Академический Документы
Профессиональный Документы
Культура Документы
Batch: 2013
Date: 11/21/2016
The intent of this dissertation is to explore how architecture can inform healing or provide spaces
and events where healing can take place. We as human beings have an inner connection with our
environment by physical, mental, emotional and spiritual means. Healing cannot be understood in
isolation from the factors that operate in the dynamic life of an individual. These include the self,
the family, the community, the environmental context within which life is carried forth, and the
world of spirit or essence.
Furthermore, the arts and art therapy have, over the years, been used to heal different aliments
such as cancer, mental illness, aids, addiction and the elderly have been successful in doing so as
it heals across all ages and race. The question I pose is can architecture do the same? Besides,
can architecture play a superior role in healing? In our built environment we often interact with the
buildings themselves without knowing the fact of relationship between building and surroundings.
Can we create those interactions by evidence based design methods? This dissertation
summarize the principals of life enhancing role of architecture and planning in the healing process.
Through a theoretical approach including the history of healing architecture and the introduction of
architectural and anthropological theories, the project defines four main parameters that should be
included in the design of future spaces for social support: Functions that reflect the everyday life,
materials & textures with a homely atmosphere, importance of daylight in hospitals and details
with interior design in the human scale.
The study also comprises of case studies of two hospital which lies in Delhi NCR, india (1.
Medanta hospital , gurgaon 2. Fortis hospital , gurgaon ). Both the hospitals are multi specialty
in nature. This study includes the innovative solution for healing environment inside and outside
the hospital building through site planning , building planning , interior of the room , views, social
spaces such as waiting areas, atrium , corridors, food court , healing gardens , etc.
The Research Paper presented here would not have been possible but for the guidance &
support of
Ar. Tanya Gupta, HOD, School of Architecture for extending her support & valuable
guidance whenever wherever required.
DIPESH ANAND ,Guide & mentor for her/his relentless pursuit of high academic
standards, the can-do attitude & imbibing professional ethics have helped this project meet
high academic standards & professional working.
My parents who have taught me to strive for perfection in everything I do.
Any other person
And also my friends & colleagues who were always around to help me.
Appreciation & gratitude is owed to them.
DIPESH ANAND
Student
(_2016_)
Batch
5. Conclusion 114
6. Bibliography
7. glossary
Objective - The aim of this research paper is to obtain an in-depth understanding of the
physical aspects in hospital design and how these physical aspects play important roles in
creating a healing environment. Other objectives of the present paper are:
• To acknowledge the critical experiences of patients, staff and visitors in hospital
buildings,
•Importance of daylight in hospital architecture,
• To outline the physical aspects in healing environment,
• To investigate the previous and current research available on the subject of health and
environment, design for healing and the effect of day lighting on human beings,
• To examine the elements of physical aspects of existing project brief of public hospitals,
•To study the need for social support during hospitalization,
2. Connection to nature -
Nature window views
Garden accessible to patients
Nature art : no abstract at
Daylight factor
Internal courtyard connected to ward , patient room
Quiet in the ccu (coronary care unit)
Music during minor surgery
Air quality
Landscaped courtyard
Floor to ceiling windows
Therapeutic benefits
Landscaped setback
Front porch - (overhang may scale down the size of the building)
Entry garden
Plaza(include trees, shrubs, overall is not of green image , but of a paved urban plaza).
3.social structure -
Green lawn for social improvement in structure.
Imaginative maze for children.
Covered sitting terrace or patio within a nature surrounding.
Single occupancy vs multi occupancy patient room study.
Elements in the social dayroom.
In the 17th and 18th centuries, the dual emergence of scientific medicine and Romanti- cism
fortuitously combined to encourage the re-emergence of usable outdoor spaces in hospitals.
