How to design a better hospital? Start with the Light

Just like medical care has evolved from bloodletting to embryonic theory, medical spaces inhabited by patients are also being transformed. Today, architects and designers are trying to find ways to make hospitals more comfortable, in the hope that relaxing spaces will lead to better recovery. But building for healing involves as much empathy as synthesizing cold, hard data.

“Some of the best care can be to keep people calm, to give them space to be alone – things that may seem frivolous but really important,” said Anmari Adams, a professor at McGill University who studies the history of McGill. hospital architecture.

In the 19th century, the famous nurse Florence Nightingale popularized the plan of the pavilion, which included wards: large rooms with long rows of beds, large windows, lots of natural light and lots of cross-ventilation. These projects were informed by the theory that humid interiors spread diseases. But the wards offered almost no privacy for patients and required a lot of space, something that became difficult to find in increasingly dense cities. They also meant a lot of walking for the nurses, who had to tread up and down the aisles.

In the next century, this focus on natural light faded in favor of prioritizing sterile spaces that would limit the spread of microbes and accommodate a growing raft of medical equipment. After the First World War, the new norm was to group patients’ rooms around a nursing home. These projects were easier for nurses, who no longer had to walk long corridors, and were cheaper to heat and build. But they have retained some of the attributes of older residential hospitals, such as sanatoriums, where patients will recover for long periods of time; both mimic luxury hotels with ornate lobbies and fine dining, measures designed to convince middle-class people that “they’re better off in hospitals than at home when they’re seriously ill,” Adams wrote in an article on hospital architecture. for 2016 Journal of the Canadian Medical Association. This design, she argues, is designed to give people faith in the institution: “a tool for persuasion, not healing.”

In the late 1940s and 1950s, hospitals were transformed again, this time into offices such as offices without redundancies or many features designed to enhance the experience of their stay there. “It’s really designed to be operational and efficient,” said Jesse Reich, director of patient survival programs and magnetic programs at the University of Pennsylvania Hospital. Many of these rooms had no windows at all, she said.

By the mid-20th century, the hospital had become the opposite of what Florence Nightingale had imagined, and many of these buildings or those modeled on them are still in use today. “A typical hospital is designed as a care machine, but not as a treatment site,” said Sean Scenzor, director of Safdie Architects, a company that recently designed a hospital in Cartagena, Colombia. “I think what is missing is empathy for people as human beings.

Although Nightingale operated largely with anecdotal evidence that light and ventilation were important, she was right – but it took scientists more than a century to gather quantitative data to support it. For example, a basic study from 1984, published in science followed patients after gallbladder surgery. The 25 patients whose rooms overlook the greenery had shorter hospital stays and received fewer painkillers than the 23 patients whose windows faced a brick wall.