healing environments in radiotherapy - Agnes van den Berg

Healing Environments in Radiotherapy Project Report
In the beginning of the twentieth century, the tradition to locate hospitals in natural environments
broke off. Due to a revolution in medicine and technology combined with the emergence of
modernist design styles the environmental qualities of hospitals became neglected (Van den Berg &
Wagenaar, 2006). In the late 1970s, interest in the effects of the environment on healing and health
outcomes was renewed. The US non-profit organization Planetree designed a model which indicated
healthcare design should provide possibilities to connect with nature. Healing gardens, fish tanks,
waterfalls and gentle sounds were provided to connect patients, family and staff with the relaxing
and healing aspects of nature. (Van den Berg, 2005, p. 9-12). Currently, the concepts of healing
environment and evidence based design are increasingly implemented in hospitals all over the world.
Healing environment concepts are being implemented frequently in the United States, are becoming
common in Sweden and Denmark, as well as in Canada, and also increasingly in Japan and other
Asian countries like Singapore. The Netherlands is also among the countries that have recently begun
to implement principles of healing environment (Ulrich, 2009).
© hubinet.com
1.3 Evidence-based design
Until recently, efforts to design healing environments in healthcare were mostly based on common
sense and philosophical notions of healthcare providers. When professional awareness of the role of
the environment on the healing process increased, scientific evidence of the relationship between
health and environment was called for. Ulrich (1984) was the first to produce scientific evidence for
health impacts of healing environments. His research showed that surgery patients who were able to
view nature from their rooms had shorter postoperative hospital stays, and suffered fewer occasions
of being upset or ‘down’, and less post-surgery complications such as persistent headaches or
nausea. Furthermore, patients who did not have natural views needed stronger pain relief drugs than
patients with a view of nature. Such findings call for architecture and medicine to unite, to develop
research agendas to explore the interaction of science and design in order to move into new
directions in the design of health care facilities (UMC Groningen, 2009).
This scientific approach to designing healing environments is called evidence-based design, as an
architectural parallel to evidence-based medicine (Van den Berg, 2005, p. 13). The Center for Health
Design describes evidence-based design as “the process of basing decisions about the built
environment on credible research to achieve the best possible outcomes” (2009). Hereby the goal “is
to create hospitals that actually help patients recover and be safer, and help staff do their jobs
better” (Ulrich et al., 2004, p. 26). Evidence-based design can therefore be seen as scientifically
grounded practical guidelines to creating a healing environment.
1.4 Project goals
The radiotherapy department at the target hospital is currently situated in a basement with little
access to daylight and fresh air. The commissioner wished to gain insights into elements of healing
environments specifically for cancer patients, in order to be able to make informed decisions about
4