The intention behind the concept of healing architecture seems immediately obvious and
straightforward, and it seems rather strange that not all hospitals are based on these concepts
of integrating the architectural environment as support for the medical treatment. However, the
idea of a beneficial effect on patient’s healing process sup- ported by well designed
surroundings is not a new concept. In fact, these ideas may be traced back to thoughts and
ideas evolved in the 18th century. At that time, leading doctors and nurses proposed changes
in the layout and design of hospitals in order to reduce the danger of contamination by
designing smaller wards and increasing ventilation. Later these theories are followed by
Florence Nightingale, who in Notes on Hospital from 1859 published her philosophies and
thoughts of the supporting effect of aesthetic environmental settings for the patient’s physical
and psychological condition. In Denmark, the first public hospital is planned by request of king
Frederik V in 1752. At that time, the medical knowledge was underdeveloped and the
experience of building health care settings were naturally lacking. In the 17th and 18th
centuries, the dual emergence of scientific medicine and Romanticism fortuitously combined to
1. Reduce staff stress and fatigue and increase effectiveness in delivering care
2. Improve patient safety
3. Reduce stress and improve outcomes
4. Improve overall healthcare quality
The idea behind the concept of healing architecture is not a new concept but is rather a
earlier explanation in more advanced techniques that the surrounding environment, daylight,
nature , views and access,.. etc. had a healing effect on patients. in todays planning of new
modern hospitals has shifted to patient-centered care and the well-being of the patients and
their families, attempting to balance the building codes , functionality and aesthetic
considerations.
Today we are building upon this rational thinking , however with a broadened mind.
evidence and science is no longer limited to medicine , they are also related to interior and
architecture of hospitals. Developed as an extension of evidence-based medicine, research
within the field of architecture and its effect on patent outcomes is still gaining ground,
documenting the benefits of patents hospitalized in well-designed environmental settings
(Ulrich et al 2008 and Hamilton 2003). today most of the hospitals are build on EBD method
for increasing the healing power in our future hospitals.
Through EBD, various proofs has been found, that the sensory perception patents meet
during hospitalization have an impact on their experienced level of stress, and if high, this
will reduce the immune system causing higher level of infection disease and delayed wound
healing. This way, undue noise, interrupted sleep, lack of daylight and generally
dissatisfying environments, will all be factors that affect the level of stress negatively.
(Frandsen et al 2009, Ulrich et al 2008, Francis 2002 and Horsburgh 1995).
Health, and persons in a partnership have this way a generally better health than singles.
This may result from the positive influence by our close relationships, or may in
some cases directly related to the social and emotional support. (Zachariae & Christensen
2004) The human is generally a social creature, and our relationship with other people – our
social relations – is a central aspect of our life. The amount of social support that cancer
patients is experiencing, and especially the possibilities to discuss ones disease and
treatment with other cancer patients, is considered very helping in the stressful periods of
the disease. (Zachariae & Christensen 2004)
The diagnose of cancer generally cause depression , stress , tension , anxiety among the
cancer patient and their families. the risk of developing a profound depression is increased
due to isolated social spaces and lack of control over the situation. the patients are
experiencing upturn process of adaption in order to accept and understand the disease,
changed prospect, various treatment., etc. at that point of time social support is much more
of need to conquer depression and stress.
Cancer is a very difficult disease to handle and it is very much important to have social
support during these situations for comfort and support. other patient suffering from same
disease regard as a useful support for them, especially for increasing hope and belief. they
may are from different places, but they communicate in same language at that time (
Rasmussen 2003).
The solidarity with other patients may range from intense intense conversation and social
support to inspiration of other patient activities and actions. that's why patient don't feel left
alone with their disease. particularly at time of changed treatments social support from other
patient is proven useful.
A serious disease cancer not only affect the patients but solely the entire family. Partners,
parents, children, close relatives are also implicated by the disease and long period of
treatment. As it is important that families facing same situation get socially interacted with
each other at equal status. in these forums , families can talk about the problems facing
them without influencing the patients. Families to cancer patents are experiencing a tough
psychical stress, but their well-being is rarely in focus. Depression, confusion, anger,
sadness and other negative feelings and emotions are often unavoidable consequences for
the relatives to a cancer patient, which may be overcome or reduced with increased social
support to the families themselves. (Hansen & Thastum 2005)
Though we have stated that social support is very much of importance in treatment of
cancer in order to satisfy their mental condition. the main focus in designing phase there will
be patients themselves and the need of their families will be taken into considerations. there
will be such living areas in single patient room for the social interaction of their families so
that they do not feel that they are totally in medical staff .
