How Do Healthcare Environments Affect Well-Being?

How does design impact stress, recovery, & efficiency

• Loud noise, overcrowding, harsh lighting, & lack of privacy

• Reduced stress: control, nature, acoustics, & lighting

Must balance multiple stakeholders

• Balance the needs of patients, staff, & visitors (competing priorities)

• Privacy vs. surveillance

• Space vs. efficiency

• Safety vs. comfort

• Cost vs. quality

Patients

Need to recover from an illness, need rest, feel stressed or anxious, & may want friends & family around

• Privacy, control, & positive distractions

Staff

Need optimal working conditions

• Clear navigation, functional, access to natural light & quiet areas

Visitors

Welcoming & comfortable environment with seating & quiet private areas

• Good maps, sound-absorbing materials, privacy, & TV positioning

Researcher: theory of supportive design

Ulrich, 1991

Theory of supportive design

Healthcare physical & socail environments promote well-being if they are designed to foster

• Control

• Social support

• Positive distractions

A sense of control over physical-social surroundings

Adjustable lighting, adjustable temperature, openable windows, refridgerator

Access to social support

Space & chairs for family & friends, internet, bedside phone, sleeper sofa

Access to positive distractions

TV with many channels, space for photos, plants, paintings of nature

Ambient features

Intangible aspects of the environment

• Natural light, soothing music, lower noise levels, & comfortable temperatures

Architectural features

Relatively permanent aspects of the physical healthcare environment, such as the spatial layout of the hospital, size & shape of rooms, & placement of windows

• Single rooms, clear pathways, & easy access to gardens

Interior features

Less permanent aspects of the healthcare environment

• Ergonomic furniture, neature-based artwork, & soft, non-reflective colors

• Furnishings, colors, interior plants, & artwork

How design reduces or increases stress

• Healthcare design can function as a stressor or a restorer.

• Environmental stressors include loud noise, chaotic layouts, overcrowding, harsh lighting, and lack of privacy, which can suppress the immune system and increase staff burnout.

• Supportive design such as control, nature & positive distractions, & acoustics & lighting can reduce stress.

Why and how stakeholder needs conflict

• Balancing the needs of patients, staff, & visitors is a major theme, often leading to competing design priorities.

• Patients desire private, single-patient rooms for dignity and rest, while staff may prefer open-bay designs to improve visibility, allowing monitoring of several patients.

• Visitors want spacious rooms with extra seating, but this can increase staff walking distance and fatigue and reduce efficiency.

• Patients want a comfortable and inviting environment, whereas staff may need safe, secure areas.

• Finally, administration may prioritize lower construction costs, while the patient may want softer, sound-dampening materials.

How supportive environments improve outcomes

• Supportive environments promote healing by reducing anxiety & optimizing care delivery.

• Rooms with natural light, views of nature, or positive distractions can reduce hospital stays.

• Access to natural light and pleasant views can reduce the need for pain medication.

• Well-designed spaces reduce staff walking fatigue & stress, lowering the risk of medical errors.

• Finally, improved safety with clear designs contributes to fewer patient falls and reduced infection risk.