The Healing Environment Without and Within

The healing environment: without and within By Deborah Kirklin, Ruth Richardson

This book provides a broad over view of topics dealing with medical humanities without and within medical environments.  It mainly covers the physical areas that patients may have to inhabit during illness or recovery.

The book discusses bringing outside arts within, performance and music and other forms of art, not what would appear to be permanent cures but positive none the less.  When I began reading this information I considered the word permanent and thought that it was an interesting word or sentence to use, because what is a permanent solution?  Personal identity and taste is constantly in flux.  The world of fashion for example rapidly changes from week to week.  A persons’ choice of furniture and fixture, perhaps even the entire layout of their home will evolve over the years.  In the world of medicine, doctors and scientists are constantly researching, developing and refining how to treat illness and disease.

So should the NHS adopt a similar semi-permanent, low cost, environmentally and patient conscious approach to their interiors.

“Physical appearance, geometrical forms, colours, fixtures and furniture affect the atmosphere of the ward.”

The importance of architecture and the built environment of the hospital covered in a chapter, serves as an introduction to further investigation.  The built environment can be measured and its impact is either positive or negative, very seldom is it neutral.

New hospital buildings are described in contrast against old hospital buildings within the book.  It is observed that the quality of treatment and staff is greatly improved within a modern, well-lit and designed hospital. Studies have shown that improving the built environment can achieve the positive of reducing the average amount of time a patient stays in hospital.  This benefits the patient and has obvious beneficial cost implications for the NHS.

When considering environment for hospital patients it is perhaps necessary to recognise that a future patient has a pre-existing social environment shaped by friends, family, personal interests and a variety of external variables including hobbies and activities.  Hospitalising a person, it appears is essentially removing them from their comfort zone.  Patients do not give up their hobbies simply because they are being hospitalised, albeit sometimes for a temporary amount of time.

The ability to have personal control over the environment is as important to patients as aesthetic and functional design throughout the hospital is important to staff, even if that control is limited.  Patients like the idea that they could participate in a social context but also retain autonomy and have their own personal space.  The ability to decide how much privacy or community they require is very important.

The views, opinions and experiences of patients and staff should factor into the future design of hospital environments.  It might be an idea to start interview sessions or begin an online submission of ideas, sketches and photographs in order to formulate a collaborative process of design with staff, former and current patients.  The idea is to look at each individual hospital environment as its own ecosystem but still part of a larger environment, and in nature an ecosystem is constantly adapting.

“Architectural styles, like medical certainties, change over time.”

This book was written in 2003 so it is interesting to investigate further and discover what advances have or have not been made.