2.1 INTRODUCTION
In chapter two of this research, hospitalized patient` requirement for social interaction and
social support has been identified. Day by day patient`s general level of stress and fear
increased not only due to changing pattern in disease. Also struggles to perform normal
activities like low level of visits from family and friends may occur a factor of fear. the future
planned single bedroom hospitals is furthermore increasing the rate of fear and stress ,
loneliness and the need of social support in hospitalization is playing a crucial role in future.
spaces for social support interlinked with hospitalized patients is much more important which
will enable knowledge sharing and diverts inspiration among the patients.
Social support in future hospitals is encouraged through social interaction that may vary in
different levels and variation. The social interaction can be done through informal meeting
which we experienced in our daily lives such as, we experienced in trains , mall, parks , gym
, city square, etc. and complete social relationships like we experienced in our homes in
safe and physically well being surroundings. Through these measures social interaction will
increase and knowledge sharing and inspiration with patient of equal status are potentially
responsive. The physical surrounding have potential to have ideal settings where common
areas are constructing both initial contact and developed social relationships. In this
contrary the social space may seen as intersection between a public space and a homely
environment. Usually our everyday activities are performed with our family and friends,
while in the hospital these simple familiar activities suddenly are occurring with unknown
people in a semi-public space.
If we improved these social spaces then the healing power will also get increased and may
even considered as an influential elements in regard to healing architecture. There are,
however, not found any specific EBD research that define detailed aspects in regards
to design and physical planning of these spaces. (Ulrich et al 2008) Instead, the project is
stating the thesis that by introducing architectural and anthropological theories, a more
thorough understanding of the human perception of space and even specific transferable
architectural aspects There are, however, not found any specific EBD research that define
detailed aspects in regards to design and physical planning of these spaces. (Ulrich et
al 2008) Instead, the project is stating the thesis that by introducing architectural and
anthropological theories, a more thorough understanding of the human perception of space
Social support during hospitalization is experienced in various levels of intensity. The need, the promotion and finally the
development of social interaction is the main essential steps towards the potential social support.
In this chapter will introduce some of the general theories regarding social interaction and
human behavior in the public space that architects and designers has used until now when
planning and designing urban Scapes.
Giving the possible privacy with some social spaces are necessary and are stated as a
basic qualification of rapid recovery. But constant withdrawal and always keeping oneself to
oneself so as to be spared social contacts and confrontations is often one of the symptoms
of mental illness, and so care is concerned with developing the patient’s social capacity.
The social element also has to be gradually stepped up, but of course depending on
individual situations. The design of the physical environment, accordingly, must support the
individual patient’s gradual expansion of his / her personal sphere. from patient`s own bed to
open door to green or entering to another patient room and sitting down to such social well
being corner to talk. Moving out to the social green area , sit on a bench near green plants ,
having a cup of coffee. Meeting a relative in cafe`. Going on a tour of hospital visit. All these
activities get used to patient daily lives which never make them felt that they are hospitalized
or progressively widening the social context.
Now I will discuss writings by architect and professor Jan Gehl and anthropologist Edward
T. Hall, in their theories described in Livet Mellem Husene (Gehl 2003), Byer for Mennesker
(Gehl 2010), and The Hidden Dimension (Hall 1973), respectively.
The call for social contact between individuals is a concept that covers many different
variations, from simple unpretentious contacts to more complex and emotional
conversations and intercourse. (Gehl 2003). Jan Gehl defines in Livet mellem Husene
(2003), the various contacts by their intensity, where close relationships have great intensity,
and the passive and casual meetings have low intensity. From this figure (below), the public
space primarily represents the casual and passive kind of contacts, which compared to the
more intense contacts are considered modest. However, they stll possess great quality and
attractive and inviting social spaces are very much required for day meeting to interact
socially patient with equal status for social support which enhances their knowledge about
such situation.
2.2.3 Activities in the public zones
In regards to activities in the public space, Gehl (2003) defines three types; essential
activities, optional activities and social activities – all with different demands to the physical
environments. The essential activities which are performed they are regardless of the
physical planning of social environment , they are not in contact to such areas, this may be
the medical treatment.
The physical environment often performs a very specific character in regards to social
interaction also concerned anthropologist Edward T. Hall (1973). In the writing "The Hidden
Dimension", he refers to a research study performed by doctor Humphry Osmond, who
ascertained that some types of spaces, for instance waiting rooms in train stations had the
ability to keep people apart, while French cafes did the opposite and made people engage
interaction. He defined the arrangements that discouraged social interaction as sociofugal
Small detail of furniture arrangement can change the character of the space , if prioritized by
an architect, social spaces of the future hospitals can be improved.
