RELATED STUDIES

Applying the Benefts of Biophilic Theory to Hospital Design

The challenges faced by global health in the 21st century necessitate a shift in healthcare
services, emphasizing a comprehensive consideration of human needs rather than a strictly
therapeutic approach. The relationship between humanity and nature profoundly influences
individuals' emotions, thoughts, culture, and health. However, modern built environments have
marginalized and neglected nature's role in promoting the well-being and happiness of
individuals. To address this issue, the humanization of healthcare spaces and the incorporation of
nature can empower patients and have a positive impact by reducing stress, alleviating pain, and
improving emotional well-being.

Although there is a growing body of research highlighting the benefits of engaging with
nature in hospital settings, further studies are required to deepen our understanding of the
human-nature relationship and its influence on health. Such studies are essential to reshape our
approach to patient care by adopting a new vision of medicine, healthcare, and healing
environments. Notably, historical perspectives have acknowledged the therapeutic potential of
the environment, even suggesting that many illnesses can be treated without medications by
paying attention to factors such as air quality, food, rest, physical activity, and mindset. Florence
Nightingale, in the 19th century, recognized the positive impact of light, color, and the hospital
environment on patients' well-being and recovery.

The concept of biophilia, coined by Erich Fromm in the 1960s, describes humans'
inherent attraction to all living and vital elements. Extensive scientific literature supports the link
between the environment and the effectiveness of treatment. However, little attention is paid to
the design quality of hospital facilities, despite the strong connection between the environment
and health outcomes. Human evolution is intricately linked to natural conditions and stimuli,
such as sunlight, plants, animals, water, and landscapes. Scientific studies conducted in various
settings, including healthcare facilities, workplaces, children's spaces, and community spaces,
have consistently demonstrated the positive effects of biophilic design on human health and
performance.

Applying the principles of biophilic design to healthcare facilities is particularly

intriguing due to the high stress levels experienced by patients, their families, and healthcare
professionals in hospitals. Moreover, hospitals and cities, although separate systems, are
interconnected and visited by the same individuals. The exceptional relationship between these
two systems arises from the isolation required in hospital structures to facilitate medical practice.
By humanizing spaces and reintegrating nature into hospital design, therapeutic support can be
provided, positively impacting patients' psychological and physical well-being and enhancing
their recovery process across different levels of treatment and for various diseases.
 Furthermore, biophilic design choices not only improve the well-being of staff but also
contribute to economic benefits by increasing productivity and reducing health-related costs.
Incorporating elements such as plants, natural ventilation, natural light, and exposure to nature
enhances staff's efficiency, promotes the activity of the parasympathetic nervous system, reduces
stress levels, and fosters overall well-being. These design choices also decrease sick leave,
improve satisfaction levels, and enhance attention and organizational capabilities.

Early studies, such as Ulrich's research in the 1980s, demonstrated the significant positive
effects of views of nature on surgical patients' outcomes, leading to shorter hospitalization
periods and decreased use of analgesics. Subsequent studies further confirmed the benefits of
direct contact with nature, including lowered stress levels, more positive thoughts, and increased
coping ability. Additional research has highlighted the positive impact of plants, natural light,
natural materials, and fractal structures on patients' psychological response to treatment, pain
reduction, anxiety alleviation, fatigue reduction, and improved recovery rates. These findings
contribute to the concept of humanizing hospitals as a therapeutic practice that considers patients'
integrity, encourages their active participation in the healing process, and recognizes the social
structure of the hospital.

In summary, the global health challenges of the 21st century call for a reevaluation of
healthcare services, with a focus on holistic human needs. Incorporating nature into healthcare
design has the potential to empower patients, reduce stress, alleviate pain, and enhance emotional
well-being. Extensive research supports the benefits of biophilic design, emphasizing the
significance of the human-nature relationship in promoting health and well-being. By adopting a
human-centered and nature-oriented approach, healthcare facilities can create healing
environments that improve patient outcomes, enhance staff well-being, and generate economic
advantages. However, further research is needed to deepen our understanding of this relationship
and to guide future design practices in healthcare settings. (Totaforti, 2018).

