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Introduction:

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”Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. Healthcare facilities are places where patients with health conditions go for treatment. The contemporary hospital carries the duty to tend to the healing process of its patients, that being so it ought to provide conditions that meet a broad range of necessities, from diagnosis, treatment and therapy of diseases and injuries to the sentiment of comfort and well-being, whether physical, psychological or social. Consequently, the mission of hospitals concerns not the operative section alone, but the providing of a favourable accommodation environment, a therapeutic environment that is. A number of academic research studies have proven that there is a remarkable impact of the hospital’s architecture on the healing process and well-being of both patients and their families. Other factors that are greatly impacted are the efficiency and effectiveness of the healthcare staff, as well as on the quality of hospita’s services. It can improve the patients experience and have a significant effect on their psychological strain, sense of safety, their need to take analgesic drugs and also on shortening the span of their hospital stay. Moreover, when it comes to healthcare staff, a high-quality built environment has a positive correlation on their efficiency, focus and consequently can help prevent medical errors. 

What is healing architecture?

The philosophy that guides the concept of the healing environment is rooted in research in the 
environmental psychology (the psychological effects of the space and the environment), psychoneuroimmunology (the effects of the environment on our immune system) and neuroscience (the way our brain perceives spaces-architecture). Patients are people who are under a medical care or treatment, this means that their physical and mental health can easily be affected. Most people tend to associate hospitals and healthcare centres with negative memories. This causes unpleasant feelings such as anxiety, frustration and fear and are therefore quite a demoralizing place to be. Those emotions have a negative effect not only on our mental but on our psychical health too, they could increase blood pressure, cause muscle tension, clogged arteries, gastric discomfort and, most importantly, immune system suppression.  

Therefore, the primary role of a healing environment is to help patients eliminate their negative thoughts or feelings and lower their stress levels in order to have a subsequent positive impact on the results of their treatment and recuperation.

A healing environment is achieved when healthcare facilities are designed in order to respond to people’s needs. Hospitals need to be planned in order to move from the view of ‘man as a object’ to a ‘man as person’. 

Ron Smith and Nicholas Watkins have established four key elements which, if applied in the design of a healthcare environment, can have a positive effect on the recovery of patients. This ideal therapeutic environment can be achieved by eliminating environmental disturbances, providing positive distractions, enabling social support and giving a sense of control. Thus, healing architecture is directly linked with the environmental (physical), social and psychological comfort. More specifically some of the main characteristics of an effective healing environment are the use of lighting, daylight and artificial, the colors and textures of the surfaces, the views of nature, orientation, air quality, temperature and humidity, noise levels, as well as privacy, communication, and the patient’s family accommodation.
 

Historical background:

Discussions about the importance of the built environment for the patient’s health and well-being and the provision and support of healthcare delivery extend at least as far back as 400 BC. Buildings created for the sole purpose of housing healing processes have been designed and erected since ancient times. Examples can be the ancient Greek Asclepions, healing temples where a patient could receive spiritual or physical healing, the Ottoman baths, an integral part of the Turkish and Arabic cultures, as well as the healing gardens which can be found in early Asian cultures. In those places healing was achieved with several different methods, but all of them had the same purpose, to treat the patient. As Esther Sternberg mentions in her book ”there are as many kinds of healing as there are cells and organs in the body and diseases that can affect them, but all involve restoring the body to a state of balance”
 

Evidence based design: 

Evidence-based design has become the theoretical concept for what are called healing environments. Evidence-based design is the process of making decisions associated with the built environment, which are based on reliable and valid research data, in order to achieve the best possible outcomes. In other words, the design process of spaces that are intended to deliver specific results and be used by a fixed social group with particular needs, has to be based on substantiated and factual research. The general abstract fact that built environment affects the entitre living experience of human beings comes almost intuitively and automatically to us. However, as the design of healthcare facilities is a complex and dynamic process, it has to be supported by design support models, when architects design hospitals and healthcare centres, the impacts that their built environment will have on humans must be taken very seriously, firstly because of their critical use and secondly because the design implements research evidence, of more than 2000 studies that link the physical environment of healthcare to outcomes, into practice. And it is very important to understand the impact of environmental characteristics because it will assist to design spaces that will have a positive effect on users (patients, staff, visitors etc.). 

In theory evidence-based model can be applied to any for all design decisions. However, in practice evidence-based design is mainly used in the healthcare industry. It is one of the principal means to create the optimum conditions for a healing environment. So, if we would like to give a more specific definition of evidence-based design, it is a process of creating healthcare facilities that are based on the best available research evidence with the goal of improving outcomes (primarily in the recovery process of the patient) and of continuing to monitor the success or failure for subsequent decision-making.

In 2008, Roger’s Ulrich new and more exhaustive research study got published by Center for Health Design and Georgia Institute of Technology, and two general conclusions of his research were: (a) the state of knowledge of evidence-based healthcare design has grown particularly quickly in recent years (b) the evidence shows that a well-designed hospital physical environment can play a very important role in creating a place with a sense of safety that promotes patients’ healing process and creating optimal working conditions for the staff.

In conclusion, one of the main reasons that healthcare facility design and planning is increasingly based on scientific research is because the final design must help to create an environment, that will support healing, will help the patients who are put under stress and that will also increase healthcare staff effectiveness in delivering care.
 

A research study that was published in World Design Conference for Health in 2000 by Roger S. Ulrich, named the environmental factors that affect the outcomes of a patient’s treatment and recovery, some of them are: noise, presence or non-presence of windows, sunny rooms, multiple occupancy versus single patient rooms., flooring materials, furniture arrangements and additional environmental factors, such as air quality, music, colors, art and elements of nature, etc.

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