In regards to the human interaction in public spaces, this is best unfolded on the horizontal
level, where it has a rather large area of function. On this level, the social visual field is
capable of intercepting other person’s features and mood in distances up tll 20 meters, and
in shorter distances (1-3 meters), where we normally perform social conversations, our
visual senses are supplemented with other senses in order to form a general impression of
the person we are talking to. (Gehl 2003) Hall (1973) defnes very precise personal
distances, where 0,45 – 1,30 meter describes the close social contact between family
members, for instance around the dining table. Distances between 1,30 – 3,70 meter is
defining the more public social distance between friends, colleagues, etc. and is usually
seen in comfortable seating arrangements. These personal distances influence many details
in the planning of social spaces, and for instance this affects the sizes of tables. If too small,
two patents not knowing each other, would most likely not sit at the same table, as their
Through other studies of human behavior in public spaces, Gehl (2003) argues, that the
social activities has its own self-prevailing effect, where human actions attract attention and
furniture
As concluded, my research is that spaces for social support in future hospital environments
is defined as an intersection between the public space and physical environments with a
comfortable, homely atmosphere - a social place, where patients engage meetings and
social interaction, thus enabling social support.
The first step towards social support is consequently for the patients to meet each other,
which may include the theories of Gehl (2003 and 2010) and Hall (1973), described in the
previous chapter ‘The public space - how to promote social interaction’. The next step is to
develop this initial social interaction to intense level, and this process is believed to require
specific demands of the physical environment. In our daily life these levels of superficial
conversations are usually performed with our families or close relatives in safe and familiar
surroundings. (Rasmussen 2003) When hospitalized, the family contact may be reduced
(Ulrich et al 2008) and the environment today is often characterized by institutional settings
– far from familiar and well-known. Hence, the two aspects that form the basis of this social
interaction and support in our everyday life are apparently not present today.
From architectural point of view it is very difficult to raise the visits in patients room. instead,
other patient and staff can act as a family member at that point of time may be even for
better social support in some health related issues.
In hospitals patient are confined to such environment where the general freedom of choice,
is strictly limited. However, the things concerning the social interaction and the allocated
social spaces do not necessarily have to be so different from the spaces we recognize from
our daily life and our own homes. By changing the design of hospital dayroom of patient to
an inviting , familiar and homely environment recognizable for the patients leads to better
social support.
The question remaining is how this home feeling and homely
environment is defined outside home?
Summary
The homely atmosphere in future hospitals may be difficult to define, as our home is
usually very personal and individual and therefore impossible to transfer directly to
a health care environment. However, it is the research of this project, that by
implementing three fundamental characteristics of our home and everyday life, including
functions; materials and textures and details, it is possible to create a more homely
atmosphere in the social spaces, than we experience today. This atmosphere is
considered beneficial for the more developed levels of social interaction and social
support, as the conversations in safe, comfortable and homely environments are
believed to be more outspoken and emotional than the acquaintances in the regular,
standardized and clinical dayrooms we experience today.
Appealing and attractive spaces for social interaction and support in future
hospitals are depended on the surrounding architecture and the detail of the
physical design, seems easily accepted through evidence-based decision
maker, urban planners and anthropologists if the environment is not providing possibilities
for social activities, there will not be any interaction between patients-hence no social
support. The architectural effects described in the previous chapters, will in this chapter be
compiled in three guiding subjects, including functions (1); materials and textures (2)
and details (3), and through a translating description, their aspects are defined in
regards to the context of hospitals. This theoretical approach will define the main visionary
guidelines for the design phase of this project as well as form the basis of the evaluation
model used in the later following case studies.
The theory described by Gehl(2003) and T.Hall (1973) states that people attracts
people, if the social area remains unattracted then physical environment remain
empty all the time. When patents or their families have engaged social interaction,
maybe through the attractive functions, they should develop these contacts, which call for
spaces recognizable from their own home, partly achieved through a mix of functions –
reflecting the everyday life. Following the ideas and theories of the described
anthropologists, the materials and textures should overall assist in creating a familiar,
sensory and homely atmosphere. The final aspect considered as one of the main
guidelines for future social spaces are the details and interior planning in human scale,
concerning scale, personal distances and sociopetal spaces. Often small details change
the way
we experience a room, and some of the main physical elements in today’s hospitals, like
acoustic ceiling sheets, integrated artificial lightning, vinyl flooring, etc. are only
supported by the details of for instance coffee serving, greenery, arts and furniture, all
together defining the social space as institutional, inhuman and basically unfit for social
interaction.