Reference:
Totaforti, S. (2018). Applying the benefits of biophilic theory to hospital design. Totaforti City,
Territory, and Architecture, 5(1). https://doi.org/10.1186/s40410-018-0077-5
An Ergonomic Assessment of a Philippine Hospital Patient Room

As healthcare spending in the Philippines continues to rise at an unprecedented rate,

ensuring value for money becomes increasingly important. One approach to achieving this is
through well-designed patient rooms, which have been shown to reduce the risk of infections,
enhance healthcare workers' efficiency, and provide adequate spaces for family involvement in
the healing process. Additionally, patient rooms that promote a healing design and environment
contribute to higher patient satisfaction and increased assurance of safety during hospital stays.
Therefore, incorporating ergonomic standards in healthcare facility design becomes crucial to
prevent accidents, improve staff well-being, and optimize the overall healthcare environment.

Patients admitted to hospitals face an increased risk of falling, slipping, and tripping due
to the unfamiliar environment. Falls commonly occur in areas such as the bathroom, bed,
chair/wheelchair, trolley/table, during walking/standing, and on the toilet/commode.
Consequently, it is imperative to design patient rooms ergonomically to prevent such accidents.
Furthermore, the physical environment also plays a significant role in the health and safety of
healthcare staff. Surprisingly, healthcare workers, particularly nurses, are at a higher risk of
occupational musculoskeletal disorders (MSD) compared to other professions. The physically
demanding tasks involved in manual handling, such as lifting, transferring, and repositioning
patients, contribute to a high incidence of back pain and disorders among nurses. These work-
related injuries not only impact the well-being of healthcare professionals but also lead to
compensation claims that affect the institution as a whole.The design and functionality of patient
rooms directly affect patients, families, hospital staff, and administration. Making informed
decisions regarding patient room design is crucial for optimizing patient well-being and comfort
while strategically utilizing materials and space allocation to save costs during construction. By
considering the needs of both patients and medical staff, the physical environment can be
enhanced to improve the overall healthcare experience.

To ensure patient safety and comfort, several ergonomic recommendations can be

implemented in patient room design. For instance, wall colors such as green or blue are
suggested to create a calming atmosphere. Illumination levels should generally be set at 300 lux,
while bedside examination and treatment areas may require 1000 lux for complex tasks. Sound-
absorbing ceiling tiles can help reduce noise levels. L-shaped handles can be installed on all
doors to facilitate ease of use, and sufficient clearance space should be provided around the bed
and within the bathroom. Adequate space should also be allocated to allow nurses to perform
their duties effectively, preventing poor posture and improving staff morale and productivity.
 Space allocation in patient rooms should adhere to the Department of Health (DOH)
standards. The minimum room area should be 7.43 square meters, ensuring ample space for
emergency situations and accommodating all necessary healthcare personnel and equipment. Bed
adjustment should be possible without tilting the bed, and a minimum clearance space of 36
inches from walls or fixed obstructions should be provided on the sides and foot of the bed. The
bathroom area should meet the minimum DOH standard of 1.67 square meters, with the toilet
positioned 15 inches away from the wall. The shower area should have a slightly sloping floor to
ensure proper drainage, and the provision of a handrail can assist patients during showering.

