First do no harm

According to the AIA Guidelines for design and construction of Healthcare Facilities, 2006: “The built environment has a profound effect on health, productivity, and our natural environment. Health Care facilities shall be designed within a framework that recognizes the primary mission of health care (including “first, do no harm”) and that considers the larger context of enhanced patient environment, employee effectiveness and resource stewardship.” Environment of Care Section 1.2 in the AIA Guidelines for the Design and Construction of Healthcare Facilities 2006

Recent research has shown that healing gardens and healthcare site design can positively and negatively affect health outcomes. (Ulrich 1986, McLaughlin et al. 1996) Designing for healthcare facilities has a number of critical considerations that are above and beyond a typical design project. Hospital Administration or Facility Departments are often who we consider ‘our client’, since they are usually who hires us and pays for the design. We always have to keep in mind, however, that we are designing for the patient. There are a large variety of patient types and each has unique needs that the design must take into consideration in order to “do no harm”

Information is available on specific needs of different patient types in books, journals and on the web; talk to department clinicians regarding their patients’ needs as well. Research the growing body of information on how the design of the physical environment affects patients before you begin your design. Good sources for research are HERD, The American Horticultural Therapy Association’s Journal, The Center for Healthcare Design and Informedesign. If at all possible, attend one of the seminars that are offered all over the country on healing garden and healthcare site design. Find books specific to your patient type and study them. Be sure to interview Clinical Staff to make sure that you understand how your garden will fit into the facility. Coordinate focus groups with patients to better understand their perspective. Be sure to follow up after the project is completed to learn if any adjustments are needed to make the garden truly healing.

Healing Gardens

A large body of research has shown that views of gardens and landscapes lower blood pressure, help with quicker recoveries and reduce the need for pain medication after surgery . Roy-Fisher Associates thinks that well designed healing gardens and careful healthcare facility site design can be as important a tool in healing environments as medical equipment and drugs. This theme was evident over and over again at the recent symposium at the University of Georgia: “The Art and Science of Healing Gardens” that I was lucky enough to lecture at and attend.

Healing and restorative gardens fit in a variety of healthcare facilities: hospitals, assisted living facilities, nursing homes, rehabilitation facilities, outpatient facilities and drug and alcohol rehabilitation facilities by providing venues for active and passive treatment modalities. In other words, by providing something as simple as a pleasant view of a green roof outside a hospital intensive care unit room, a spot for paralyzed spinal cord patients to regain some motor activity and a sense of worth through horticultural therapy, a means to calm agitated Alzheimer’s patients, a way for elderly residents to maintain activities of daily living or for stroke or injured patients to receive physical therapy in a garden.

The stress reduction provided by carefully designed gardens is important for patients, their families as well as the clinical staff. Studies have shown that fewer medical errors are made when staff stress is reduced. There are high amounts of stress associated with a loved one’s illness that compromise caregiver’s immune systems. Gardens can reduce that stress by providing a pleasant distraction, a place for social support and exercises as well as sense of control by providing an alternate to staying in hospital waiting rooms. Ulrich, 1984

GREEN ROOF IN LAKE WORTH

Hurrah! A successful, inexpensive Green Roof example exists in Lake Worth. The EcoCentre designed by John Szerdi, Living Designs has a variety of applications that work with the “Living Machine” concept that is the basis of the building design.

Planters are constructed of recycled plastic lumber and pond liner. They are placed directly on the flat roof. The planting media is LECA, an acronym for light expanded clay material. It is a light tan color. The media depth is about 10-12”. Some of the planters are unirrigated, some are irrigated by gray water collected from the building, condensate water or storm water collected in a cistern. Originally the planters were to be planted with sedges recommended to the architect by colleagues through past experiences in Virginia. Fortunately, the planting was changed to grasses native to Florida that we suggested while touring the building when it was under construction.

The planters have been in for about 6 months, both the irrigated and unirrigated planters are doing well.

  

LANDSCAPE AS A CRITICAL PART OF SCHOOL DESIGN: WHAT’S OUT WINDOW KEY TO BETTER GRADES?

 

From the Athens Banner- Herald on Friday, June 12, 2009: ‘Having green space around schools doesn’t just make the campus look better – students actually score better on tests when they can see trees and gardens outside their classroom windows, a University of Georgia professor has found.

“It’s hard to explain,” said Kenneth Tanner, head of the School Design and Planning Laboratory in the University of Georgia’s College of Education.

But research clearly shows that students who can look out at greenery do better on math, reading and some other achievement tests than students with views of walls and parking lots, said Tanner, who’s been studying the effects of school design on student achievement for more than a decade.

Tanner has his own theories on why looking at trees is better than looking at concrete.

“It’s this feeling of wellbeing,” a feeling that people get from looking at natural areas, he said. “If I’m looking into a wall I feel like I’m being blocked.”

Tanner’s most recent research examined the test scores of more than 10,000 Georgia fifth-graders. Even when Tanner statistically ruled out the effects of family income and other variables, the positive effects of natural window views stood out.’

For more research regarding trees and inner city kids doing better in schools, communities with lower violence rates because of trees and a variety of other studies that show how trees and landscape contribute to healthy populations visit the University of Illinois at Urbana’s website for a number of studies they have done. SPROUT!