To that end, I have started to examine some research which indirectly addresses these topics since I have found very little which directly applies:
Adams, A. (2010). Kids in the atrium:
Comparing architectural intentions and children’s experiences in a pediatric
hospital lobby. Social Science & Medicine, 70(5), 658-667.
This paper addresses
research conducted at The Atrium, an eight-story addition to the Hospital for
Sick Children in Toronto
completed in 1993, through both a review of architectural documentation and
interviews with the atrium’s designers as well as evaluations by children who
use the space. The authors place The Atrium in the context of late-twentieth
century shopping malls and other consumerist spaces and discuss their findings
including the social uses of the space, its role in wayfinding and issues of
connectivity and distraction. Although sustainability is not directly
addressed, The Atrium contains many things – gardens, ample natural light,
visual connection to the outdoors – which can be considered sustainable. They
ultimately ask if the role of hospital design is to create healing spaces instead of shopping malls and,
if so, what implications this has on the current model of hospital design.
Becker, F. (2008). The Ecology of the Patient
Visit: Physical attractiveness, waiting times, and perceived quality of care. The
Journal of Ambulatory Care Management, 31(2), 128-141.
I have been familiar
with this research for several years now, though this is the first time that I
have actually read the article. The research, which involved six clinics –
three deemed “attractive” and three “unattractive” by non-design research
students prior to the study – at the Weill Cornell Medical Center on the Upper
East Side of Manhattan, aimed to discover the connections between actual and
perceived waiting times to be seen by a caregiver and both the attractiveness of
the spaces as well as an overall impression of the quality of care received.
Actual times were recorded by observers over a 15-week period and the others
were collected through voluntary surveys returned by patients. Researchers
found a significant correlation between physical attractiveness and both
overall satisfaction and relief of patient anxiety, as well as a noticeable
difference in the perceived versus actual wait times where patients
overestimated short wait times and underestimated long wait times. It should be
noted that one of the attractive clinics was stated to contain “many
sustainable finishes and materials,” although this is the only overt reference
to sustainability. This model of research seems particularly exciting, and I
can envision a similar survey which seeks to correlate a clinic’s sustainability
with perceived quality of care.
Caspari, S. (2006). The aesthetic dimension in
hospitals: An investigation into strategic plans. International Journal of
Nursing Studies, 43(7), 851-859.
This paper concerns
an investigation into the strategic plans of Norwegian general hospitals, where
the researchers analyzed the documentation provided to them in order to
determine to what extent aesthetics played a role in the design of the
buildings and how these issues were ultimately prioritized. The researchers created a matrix of
‘aesthetic categories’ – harmony, food, art, rooms, light, colors, design,
sound, nature, aesthetics and quality (aesthetics was given its own category to
chart specific mentions of the term) – each with its own subcategories, and noted
mentions of each in the strategic plans. They concluded that all categories
were significantly underrepresented (“almost absent”), though it should be
noted that just because these categories were not overtly mentioned does not
mean that they were not considered during the design process. However, this
model of research does present a potentially interesting way to investigate
mentions of sustainability in strategic planning and to what end such mentions
may lead.
Shepley, M. (2009). Eco-effective design and
evidence-based design: Perceived synergy and conflict. Health Environments Research
and Design Journal, 2(3), 56-70.
While this article
should prove to be extremely valuable, the copy which I received via inter-library
loan is almost unreadable and I hope to be able to obtain a better copy soon.
From what little I’ve been able to read without getting a headache, the authors
attempt to address the intersection of eco-effective design and evidence-based
design and determine both the amount of overlap (which seems substantial) and
its ultimate result (either supportive or in conflict). If I may quote: “Though
a number of studies that assess either sustainability in the built environment
or the relationship between building design and health outcomes have been
completed recently or are currently underway, few if any studies have addressed
both EBD and EED in relation to the other.” I hope to be one of the first!
Ulrich, R. S. (2001). Effects of healthcare
environmental design on medical outcomes. In A. Dilani (Ed.) Design and Health:
Proceedings of the Second International Conference on Health and Design (pp.
49–59). Stockholm, Sweden: Svensk Byggtjanst.
This conference paper
by Ulrich is the most thorough of a series of articles and lectures given on a
similar topic; namely, a review of the existing research available at the time
concerning environmental characteristics which influence health outcomes and an
attempt to formulate a broad theory of “supportive healthcare design” which
addresses these issues. Ulrich touches on the usual suspects – noise, views to
nature, adequate sunlight, room occupancy size, flooring materials, furniture
arrangements – in order to demonstrate that there is a growing body of
knowledge which can be used to formulate an active method of design which
fosters control, promotes social support and provides access to nature. It is
interesting that Ulrich never overtly addresses the issue of sustainability,
although one could argue that an environmental sensitivity exists in his theorizing.