CASE 2- HEJMDAL
FUNCTIONS
What are the options for residence?
The dayroom is considered the primary place
for residence outside the bedroom, although
there are some smaller furniture
arrangements in the hallway itself. These are
not used during the observation, and they
seem to be placed randomly in the busiest
place of the hallway next to the elevator and
with no seclusion from the semi-public
corridor space.
CONCLUSIVE REMARKS
Lund University Hospital is a case illustrating the good intention of improving the social
spaces in the existing hospital wards. It is a significant progress just to call attention to the
problem of unfulfilled common areas, and with the enhanced focus from the staff, some
hospitals are taking the lead – and in Lund with various success. The fact that a fair amount
of square meters are dedicated to the dayroom is positive, and the room even has some
small elements, where the intersection between the homely atmosphere and the public
space is combined - although not convincingly enough. The room is still experienced quite
institutional, especially expressed by the overall materials like vinyl flooring and acoustic
ceiling sheets, and the lack of tactile and sensory elements. The idea of letting the kitchen
be a central part of the room is in general good and even recognizable from our own home,
but the fact that it is closed off from the patients may instead work as an amplified reminder
of hospitalization? The kitchen table towards the patent area, is however a self-service are,
which share familiar elements, although the freshly brewed coffee, which is chosen for
its homely character, instantly turn institutional when being served in 3 liter coffee pot with
stacked industry cups. The small details could easily have been better thought through, and
why should the patients not have access to a smaller part of the real kitchen themselves?
(1) the stimuli derived from one’s internal and external environments in the course of living
are structured, predictable and explicable;
(2) the resources are available to meet the demands posed by the stimuli; and
(3) these demands are challenges, worthy of investment and engagement”
In the 1990s, architect Alan Dilani, proposed that Antonovsky’s principles be applied to
the built environment, specifically to the design of healthcare facilities. Since then,
Dilani and many other architects, designers and theorists have begun to further explore
Antonovsky’s theory and to approach architecture, interior and urban design through a
Salutogenic lens,.
Alan Dilani conceived this idea to promote health “The Psychosocially Supportive Design
approach is offered as a useful theory and framework to guide healthcare designers and
planners who consider how the physical environment impacts wellness factors in order to
promote health”. According to him Salutogenic design not only identifies the cause of stress
it can also introduce the wellness factor that can strengthens health. “The theory suggests
that we not only design for stress reduction, but focus on salutary rather than risk factors”.
Based on his vast research he created a list of design qualities that he argues strengthen
an individual`s sense of coherence.
(Table 2) lists these attributes and categorizes them based on Antonovsky’s sense
of coherence factors.
This includes the designers and developers, as well as the doctors, staff and possibly the
patients and their families. If the entire team understands the impact that design has on a
sense of coherence and in turn on the success of a project, they may be more likely to
support the design process and to encourage the upkeep of the facilities. “The organization
should measure the sense of coherence; the staff should comprehend it and act on it”
Traditional wards where the staff is based somewhere in a room far away from
patient rooms will disappear. In modern wards, there will no longer be a nurse
station but a centrally placed workstation, which is easy to reach, and where the
staff is always available.
From there, the staff should be able to survey and watch a group of patients within a very
short walking distance. This arrangement is called a “cluster”. A ward can consist of two or
three clusters which can easily be coordinated and flexibly used depending on the patients’
demand for care. Communication and contact between staff and patients is made easier in
this way, creating a feeling of security for both staff and patients.
Research has shown that access to nature, daylight and other wellness factors like art and
music can result in the patient using fewer drugs and spending less time in the hospital.
Nature can affect our emotions positively. It can easily catch a person’s attention or interest
and in turn can stop or reduce anxiety while bringing about desirable psychological
changes. It can reduce blood pressure, ease pain and stimulate our senses positively.
An increase in the consideration of wellness factors within design could have beneficial
effects on well being and health processes and thereby creates environments that are not
only functionally efficient but also highly psychosocially supportive.
