The hospital of the future may not look like a hospital at all

Kim Ridley | July/Aug 2006 issue
As if getting sick weren’t bad enough, landing in the hospital can make you feel even worse. There’s little privacy. Noise from roommates and hallways disturbs sleep. Isolation from family and friends takes a toll on emotions. In such a stressful environment, how can anyone heal?
Many hospitals are “built catastrophes, anonymous institutional complexes run by vast bureaucracies, and totally unfit for the purpose they have been designed for,” writes Dutch architectural historian Cor Wagenaar in The Architecture of Hospitals, an international collection of groundbreaking studies, essays and hospital design plans published this summer by the Netherlands Architecture Institute. “They are hardly ever functional, and instead of making patients feel at home, they produce stress and anxiety.”
The consequences can be serious. Recent studies show that stress may hinder healing by intensifying pain, suppressing the immune system and causing heart problems, insomnia and depression. By inadvertently heightening patients’ stress, hospitals may be undermining patients’ recovery.
With a hospital-construction boom gearing up around the world, with expected expenditures of $200 billion (156 billion euros) in the U.S. alone by 2015, some architects and health-care professionals are calling for a revolution in hospital design that would create healing environments to reduce stress, re-humanize health care and return a measure of power and control to patients. The Architecture of Hospitals book, partly inspired by an international conference of the same name at the University Medical Center in Groningen, the Netherlands, offers many of these intriguing blueprints for revolution.
These changes aren’t just window dressing; they signal a radical rethinking of hospitals’ function and organization. Rather than intimidating fortresses riddled with mazes of corridors, health-care facilities of the future may resemble a homey village surrounded by gardens and parks, with a hotel, fine art displays, a wellness center that offers the luxury services of a spa and other sources of inspiration.
The transformation is already happening at places like the new Rikshopitalet University Hospital in Oslo, Norway, where architects designed a large facility on a human scale inspired by the comforting layout of a traditional village. “To promote health is to promote security and well-being,” writes Arvid Ottar, chief architect of the new hospital. “For us, such feelings are linked strongly to the feeling of recognition. We felt that our solution lay more in the domain of town planning than architecture.”
The hospital’s main thoroughfare is a bright, glass-roofed “street” that gently curves to suggest a village road. Treatment areas and labs are clustered around central courtyards on one side of the street and patient wards jut out from the other side, with every room offering views of nature. A plaza marks the hospital entrance and clinics are organized around “public squares.”
On a more intimate scale, the architects incorporated healing elements such as daylight, and chose wall colors carefully, using soothing tones for bed areas and energizing shades for physiotherapy. Ottar explains, “We believe that the right environment promotes patient health and well-being, and are firmly convinced that future studies will prove this.”
The idea that architecture contributes to healing isn’t new; it dates back to the late 18th century, when hospitals were designed to provide fresh air and access to the healing powers of nature. These concepts were forgotten by the 20th century when the rise of technology-based medicine spawned the ugly, utilitarian hospitals we all know and loathe.
Research, however, shows that wisely planned hospital spaces can help reduce stress, improve safety and health, and enable harried staff to care for patients more easily, according to Robert Ulrich, a professor of architecture at Texas A%amp%M University and a behavioural scientist who studies the effects of health-care facilities on patient safety and outcomes. Healing design elements include windows overlooking nature, gardens and perhaps most important of all, private rooms. In U.S. hospitals, single-bed rooms have been shown to lower the risk of hospital-acquired infections, reduce stress from noise, more comfortably accommodate families and reduce room transfers, a major cause of medical errors.
“Architecture can raise the spirits and amplify the positive mood and ethos of an institution,” architectural historian and writer Charles Jencks writes in The Architecture of Hospitals. He has first-hand experience with the effects of architecture on well-being at Maggie Centres, beautifully designed cancer-care centres initiated by his late wife Maggie Keswick Jencks. Located next to hospitals in Scotland and England, these centres provide education and support for cancer patients and their families in extraordinary, home-like settings designed by leading architects.
American architect Frank Gehry designed the Maggie Centre in Dundee, Scotland, a lively whitewashed building that resembles a futuristic gingerbread house with a crinkly steel roof and a small tower inspired by a lighthouse. Inside, light-filled spaces are at once exciting and serene. As at all Maggie Centres, the interior combines the elements of a home, a gallery, a church and a hospital, reflecting visitors’ varying needs and the center’s informal functions.
The hospital of the future may not look like a hospital at all. Alternatives are proliferating. At the Dutch Berlage Institute, architects are pumping out intriguing ideas like using message boards and beepers to liberate patients from dreary waiting rooms and incorporating gardens and movie theatres into clinics. Other architects envision hospitals as wellness centres that also promote health with education and offer services similar to a spa.
Sure, hospitals will still have operating rooms and high-tech procedures. But if the revolution presented in the Architecture of Hospitals succeeds, they will evolve into much more human—and healing—places. American interior architect Jain Malkin calls them “healing environments,” and says they will become “temples of healing [that] embrace the joy of living.”
Cor Wagenaar (ed.): The Architecture of Hospitals
NAi Publishers
ISBN 9056624644