CL-Child Psychiatry at Oslo Univ. Hospital, the Outdoor Care Retreat provides a peaceful space where visitors can benefit from the therapeutic qualities of nature.
“Nature provides spontaneous joy and helps patients relax. Being in natural surroundings brings them a renewed calm that they can bring back with them into the hospital. In this sense, the Outdoor Care Retreat helps motivate patients to get through treatment and contribute to better disease management”, said child psychologist Maren Østvold Lindheim at the Oslo Univ. Hospital, one of the initiators of the project.
The space can be used for treatment and contemplation and for spending time with relatives and friends away from the hospital corridors. The cabins are open to every patient connected to the hospitals regardless of disease group, and reservations are managed through a booking system.
The subdued 375-sq.-ft. spaces stand in stark contrast to the monumental hospital buildings with which they are affiliated. Referencing the playful construction of wooden tree cabins typically made by children, the luminous cabins are formed like skewed blocks of wood that extend into the landscape through asymmetrical branches. The massive wood of the main structure of the cabin will turn gray over time, blending naturally into the surroundings.
Following Snøhetta’s commitment to socially sustainable design and public space, the cabins are accessible for wheelchair users, and the angled entrance of black zinc is large enough to make room even for hospital beds.
The cabin consists of a main room, a smaller room for conversation and treatment, and a bathroom. The interior is fully clad in oak, echoing the natural material of the woodlands outside. Inside the space, colorful, sculpted pillows can be moved around freely, allowing children to build huts or lie down to gaze at the canopies through the circular window of the ceiling of the main room.
The cabin’s large glass windows can be fully opened, inviting nature into the space. In this way, visitors can peek into the woods, smell the damp forest floor, and listen to the sound of trickling water while still being inside the cabin.
Although the cabin is integrated in the hospital campus, its secluded location and natural aesthetics allow it to be perceived as a place of its own. It is a place of muted magic, a place out of the ordinary that provides a generous and much-needed breathing space for visitors of all ages.
The vision is to build more Outdoor Care Retreats in vicinity of hospitals in Norway and abroad. The cabins are always adapted to the specific location in a way that requires minimal intervention in nature. They are funded by a variety of private and public sectors.
Health And Wellness Meet In Natural Setting
Duke Integrative Medicine
Every aspect of the design for Duke Integrative Medicine, Durham, NC, reflects the program’s transformational approach to healthcare. Program spaces for traditional and alternative medicine are united through a rich use of natural materials, such as wood and stone, and a focus on the patient’s procession through the spaces. Generous views of interior and exterior gardens and numerous spots for reflection and contemplation evoke notions of mind, body, and spirit.
Nestled in the woodlands of Duke Forest, this holistic environment is both welcoming and comforting. The realms of nature and man-made—reflecting the facility’s dual use of holistic therapies and medical science—are interwoven through visual and physical connections. The orchestration of light, transparency, translucency, openness, and scale define the building’s program spaces including therapeutic treatment rooms, workshop and meditation spaces, a library, fitness facilities, and a state-of-the-art café offering healthy cooking demonstrations, guest meals, and catered events.
Duke Univ. Student Wellness Center
The Duke Univ. Student Wellness Center weaves health and wellness together into everyday student life, with student health, nutrition, counseling and psychological services, and wellness and case-management programs coming together under one roof. The new facility answers the needs of clinical care and expands the role of wellness in ensuring healthy students. Strategically situated between athletics, student services, and residential complexes, the building abuts Duke historic forest’s and a primary campus circulation path.
The design’s transparent two-story entry brings natural light into the building and allows views of the outdoors. To minimize the project’s environmental impact, oak harvested from the site was used extensively for interior surfaces and exterior seating. A contemplative garden reinforces connections to nature and extends to campus pathways. A monumental entry stair follows a translucent wall up through the lobby to celebrate the intersection of care, prevention, and social interaction in achieving wellness. Public and private functions are layered—the entry is open, but presents circulation options for students seeking care, privacy, socializing, or wellness programs.
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