Although Roger Ulrich’s Theory of Supportive Design does not specifically follow
Antonovsky’s Salutogenic approach, it does support the physical characteristics of Salutogenic
design. The Theory of Supportive Design is a stress-based model that is a marriage of semi
scientific and scientific research. It looks at how design affects healthcare outcomes in a
traditional design setting, using stress as a starting-point. According to Ulrich, manifestations of
stress can be psychological, physiological and behavioral. Ulrich states that instead of working
to mitigate these negative manifestations, the design of traditional healthcare facilities actually
worsens them. Noise, lack of privacy, and visually un-stimulating design elements can
undermine a patient’s sense of personal control or autonomy, whereas, supportive design can
aid in coping with stress and foster improved medical conditions.
He identifies general guidelines intended to help inform the designer’s creativity and point the
designer in a direction that will lead to stress-reducing design and that can be tailored to meet
specific needs and goals. Although Ulrich’s model may have helped inform Salutogenic design
and provides some key design characteristics that will alleviate stress, it lacks the integrative
and holistic approach that is key to Salutogenesis. Ulrich’s model is much more specific than
Salutogenesis and does not look at the bigger picture of health promotion through design and
how designers can achieve this goal, from conception to completion. It is still, however,
valuable to recognize Ulrich’s theory, as it is a significant contributor to current Salutogenic
design models.
Jan Golembiewski, a leading researcher of the relationship between the built environment
and mental wellbeing, states that: “Salutogenic theory is a particularly useful tool as it is
specific and easily applied to an architectural application” Similarly to Dilani, he maintains
that comprehensibility, manageability and meaningfulness— which support a strong
sense of coherence and foster a natural healing process—have clear architectural
ramifications.
He studies the architecture and design of psychiatric healthcare facilities through the lens of
comprehensibility, manageability and meaningfulness.
1.Comprehensibility- he says, is making sure that perceptual cues are present to assist
perceptual processes. These include attention to texture and materiality, controlling the size
of spaces and the numbers of patients and normalizing environmental features.
Golembiewski states that: “Under normal circumstances people have a great deal of ability
to adapt to new surroundings—even in stressful situations… However, when environmental
factors start to erode a general sense of coherence—when meaning, control and
comprehensibility are lost—resistance to disease weakens and perceptual difficulties are
exacerbated, often creating a vicious circle of increased vulnerability and anxiety”.
In his research he found that manageability, comprehension and meaning have significant
architectural ramifications and they are central to Salutogenic design. As well, his studies
that show how environmental factors may erode a sense of coherence and, in turn, will
weaken resistance to disease and perpetuate anxiety
There are tremendous reason for choosing this hospital , main aim to create
an environment which should not give a sense of boring hospital. The design
philosophy behind this hospital to provide the health and well being of the
people they serve through integrated, innovative, and compassionate care,
also creates spaces that allow for privacy, rejuvenation, choice, humanistic
scale, feel and experience, communication, and collaboration. The Hospital
should incorporate new trends like wellness, technology and creates a Gen
Next Medical Center which sets new standards for healthcare focusing on
healing & nurturing robust health. At the south corner is a quiet & sun-filled
healing garden for patient, recuperation & areas of respite for staff and
families. All major areas in the hospital will have natural light for healthy and
sustainable environment.
The architecture of this hospital considered the healing source, although
factors like daylight, room atmosphere, sound, music, art and optional privacy,
altogether are believed to assist in creating carefully designed environments
that affects and supports the psychological and physical healing of the
patients.
With acceptance of the architectural influence on human healing aspects, it is
even more obvious that healing architecture should be incorporated in the
planning of future hospitals.
Ward layouts in older hospitals generally provide long corridors organized around a central
nursing station, where medication and charts are located. Research has shown that nurses
spend much of their time walking up and down halls increasing fatigue and stress and
sharply cutting the time available for observing patients and delivering direct care.
Common console for cathlabs , MRI, X-RAY , AND ICT decreases the circulation pattern
proves efficient for patient and staff.
2. NATURAL LIGTH
Perception of sunshine contribution
study done for the fortis hospital ( included both patient and staff interviews)
Patient Staff
Survey question
Considered sunlight to be a nuisance 2% 55%
Considered sunlight to be pleasurable 91% 33%
Considered sunlight to be calming 95% 37%
Considered sunlight to be unfavorable 1% 18%
All major areas in the hospital will have natural light for healthy and sustainable
environment. Skylight at the roof transmitting natural light into the most common &
waiting areas.
