REHAB Basel, Clinic for Neurorehabilitation and Paraplegiology (Herzog & de Meuron architects; photo Daniel Thoma)
We have been overwhelmed for the past year with images of nurses and doctors in intensive care units, wrapped in protective clothing as if on a space mission, looking after patients surrounded and invaded by tubes, wires, drips, blinking machines. High tech medicine is saving our lives.
In a hospital we are delivered unto a system that processes the body yet somehow leaves “us” behind. The generation of hospitals built fifty or more years ago focused on efficiency, and they all looked alike. This made it easier to find one’s way around but failed to actively promote the healing process with psychological support from environmental cues.
Now the expectation for hospitals has changed. In particular, because we have learned about the important roles emotional wellbeing and a feeling of security play in aiding recovery. This has led to the keyword, healing architecture, which focuses on patient needs over infrastructure, technology and organizational charts. When your body is vulnerable — sick people also have altered and heightened perception of smell, noise and brightness — architecture can provide a therapeutic environment. The rooms must be welcoming, and corridors can become aesthetically pleasing paths, rather than sad, dark, poorly ventilated, and foreboding. Paths that encourage movement, since exercise is a crucial factor supporting healing.
The hospital can be best and most flexibly organized as a small-scale city — with areas for work (diagnostics and treatment), quiet living spaces with patient rooms, and meeting places with open interior and outdoor courtyards. As much nature as possible, with views of green from patients’ windows and accessibility to parkland — proximity to vegetation has long been recognized as therapeutic.
Ever more studies are showing that the more daylight there is in patients’ rooms, the more rapid the recovery from depression, cardiac episodes, and post-operative progress, along with reduced need for pain medication. (Daylight also has disinfectant properties.) Daylight in rooms and corridors can be enhanced with atriums, balconies, and careful placement and size of windows. Indeed, newer hospitals are taking into account latitude and structure orientation to optimize the daylight entering all rooms throughout the year.
The achievements of our basic science of circadian rhythms over the last 60 years, and the insights leading to clinical therapeutics over the last 30 years, provide the strongest possible building blocks for the next stage of applied chronobiology in architecture — the health-promoting design of hospitals, with commensurate improvement in our living and working spaces.
Anna Wirz-Justice PhD, Professor emeritus, a founding member of the Society for Light Treatment and Biological Rhythms and the Daylight Academy, and Board member of the Center for Environmental Therapeutics, introduced light therapy to Europe and now focuses on the applications of chronobiology in architecture and daily life at the Center for Chronobiology, Psychiatric Clinic, University of Basel, Switzerland.