Converting traditionally clinical interiors into warm, homelike spaces can improve patient satisfaction and facilitate healing, according to an article on the Healthcare Design website. The goal is to create interiors that make patients feel as comfortable as possible while still providing an efficient care model, the article said.
Studio Dental in San Francisco designed their mobile unit for their on-the-go patients, with two treatment cubes, a sterilization room, a waiting area and mechanical services housed in a trailer, according to an article on Contract magazine.
The design team mock-up different configurations and consider alternative materials and graphics. The result is a matte black box with a jutting prow that ensures privacy, security, and cleanliness within.
Skylights over the treatment rooms pull in natural light. Silver decals on one side evoke the play of light through foliage, a concept that is carried through the interior in patterns of pixelated openings.
The interior features many built-in elements and every inch of space is put to use, the article said.
The original facilities for the sick were most likely temples dedicated to “healing gods.” Imhotep was the Egyptian healing god while Asclepius was revered in the Greek civilization. Prayers, sacrifices, and dream interpretations played a role in their healing process, but the ancient physicians also stitched wounds, set broken bones, and used opium for pain. Plans for a 5th century BC temple in Athens dedicated to Asclepius show a large room 24 x 108 for multiple dreamer-patients.
Some believe the earliest dedicated hospitals were in Mesopotamia, while other researchers believe they were at Buddhist monasteries in India and Sri Lanka. Ancient writings indicate that the Sinhalese King Pandukabhaya had hospitals built in present day Sri Lanka in the 4th century BC. The oldest architectural evidence of a hospital appears to be at Mihintale in Sri Lanka which can be dated to the 9th century AD.
The extensive ruins suggest there were patient rooms which measured 13 x 13 which is surprisingly close to the patient rooms used today. In addition to surgical instruments, archeologists found a stone “medicinal trough” approximately seven feet in length and 30 inches wide that may have been used for the first hydrotherapy with mineral water or medicinal oils.
While the Greeks were recognized as the originators of “rational” medicine, they did not have hospitals. The physicians made calls and treated patients in their homes, a practice that continued for hundreds of years. The Romans provided us with the root of the word “hospital” from the Latin word “hospes” for host or “hospitium” meaning a place to entertain. While medical schools were established in Greece in the 6th Century BC, there is general consensus that the first teaching hospital with visiting physicians and scholars from Egypt, India, and Greece was founded at Gondisapur in present day Iran in 300 AD.
Among the early, well-documented healthcare facilities were the Roman military hospitals. The plans for the one in Vindossa in present day Switzerland built in the 1st century AD shows small patient rooms with ante rooms built around courtyards. Each room was thought to hold three beds indicating the ward concept was used early in the history of hospital development. One source indicated that similar hospitals may have also been built for gladiators and slaves due their financial value, however public hospitals were not available and physicians made house calls.
As the Roman Empire turned to Christianity, the Church's role in providing for the sick became firmly established. After 400 AD, many monasteries were constructed generally including accommodations for travelers, the poor, and the sick. The monarchs of the 6th century reinforced this role with emperors, such as Charlemagne, who directed that a hospital should be attached to every cathedral that was built in his empire.
Religious institutions continued to provide most of the healthcare to the poor in large, open wards, while physicians continued the practice of making house calls to the upper class. The religious influence in early healthcare is illustrated by duties of the Warden (Administrator) of St Mary's Hospital in England in 1390. He was required to not only satisfy himself of the seriousness of the medical complaint, but to also hear the confession of the patient before admission.
The wards housing multiple patients continued to be expanded and became the standard for the public hospitals for hundreds of years. Often the wards were configured so the sick could see the altar to assist with their recovery. The cross-shaped plan, which is thought to have originated in Florence, Italy, in the 1400s achieved this goal with the altar in the middle and multiple wards radiating from it.