Incorporating ergonomic principles into patient room design is crucial for ensuring
patient safety, comfort, and satisfaction, as well as improving the well-being and productivity of
healthcare staff. By creating an environment that supports the physical and emotional needs of
patients and staff, healthcare facilities can enhance the overall quality of care provided. The
proposed recommendations, including ergonomic considerations and adherence to space
standards, offer valuable insights for the design and construction of patient rooms in Philippine
healthcare facilities. (Bayabana, et. al, 2016)

Reference:
Bayabana, et. al (2016). An Ergonomic Assessment of a Philippine Hospital Patient Room. De
La Salle University Research Congress 2016. ISSN 2449-3309.
 RELATED PROJECTS
PROJECT NAME: Tambacounda Hospital
LOCATION: Senegal, West Africa
AREA: 3000 m²
PROJECT ARCHITECT: Manuel Herz Architects

Figure 1. Aerial Perspective

PROJECT DESCRIPTION:
The design of the new Maternity and Paediatric Hospital brings a sense of coherence and greatly
improves the comfort of patients and their visiting families. Herz’s structure comprises a two-
storey building in a curvilinear form which brings two clinics – paediatrics and maternity –
together under the same roof and offers approximately 150 hospital beds. The extensive length of
the building allows for the smooth circulation of staff and patients and accommodates multiple
communal spaces both between the rooms and in the courtyards formed by the bends of the S-
curve, turning it into the truly social spine of the hospital.
 Figure 3. Ground floor plan and first floor plan

Manuel Herz’s Design. Herz’s design includes several passive climate design innovations to
combat the challenges posed by the extremities of the local weather, and to help forgo the need
for air conditioning. The building is characterised by a narrow width of only 7m, a feature which
allow rooms to be aired and cooled naturally through cross ventilation. In addition, his
mashrabiya-inspired use of lattice-like brickwork with apertures has the advantages of blocking
sun and facilitating air circulation, whilst also giving the hospital its distinctive recurrent visual
motif and its beautiful play of light and shade

Figure 4. Lattice-like brickwork

 Figure 5. Air and sun circulation diagram

The holistic nature of the project has helped generate further infrastructure for the are beyond the hospital. A
sensitivity to the local landscape has also been a key facet of this multi-dimensional project, with Herz’s design
endeavouring to create as little disruption as possible to the local trees.

Source: archdaily.com/961242/tambacounda-hospital-manuel-herz-architects/tambacounda-
hospital
PROJECT NAME: Amarante’s Hospital
LOCATION: Armante, Portugal
AREA: 21 m²
PROJECT ARCHITECT: David Coutinho Correia

Figure 2.1. Exterior Perspective

In contrast to the common perception of hospitals as cold and austere environments, the case of
Amarante's hospital challenges this notion. Designed by David Coutinho, the hospital aims to
enhance the connection between patients and the healthcare facility, ultimately improving their
overall hospital experience. The architectural project employs a grid-like arrangement of
volumes that create various courtyards, some enclosed and others open, deliberately blurring the
boundaries between the hospital and its natural surroundings. The design prioritized functionality
and efficiency to ensure the hospital effectively met the needs of its users.
The Hospital of Amarante is located on a plot of land of mild relief. The building, four storeys
high, is shaped like a rectangle, formed by a grid of independent volumes, interconnected by a
longitudinal axis. The interstitial spaces between the volumes create two types of patios: closed
on the inside and open to the outside.

Figure 2.2 Patio

Its program combines the uses of an outpatients’ department with those of an emergency
department; each one has its own access. The outpatient clinic, to the north, is on the ground
floor and the emergency ward, to the west, is on floor -1. The building houses a day hospital, a
mental health unit, a physical medicine and rehabilitation service, diagnosis and day-surgery
complementary means and 60 hospital beds.

Figure 2.3 Interior Perspective

Figure 2.4 Main Entrance

Figure 2.5 Reception

 Figure 2.6 Hallway

Figure 2.7 Auditorium

The Amarante's hospital project was driven by the desire to transform the traditionally
impersonal and distant relationship between hospitals and patients. The primary objective was to
establish a warm, inviting, and human-centered environment that not only fostered a sense of
closeness but also seamlessly integrated with the surrounding natural landscape, blurring the
boundaries between the interior and exterior spaces.

Source: https://www.archdaily.com/328789/amarantes-hospital-acxt?ad_medium=gallery