3. GREEN ENVIRONMENT
ARRANGEMENT OF FURNITURE IN
MATERNITY WAITING AREA FOR
MOTHER is designed in such a homely
attmosphere which reduces stress level
among the patient. The detail with the false
cieling and sofa shows the intention making
the waitinf area comfortable , homely space
but the specific choice of curtain make it
seem clinical in some respect.
Patient Based Art Programs include artwork that is selected based on the unique needs of
each patient groups (such as Cancer, Pediatric, Geriatric, Women, Heart, ICU, Rehab and
Psychiatric). Patient Based Art helps to deinstitutionalize the clinical setting while illustrating
VIEW OF THE GREEN AREA FROM DOUBLE information rate . Because most natural
brick wall.
HEALING ARCHITECTURE IN HOSPITAL DESIGN 86
@2016 , Dipesh anand
B. EVALUATION MODEL IN RELATION GUIDELINES SET THROUGH
STUDY OF EDWARD T. HALL AND GEHL THEORY.
B.1 FUNCTIONS
What are the options of residence ?
The living area in suit room considered as
primary place for visitors , where visitors
always remain close to the patient. Although
looking at the furniture arrangements in the
living room looks almost like you are in such
a homely atmosphere, which ultimately
increases the sense of coherence among
the patient. The lighting in the room sets a
relax mood of patient and visitors both ,
which changes the pathogenic place to
Salutogenic place.
Furniture and distances ? The room is divided in patient and visitors use in presidential suite.
Other details ?
Specific details such as flower pot
at the window bay as well as lamp in
the living area arouses a feeling that
a patient is in his/her home. t is done
to define attractive and welcoming
social space.
Area: 43 Acres
Client: Global Health Pvt. Ltd. (The Institute of Integrated Medical Sciences & Holistic
Therapies)
Architect: cardinal hardy architects / jodoin lamarre pratte architects / group arcop
There are enormous reason for choosing this hospital , The prestigious
Medicity project, a state-of-the-art institute of integrated medical sciences and
holistic therapy, will, for the first time in the history of medicine, combine
different streams of medical science such as allopathy, Ayurveda,
homeopathy, naturopathy and unani, to find a holistic treatment for modern
ailments and diseases.
The design philosophy behind this hospital to provide the health and well
being of the people they serve through integrated, innovative, and
compassionate care, also creates spaces that allow for privacy, rejuvenation,
choice, humanistic scale, feel and experience, communication, and
collaboration.
The architecture of this hospital considered the healing source, although
factors like daylight, room atmosphere, sound, music, art and optional privacy,
altogether are believed to assist in creating carefully designed environments
that affects and supports the psychological and physical healing of the
patients. This is a project that is very close to our heart. The Trehan family,
who formulated the vision and encouraged a detail-oriented execution of the
project, were wonderful people to work with. We wanted to create an uplifting
and happy space far removed from how we generally see hospitals. It was a
tremendous opportunity to create a difference, especially amongst people who
were unwell and recuperating.
MEDANTA HOSPITAL
A.1 COMPREHENSIBILITY
1. Way finding
Clear organization and simple circulation system within medical areas eases patient and
staff use. In case of medanta there is no such common ward arrangements which arouses
a problem related circulation of staff and visitors. Ample amount of daylight is penetrating in
the corridor areas so that there will no dark spots in the corridor, proper signage boards
and welcoming staff helps visitors in way finding to their destination.
Daylight in corridor ,but does,nt have soft edges lift lobby showing rectangular dead end
The language of forms in architecture also has a correlation to the feeling one
obtains from the space. For example the natural environment has soft edges, but no
right angles (Red stone). However, the right angles in our everyday life are endless
in the built environment. The architecture of a healing environment can take on the
qualities of natural conditions through imitation in form. While one might feel
constrained and boxed in rectilinear spaces, the fluidity of an organic space creates
no such feeling. Without right angles, the spaces become seemingly less harmful
and comforting to the human eye. "It is not the rectangle which is the problem, but its
life-sapping characteristics. Where materials, textures, colors, light, living line and
human activity can reinvest such forms and spaces with life, the ly None the less, in
2. Colors
As the color of the ceiling and walls are mainly white , slightly change in bedrooms but
although it is kept as institutional look. The ceiling is cement plastered incorporating
various HVAC or piping with adequate cove lighting.
