How do you design a better hospital? Start with light

Just like medical As care has evolved from blood transfusion to germ theory, the medical space in which patients live has also changed. Today, architects and designers are trying to figure out how to make hospitals more comfortable, in the hope that relaxing spaces will lead to better recovery. But building to a cure requires as much empathy as cold, hard data aggregation.

“Part of the best possible care is keeping people calm, giving them space to breathe,” said Annmarie Adams, a professor at McGill University who studies the history of hospital architecture. being alone – things that seem frivolous but are really important.

In the 19th century, the famous nurse Florence Nightingale popularized the pavilion plan, which contained zones: large rooms with long beds, large windows, lots of natural light and lots of ventilation. These designs were informed by the theory that submerged indoor spaces would spread disease. But wards have little privacy for patients and require a lot of space, something that is becoming difficult to find in increasingly crowded cities. They also mean a lot of walking for the nurses, who have to trudge up and down the aisles.

Over the next century, the focus on natural light has faded in favor of sterile spaces that limit the spread of germs and accommodate an ever-increasing amount of medical equipment. After World War I, the new standard was to assemble patient rooms around a nurse’s station. These designs are easier for nurses, who no longer have to walk through long corridors, and they are cheaper to heat and build. But they still retain some of the traps of old-fashioned inpatient facilities, like nursing homes where patients will nurse for long periods of time; both mimic the luxury hotels with their ornate lobbies and delicious food, measures intended to convince middle-class people that “they are better in the hospital than at home when they are seriously ill.” , Adams wrote in a 2016 paper on hospital architecture for Journal of the Canadian Medical Association. The design, she argues, is meant to instill confidence in people in the organization: “a tool of persuasion, rather than a cure.”

In the late 1940s and 1950s, hospitals transformed again, this time becoming office-like buildings with no frills or features meant to improve the experience of being there. “It really is designed to work and be effective,” says Jessie Reich, director of patient experience and magnet programs at the University of Pennsylvania Hospitals. She points out that many of these rooms have no windows.

By the mid-20th century, the hospital had become the opposite of what Florence Nightingale had envisioned, and many of these buildings, or those modeled on them, are still in use today. “The typical hospital is designed as a machine to deliver care, but it is not,” says Sean Scensor, principal of Safdie Architects, a firm that recently designed a hospital in Cartagena, Colombia. is a place of healing. “I think what’s missing is empathy for people as humans.”

Although Nightingale has operated largely on anecdotal evidence that lighting and ventilation are important, she was right – but it took more than a century for scientists to gather quantitative data to support her. For example, a important research in 1984 published year Science Follow-up of patients after cholecystectomy. The 25 patients whose rooms overlooked the greenery had shorter hospital stays and took less pain medication than the 23 patients whose windows faced a brick wall.


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