Select Committee on Health Appendices to the Minutes of Evidence


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 cent respectively.

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 from surgery

  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 the former:

    —  had shorter post-operative stays (7.96 days compared with 8.70 days);

    —  had fewer negative evaluation comments from nurses;

    —  took fewer strong and moderate analgesic doses;

    —  had slightly lower scores for minor post-surgical complications.

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 the hospital:

    —  two-thirds of both staff and patients rated the value of the arts programme in the healing process very highly.

    —  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 hospital.

E.  Room for improvement

  Leather, P.

  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 pressure readings;

    —  shorter post-operative stays (8 days down from 11 days);

    —  lower drugs intake (DF118 and Tamezepam).

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