View showing the texture and colors of waiting areas and private rooms
Stepped terrace landscaping in front of window. visitors having view of terrace landscaping through window.
View of the lounge area for the visitors for night stay.
A.2 MANAGEABILITY
1.Natural light
Perception of sunshine contribution
study done for the medanta hospital ( included both patient and staff
interviews)
Patient Staff
Survey question
Considered sunlight to be a nuisance 2% 45%
Considered sunlight to be pleasurable 89% 35%
Considered sunlight to be calming 91% 32%
Considered sunlight to be unfavorable 1% 12%
As the orientation of the building is north -south oriented, building has two big bed tower
which is interconnected with one central arm. The two bed tower enclosed an green area in
between which is having shaded area due to south-east block. While talking about the
interior space of bedroom , The bedroom on outer side of south-east block get ample
amount of daylight while the inner face is in shaded region , on the other side north-west
block getting the west sun in the inner side while the outer side is in shaded region. Other
areas like food court and waiting lounges are getting ample amount of daylight. Some
areas like waiting areas in OPD section on above floors are not getting daylight , seems to
pathogenic in that case , which increases the stress level among the patient and visitors.
Healing garden enclosed between the building block not Some waiting areas are not getting ample
getting direct sunlight from east direction. amount of daylight makes them boring .
Bedroom facing south-east direction , ample amount Bedroom facing north-west direction, deficient of
of daylight through window. daylight.
Schematic diagram showing the interaction of bedrooms and healing garden adjacent to each other on 5th floor
The Trees of Life installation at the Medanta hospital, Gurgaon, created by Rajasthani artist Ruchit Tiwari .
View of the nature through different room increases the coherence factor among the patient.
Art work in bedroom distract patient mind. Temple and green areas outside the building.
Lavish food court give variety to visitors. Television in patient bedroom distract patient mind.
The purpose of creating a green oasis which patients can retreat to unescorted by staff, in my
opinion, has to be achieved. Even in a number of problems where the outdoor environments are
concerned, everyone agrees that the existence of the gardens and light courts is something
absolutely positive and something that is very good for the patients. It is also clear that being
allowed out in the gardens is perceived as conferring an opportunity of greater sovereignty. In
this way I think the aim of increasing normalcy has been achieved.
Patients often experience different needs from time to time, and so the architect should
consciously design the place or the environment so as to facilitate the process which recovery.
In the design process, the architects should consciously reduce the institutional ambience and
create such Salutogenic design which will shift the pathogenic approach . As I see it, there is
scope for the patients to use different parts of the environment, both indoors and outdoors
depending on the stage of the recovery process they have come to. Outdoor spaces are always
with lusting green and the sound of water to heal their agitation. Indoor is more towards the
sunlight that enhance the healing and the ventilation to give the patient high level of
conformability.
1. The connection with the personalized environment - Healing begins when one is in a
space of Homely atmosphere. The physical space however is one that must be comfortable and
a reflection of oneself. The physical environments have great influence on our social behavior
and the possibilities for patents to engage social activities promoting social support. The
common spaces should provide more than just the possibility for patents to form this basic
contact.
2. The connection to sensory experience : The integration of all the senses helps complete
the highest potential of an environment to allow for healing to emerge. As, Human beings cannot
live without natural surroundings. The symbiotic relationship that exists between the two is one
that has to be nurtured. A physical and visual link with nature has positive beneficial qualities
that help in healing and health in general.
3. The connection with Light: Natural sunlight kills harmful bacteria and cleans air. Apart from
these obvious natural benefits of sunlight, natural light - when controlled - gives a space
character that is sensual so giving a space an emotive quality which can be felt by the end-user.
Light is also a symbol of growth and life as it benefits the natural world in that way.
4. The connection with the City: The city environment is harsh and busy and tends not to offer
many places or spaces of retrospection and contemplation. The site should be a part of the city
but detached from the fast pace. The end user should be able to arrive conveniently with public
transport to the site to allow a large catchment of people seeking a place for healing. The site
should also be in a place that is not difficult to navigate and find.