Selected evidence of the value of design
in health care
A. The Architectural Healthcare Environment
and its effects on the Patient Health Outcomes: A report at the
end of the first year of study
The University of Sheffield School of Architecture
in association with NHS Estates, Poole Hospital NHS Trust, South
Downs Mental Health Trust (January 1999)
This study for NHS Estates compares orthopaedic
patients on a refurbished ward at Poole Hospital with those on
a conventional 1960s ward. It was found that patients treated
on the refurbished ward required fewer analgesics than those on
the older ward. Patients not undergoing operations were discharged
significantly more quickly from the newer ward (6.4 days compared
with 8.1 days).
The study also compared psychiatric patients
treated at Mill View Hospital, a purpose-built unit in Hove, with
those of two wards at Freshfield Mental Health Unit in Brighton
Medical Hospital, located in a Victorian former workhouse. The
length of stay was again lower in the new unit. Mental health
patients treated entirely in the new building had an average reduction
of 14 per cent in their stay (36.5 days compared with 42.4 days).
Also in the new unit, 79 per cent of the mental
health patients were judged to have made good progress (compared
with 60 per cent in the old unit) and the level of verbal outbursts
and threatening behaviour was reduced by 24 per cent and 42 per
B. Alzheimer's Special Care Units
Regnier V, 1998.
Places, Vol 12, no 1, Fall 1998, pp 38-41.
Research in the USA on Special Care Units and
Assisted Living Treatment Residences for people with Altzheimer's
disease and related dementias shows that certain design generates
more agitated behaviour while other design makes people calmer.
For example, unobtrusive and secure exits reduce paranoid delusions
and increased bedroom privacy reduces verbal agitation, physical
agitation, aggression and paranoid delusions. The study concludes
that the benefits of these design features on health and quality
of life are independent of other quality care characteristics.
C. View through a window may influence recovery
Ulrich, R 1984.
Science, Vol 224, 27 April 1984, pp 420-421.
A study in a suburban Pennsylvania hospital
examined the records of patients recovering from cholecystectomy.
It compared patients whose rooms had windows overlooking trees
with patients who looked out onto a brick wall and found that
had shorter post-operative stays
(7.96 days compared with 8.70 days);
had fewer negative evaluation comments
took fewer strong and moderate analgesic
had slightly lower scores for minor
D. Study of the effects of the visual and
performing arts in healthcare
Staricoff, R L, et al.
Hospital Design, June 2001.
Ongoing research at the Chelsea and Westminster
Hospital into the impact of their visual and performance arts
programme has demonstrated the value placed on it by those using
two-thirds of both staff and patients
rated the value of the arts programme in the healing process very
75 per cent of both staff and patients
cited that the arts programme greatly diminished stress levels
and changed their mood for the better.
The quality of the working environment is cited
by staff as a key reason for wanting to join and remain at the
E. Room for improvement
Institute of work health and organisation, 2000.
Work by Nottingham University sought to identify
aspects of design that contribute to the creation of a therapeutic
environment for patients by comparing three environments at pre-
and post- redevelopment stages. The new well-designed wards were
viewed as relaxed and comfortable, resulting in:
lower pulse and mean arterial blood
shorter post-operative stays (8 days
down from 11 days);
lower drugs intake (DF118 and Tamezepam).