For our health’s sake

Photo: Palomar Medical Center West. Courtesy: CO Architects

For centuries, an instinctive approach to recovery and convalescence during and after illness has been to seek respite at a seaside or mountainous retreat to breathe fresh air and spend time in a natural environment.

This intuitive method relies on a belief in the healing power of nature and in the interrelationship between human health and the environment. This belief is now beginning to transform our health care settings, as evidence mounts that this method is a sound one that can deliver tangible and positive clinical outcomes.

Health care organisations are starting to pay attention to the effects of exposure to nature and realise that there is a need to create hospitals that provide not just medical treatment facilities but that also offer landscapes and gardens that promote health.

Roger Ulrich’s research
At the forefront of research in this field is Professor Roger Ulrich, the Director at the Center for Health Systems and Design, Texas A & M University. In 2002, he presented a paper entitled “Health Benefits of Gardens in Hospitals” which reviewed the scientific research on the effects of gardens and their use within health care settings.

The findings were profound as they showed that the simple fact of being able to view nature, such as trees or a garden scene, from a window improves stress levels, helps calm patients, reduces the length of hospital stays and decreases the amount of pain medication required. This was demonstrated in improvement of both psychological and physiological symptoms such as heart rate, blood pressure and electrical activity. As little as three to five minutes of viewing nature was shown to deliver restorative effects to patients.

In his review, Ulrich also found that having access to a garden increased patient and family satisfaction with the health care service.

The benefits don’t stop there: the availability of a garden area assists in the recruitment and retention of staff members, who are also able to benefit from a garden’s stress-relieving properties. So gardens are not just beneficial for patients but for all members of the health care community.

In his review, Professor Ulrich also made the point that garden spaces have not traditionally been high on the priority lists for many hospitals. “Faced with imperative demands such as paying for costly new medical technology, administrators may often consider gardens as desirable but non-essential,” he said.

Palomar Medical Center West
However, as clinical evidence increases about the benefits of gardens, the economic imperative is changing and architects and landscape designers are already bringing to life the vision of health care settings where gardens are an integral part of design.

Next year, the Palomar Medical Center West (PMCW) in California is set to open, and it will include a 1.5 acre rooftop garden specifically created for the purpose of giving patients access to nature as a mechanism to reduce stress.

“Evidence shows that access to nature reduces stress associated with the typical clinical environment and has a positive healing effect on patients,” says Frances Moore, Senior Project Architect for PMCW, from the Los Angeles firm CO Architects.

“The roof form houses the most technologically intense part of the hospital, while bringing nature closer to the patients and workers,” she explains.

“The signature tower building – with its gently curving form – figuratively opens its arms to welcome patients. Site planning, landscaping, non-institutional architectural expression, and materials selection are all strongly influenced by the desire to merge nature and building, with each aspect informing the other to create a unified whole.”

Landscape architect Andrew Spurlock from Spurlock Poirier Landscape Architects has also been involved with the project and says the roof garden is one of a series of healing gardens throughout the site that include interior gardens on each patient floor, an outdoor terrace with flower garden and naturalized meadow, stroll gardens, parking-lot gardens, and garden mall.

“Garden areas can be locations for community events and meetings. The gardens offer a setting for demonstrating and promoting PMCW’s role in ongoing wellness education for the community,” he says.

Brooklyn’s Memorial Sloan-Kettering Center
In Brooklyn, New York, the Memorial Sloan-Kettering Center, which caters for cancer patients, has a ‘Central Garden’ that can be viewed from each of its treatment ‘pods.’ It has been designed specifically with the idea that recovery accelerates when patients are connected to nature.

“Planters, vegetation and a water feature define the Garden’s spaces, create texture and colour along circulation paths, and provide a calming sense of connection to natural elements,” says Jan Carl Willemse, Partner-in-Charge at ZGF Architects.

“These design moves acknowledge the value of biophilia, with its growing body of medical and psychological research indicating that patient recovery is accelerated and staff productivity and satisfaction are increased in environments that offer connections with nature.”

Melbourne’s Royal Children’s Hospital
In Melbourne, Australia, the recently completed AUD $1 billion revamp of the Royal Children’s Hospital was built with nature in mind. The work of Roger Ulrich was one of the references used to underpin the design of the building, along with the work of psychologists Kaplan & Kaplan, the Reggio Emilia education philosophy and the ideas encapsulated in the art of Scandinavian Olafur Eliasson. The result is a light-filled building integrated with the surrounding parklands and constructed with children in mind.

“You have access to natural, direct light constantly and the sun and the gardens kind of wrap around the entire building,” says Lead Architect Kristen Whittle. “Once you walk in you always have a view outside, you always know what time of day it is and you always have a sense of where you are in the building because you’re always looking out.”

As health care organisations the world over start to pay attention to gardens, the next step will be the consideration of the differing needs of various groups of patients in terms of what a garden needs to provide.
Gardens in health care settings need to be created on evidence-based design principles to ensure the best possible design outcomes for patients, their families and health care staff. It is hoped that the resources to undertake this research are forthcoming as it is clear that gardens are not just about aesthetics but operate as positive clinical interventions in themselves.

Leave a comment