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| Kohinoor lobby |
Imagine visiting a hospital setting that is notable for its classic serenity and elegance. As you enter the gate of this institute, you will find broad tree-lined roads criss-crossing the campus area and lush tropical vegetation forming a green canopy that shelters the hospital building. A few steps further, series of illuminated vertical masts, characterise the entry into the hospital. The lobby incorporates playful nature-themed motifs, such as mobile sculptures depicting colourful pictures of flowers and birds. An amazing 30 feet high waterfall tower at the left corner of the reception area captures your eye as water cascades over its shiplapped panels to create a stunning water wall feature. As you walk around various departments within the hospital, you will find well-furnished rooms with big windows that allow natural light and fresh air to breeze in as well as open spaces which give ample scope for free movement. Plants at every corner creates a refreshing feel. Every detail, from the artwork on the walls to the furnishing inside every room compliment each other perfectly.
Wondering if this is a fairy tale description of a hospital or a reality? Can hospitals also look and feel impressive?
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| Reception area of Hinduja Healthcare |
Of course yes! Hospitals these days are harmoniously designed to be a safe and comfortable place for their patient, visitors and medical staff. But this was not the case some years ago. Traditionally, hospitals were known to be noisy and cluttered. They were passive reflections of institutional designs that gave little regard to the potentially detrimental effects that these environments have on the patient’s physical or emotional well-being. But today it is different. Today, hospitals not only focus on advanced medical knowhow (also known as evidence-based medicine), but reflect the realities of modern-day healthcare whose prime goal is to deliver care keeping the patient first. Thanks to the introduction of creative interior decorators in the Indian hospital infrastructure segment, who are responsible for transforming the look and feel within hospitals.
Talking about healthcare delivery in modern times, it is a known fact that hospital interiors have a strong impact on a patient’s health. According to experts around the world the right kind of elements incorporated in the interiors can help fasten the recovery process of a patient.“Healing and recovery are holistic processes and can be aided substantially by the right setting,” claims Ram Raheja, Director, S Raheja Realty. To define interiors that create a healing environment, one can say that these designs support health and well-being. Additionally, these designs help in improving a patient’s outlook on care and ultimately increase patient satisfaction. It can also streamline workflow and eliminate the opportunity for medical errors.
This is one reason why hospital administrators are now-a-days trying to evolve their hospital designs beyond their infamously sterile décor towards creating an healing environment.
Ratan Jalan, Founder and Principal Consultant, Medium Healthcare Consulting is of the opinion that not only hospitals but even architects and interior designers for hospitals are now focussing on creating a healing environment for patients. He, refers to an hospital project he had worked on in the past saying,“While I was the President at Asian Health Services, possibly India’s first hospital architecture firm, we had released an ad to recruit architects with a headline, ‘We need architects who can help patients recover faster.’”
Creating a design that heals
Designing a healing environment within a hospital is more than just wrapping a pretty facade on a building or decorating the lobby. It’s the orchestration of every moment that a patient experiences, right from the point of arrival into the hospital, to the registration and throughout their treatment time. In reality, designing healthcare environments is a complex discipline. Apart from patient experiences these designs are drawn on the basis of biology, chemistry, patient-outcomes research, psychology, physiology and the list continues.
Meeta Ruparel, Director, AUM MEDITEC, listing down some of the pre-requisites for creating such designs says, “There are many factors that need to be kept in mind while preparing a design. To name a few: vision of the project, strategic design concept (exterior and interior), facility/ services aimed to be provided, equipment requirements that are proposed to be installed, safety criteria, patient and staff comfort, efficiency, mandatory standards/ regulations applicable, environmental factors, land properties (type of land), demography studies, etc., and let us not forget the budget allotted, because the cost of interiors has a wide scale continuum between cost and aesthetics. This needs to be balanced in synchrony with the management’s or the project vision.”
She strongly recommends the use of environmental research before preparing the design. This would enable an appropriate design in harmony with the prevailing environment system.
The right elements
After understanding the pre-requisites for designing a healing environment, let us move on to elements that are helpful in optimising physical, mental, emotional and spiritual healing for the individual needs of patients coming from a variety of background and culture.“Use of cheerful colours, textures, patterns on the walls, artwork, signages, etc., contribute to faster recovery of a patient,” avers, Girish Deshpande, Architect, Focusz Designs.” While designing a hospital emphasis is given to ample natural light and view to all patient rooms and other areas to foster wellness,” he adds. These elements play an important role in developing a surrounding that will reduce stress and engage the senses in therapeutic ways.
Bringing in some natural light
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| HHS Labor Delivery Suite |
John Saladino, a famous interior designer from Rome, once said, “In my view, no space without natural light is worthy of human occupation.” A candid statement indeed. Natural light beyond its aesthetic appeal, reduces eyestrain, increases productivity and reduces excess consumption of electricity. Making good use of natural light cuts the need for artificial lighting and helps provide a feeling of well-being among patients, visitor and medical staff. It also lifts spirits and makes spaces appear larger.
Jalan adds, “Full spectrum light has been shown to reduce depression, even in cases of deep depression. Just to give an example, the role of sunlight, which is a crucial element in the design process, is rarely appreciated. Florence Nightingale, in her famous book Notes on Nursing, has devoted almost an entire chapter to sunlight. Similarly, the choice of colours and even paintings can do miracles.”
Adding colour
Colours are said to be nature’s healing element. They have the tendency to elicit certain emotions, moods and physical feeling. Using appropriate colours in waiting areas, examination rooms, ICUs or other patient private rooms will not only enhance the look of the hospital but will also help patients recover faster. Shades of blue, green, grey, yellow and lavender are mostly recommended by interior designer to create a soothing appeal. Nevertheless, choosing colours also depends on the departments and facilities provided within the hospital.