The plan is similar to many hospitals today with the nurse's station rather than the altar at the centre. Florence was well known for quality hospitals with good physicians and clean beds. Martin Luther, who was generally critical of all Roman Catholic institutions, even recognized the quality of the facilities during a visit in 1500.
In 2012 the Rush University Medical Center in Chicago opened its transformed campus after a radical redesign of the 175-year-old institution’s complex.
The educational hospital now presents a sleek, up-to-date exterior to match the cutting-edge methods of care within its walls.
The Chicago branch of global architects Perkins Will worked closely with the hospital and its users during the center’s design stage in order to create an optimal working environment.
Its environmentally friendly construction also means that Rush is the biggest newly built health facility in the world to receive a Leadership in Energy and Environmental Design (LEED) Gold certification.
Volunteers are creating works of art to be displayed throughout hospitals within Florida's Lee Memorial Health System, according to an article in on the NBC-2website.
A Global Alliance for Arts and Health report says almost half of the country's healthcare institutions have art programs. Displaying art is the most common type.
As patients wait for imaging and procedures, they can look up at the ceiling and see the art that volunteers have made for them, the article said.
According to 3D Power, the Indian healthcare industry is expected to grow to $79 billion in 2012 from $40 billion in 2010. This number will increase to $230 billion by 2020. This exciting growth responds to various demographic and economic trends, including an increasing population, rise in disposable income, increasing consumerism and demand for high-quality healthcare, greater incidence of lifestyle-related diseases, increasing employer-based insurance coverage, and increased government spending on public healthcare. Advancements in medical sciences and technology as well as an influx of foreign-trained doctors in the workforce also have led to an increasing focus on providing state-of-the-art equipment and services to patients.
In the last 10 years, there has been a parallel demand for high-quality hospital infrastructure to support the growing demands for healthcare. In India, healthcare is provided in primarily three types of settings: government-funded and run hospitals and healthcare clinics that provide free healthcare services, private for-profit hospitals and health centres, and mission-based non profit hospitals. The first two types of settings comprise the majority of the healthcare infrastructure in the country.
Trends in private healthcare projects
Private for-profit hospitals are seeing a marked growth with several facility design projects underway in different parts of the country. According to WHO health statistics from 2010, around 75% of the total annual healthcare spending in India came from the private sector. Hospital systems such as Fortis and Apollo have been immensely successful in the last 10 years in providing high-quality healthcare services to a growing educated and affluent urban population. While revenue generation is a key goal for these hospitals, emulation of Western standards and ensuring the best outcomes for patients is important in order for them to attract and retain customers.To stay competitive in the market, hospitals are opting for external accreditation through international organizations such as Joint Commission International or India’s National Accreditation Board for Hospitals and Healthcare Providers. Accreditation also is seen as an important process for improving patient safety and quality of care provided to patients. With medical tourism being an important driver, many private hospitals aspire to provide high-quality built environments similar to those found in U.S. and European hospitals.
Commenting on some of the key drivers for private hospital design in India, Gaurav Chopra, vice president and director, South Asia region, HKS Architects, says, “While there is a growing focus on patient-centred care, many new private hospitals are investing heavily in new technology and equipment, and often the built environment mandate is to house this technology. Also, given the demand for hospital beds and its direct relation to the bottom line, the focus of hospital design projects is primarily on increasing bed capacity.”
According to Chopra, many private hospitals provide a combination of multi-bed wards (15-20% total bed count), single occupancy rooms (around 70%), and luxury single rooms for high-paying customers (around 5%). Infection control is an important concern for healthcare facilities in India and selection of cleanable and durable materials is a key design driver. Local culture and traditions, as well as climate, are important factors that impact the layout of spaces and building form and design.
For example, family members are usually present at all times during a patient’s hospital stay, which requires larger patient rooms. Providing larger waiting rooms for families in the emergency department, surgery, and ICU also is necessary. In addition, 3D Power acknowledges that spirituality and religion are an important part of life in India, and hospital artwork may refer to symbols and images of the dominant culture in the region.