Experiencing nature
Plants bring in a sophisticated and a natural feel to the hospital décor. Citing an example on how adding plants can help in creating an healing effect, Raheja refers to the Hinduja Healthcare hospital in Mumbai that he has recently designed. He says, “The rooms of the hospital overlook an expanse of green and we have included a terrace garden for fresh air and a lounge with a healthy café. From the minute a patient checks in to the moment he or she checks out, we have created a luxurious yet uncomplicated restful space for them to heal.” Further, he believes that adding the green element create a therapeutic aura.
Other elements such as the right kind of flooring, artworks, signages, furnishing etc., also facilitate in enhancing the ambiance within the hospital.
The trend today
With more and more hospitals in India adding natural elements into their hospital décor, experts find this phenomenon to be one kind of health reform wherein hospitals are transforming themselves into healthcare centres of excellence. In the quest to create a healing environment, some hospitals in India are going green. The green building concept in India was initiated in 2007 by Indian Green Building Council (IGBC). The concept of green architecture primarily centres around creating an eco-friendly environment as well as reducing carbon footprints. While creating such design, architects and interior designers implement a range of energy efficient measures to reduce energy consumption, decrease greenhouse gas emissions and improve the quality of patient care.
Moreover, as the green building concept focusses more on structural applications, hospitals and designers felt to need to add aesthetics that could breathe in the feel good factor inside the hospital. Speaking of what Indian hospitals look for, Deshpande informs, “Modern designs focus on surfaces that can be cleaned easily and do not harbour contaminates. The main concerns for hospital designs are functionality, cleaning abilities and infection control.” In order to overcome the functional and safety challenges that hospitals and interior designers undergo, the concept of evidence-based designs has been introduced in recent times. This concept focuses on efficiencies and thus helps reduce operational expenses.”
Evidence-based design is a field of study that emphasises the importance of using credible data in order to influence the design process. The approach has become popular in healthcare architecture in an effort to improve patient and staff well-being, patient healing process, stress reduction and safety. Evidence-based design borrows terminology and ideas from several disciplines including environmental psychology, architecture, neuroscience and behavioural economics,” defines Deshpande.
Elaborating further Raheja says, “One can define it as a wide range of functional aspects, with personal human experience as the primary objective. We’ve researched behaviour and habitual patterns of patients and thus created different zones for comfort and relaxation within what have earlier been seen as impersonal and unimpressive public spaces. Symphony and harmony of detail-oriented practical realities with aesthetics is of essence to evidence-based interiors.”
But does evidence-based design help in creating a healing environment?
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| Kohinoor private rooms |
Telling us why it is important to opt for evidence-based concept while creating a healing environment, Jalan explains, “Internationally, evidence-based design is emerging as an important philosophy. Research has shown that evidence based interiors form an integral part of any hospital setting.
For instance, many patients complain about noise in hospital. In fact, in the US, it forms a part of the government required Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS) survey questionnaire ‘How often was the area around your room quiet at night?’ A well thought through hospital interior design that uses the right technology and materials could help to reduce this problem. The same is applicable to other design elements. For instance, it is a common knowledge that sunlight contributes to healing.”
Evidence-based interiors research has also said that these designs can lower stress levels (glucocorticoids) for both patients and staff. The correlation between stress levels and clinical error has been extensively documented and so design elements which decrease staff stress levels would clearly aid in providing quality care.
“Design aspects which have been demonstrated as reducing stress include colours, ambient light and even fragrances. The choice of colours – including the patterns, shades and brightness—impacts far more than the sense of sight. Soothing arrangements like those seen in Japanese rock gardens, also called Zen gardens, are great examples of the intentional use of light and colour. The Ryoan -ji Temple in north of Kyoto is perhaps the most famous instance. Full spectrum light has been shown to reduce depression, even in cases of deep depression. Some fragrances are widely hailed for their role in positively influencing mood. Lavender, for instance, is a well known sleep aid,” Jalan adds.
Interestingly, this concept also enables hospitals to reduce capital expenditure. “There are several ways it does, but these can also vary project to project. The right amount of research helps in the functional requirements of the hospital. Data analysis, R&D and programming as per the same, are most important parts in healthcare design. This will make the project truly functionally efficient and not just esthetically wonderful,” informs Raheja.
| The Hinduja Healthcare Case Study |
| Hinduja Healthcare, Mumbai has adopted the concept of evidence-based design. Ram Raheja, Director, S Raheja Realty briefly explains the making of this hospital.
The concept Our core objective was to blend two diverse programmes, healthcare and hospitality, into one. This was a challenge, which we embraced as a opportunity to create a state-of-the-art , one of its kind project. It took us approximately three years to complete this project. The challenges This project had several challenges, some were programmatic but a major one was the site constraints. Working within a dense urban fabric in an infamously chaotic metropolis has its ups and downs. The success of this project should be given to collaborative effort. The design process The design process experimented vertical and diagonal sequencing of medical programmes and ancillary services within the context. As a hospital, we had to continuously maintain a balance between crisp efficiency and relaxation, public and private spaces, isolation and inclusion. We’ve worked consciously towards creating a modern and aesthetic space for convalescence at Hinduja Healthcare. As light and texture are essential in transforming a space, the finest organic fibres and plush surfaces have been combined with the use of light and shadow through perforations and curtain wall systems to ensure peace and tranquility. We’ve incorporated extensive use of white and beige in the interiors to create warmth for the patients and visitors. |
Scope for the future
Looking at the developments in the hospital infrastructure space in the past decade, one can say that the segment has grown by leaps and bounds. Experts predicts that the sector will still continue to grow. Besides this, as evidence-based design increasingly gains popularity among Indian hospitals, architects and designers will continue to add new concepts that help embellishing environments inside hospitals.
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