The Effects of Interior Design on Patients and Staff - Essay Example

?The Effects of Interior Design on Patients and Staff The interior design of health care environment has long been a major factor considered by designers to ensure efficient delivery of health care to patients. This is because research indicates that the interior design of health care facilities impacts greatly on the well-being of patients, as well as the ease of health care delivery by the medical staff. The interior design include among other things the spaces in the laboratories, spaces between patient bends, wide doors capable of accommodating patient beds and well as the color of the walls. Research indicates that such considerations have led to the establishment of functionally effective facilities but psychologically “hard.” Hard designs have been found to be unsatisfactory as far as marketing facilities to patients is concerned. Ulrich (2010, p.97) argues that the failure of hard facilities are attributed to the fact that they are stressful and does not satisfy the psychological needs of patients, staff and visitors. Research indicates that poor design impacts negatively on the well-being of patients. In addition, poor designs can affect the psychological pointers of wellness negatively. In this regard, research has associated poor design of the interior medical environment to a number of negative consequences for patients such as delirium, anxiety, high blood pressure, and increased intake of pain drugs. Therefore, the interior design has a responsibility to produce health facilities that enhances functional efficiency, marking, codes and reduces cost. In addition, designers should also aim at promoting the wellness of patients by designing physical environment that is psychologically supportive. Ulrich (2010, p.97) argues that a psychologically supportive environment promote patients’ coping with illnesses such as stress and depression. In addition, a supporting environment impacts greatly on the healing effects of drugs, which enhances the recovery process. Poor designs, on the other hand, does not promote patients’ coping with stress since it is associated with stressors that only worsen the patient’s condition. Poor designs have also been found to have effects that negatively impacts on the healing process. Based on the above comments, this paper will examine the extent to which the interior design on medical environment stimulates patients and staff. Why a good healthcare environment is important for patients Edge (2003, p.2) argues that environmental factors influences how people behave in a given building setting. As a result, dating back to 1960s, architects have strongly believed that if someone can manipulate his environment to enhance physical well-being, then he or she can influence it to promote the behavior required and do away with the negative consequences. The concept has since played a major role in the design of hospitals facilities all over the world. Naturally, when someone is not comfortable with the physical environment where he or she lives, the person can solve the problem by either finding the ways of adapting to the same environment or simply departing the area. However, this does not apply in hospital facilities. This is attributed to the fact that patients have no control of designing to change the environment or leave altogether because they are held captive in their surroundings. As a result, the responsibility of enhancing the wellness of patients on the hospital is placed upon the designers according to Malkin (1992, p.16). Edge (2003, p. 3) notes that designers usually face a huge challenge in coming up with a good interior design that enhances the well-being of patients. Patients usually come to the hospital suffering from a given ailment. As such, it is imperative that the interior design of the hospital facilities positively influences the psychological state of patients and promote their recovery process. “Good quality design will contribute to providing an environment in which patients will be safe and secure. Well-designed buildings, capable of adaptation to meet rapidly evolving medical and technological advances and social change, are more likely to help staff deliver their objectives and long-term best value. Good design will also ensure a reduction in defects and more sustainable solutions.” (Race 2012, p.6). Stress has been pointed out as one of the major obstacle to healing process of patient in the hospital. Poor design of the health care setting has been pointed out as one of the major contributors of stress among patients in the hospital (Edge 2003, p. 5). On the other hand, a psychologically supportive interior design of a hospital setting has been found to promote patient’s coping ability with stress thereby promoting the well-being of patients in the hospital. Generally speaking, there are two different sources of stress for patients namely stress resulting from uncertainties, reduced physical capabilities, and those resulting from painful medical methods. Second is the physical-social environment such as those resulting from noise, and privacy invasion. These kinds of stress should be avoided at all cost by designers by ensuring that the physical environment is created in a manner that eliminates stressors among patients in the hospital (Race 2012). This is because patient stress impacts negative on physiological, behavioral, and psychological aspects that works against patients’ health (Kiecolt-Glaser and Glaser 1990, p.28-29). Physiological impacts in this case pertain to the changes on the levels of activities in the patient body system. Psychological component in clued among other things depression, anxiety, and sense of helplessness. Psychologists have found out that stress responses are capable of suppressing the functionality of the patients’ immune system. However, the suppression of the functionality of the immune system exposes the patient to diseases that could have otherwise been avoided by creating an effective interior design free of stressors. In addition, the suppression of the functionality of the immune system also works against patients’ recovery process, therefore should be eliminated by ensuring that the interior design is conducive for patient’s stay and recovery process. Stress has also been linked to certain behavioral tendencies among patients such as drug abuse, suicidal tendencies, social withdrawal, sleeplessness, and alcoholism, which adversely affects the recovery process (Dijkstra 2009). In this regard, designers are advised to create an interior medical design free of things that subjects patients to stress that interferes with their well-being and recovery process. This including ensuring that the design is free of stressors such as extreme noise, enough spacing within the room that allows medical staff to easily attend to patients according to Ulrich (2010, p.98). Stress is not only a problem for patients in the hospital but also to the visitors and patient’s families and the staff. Research conducted recently showed that most caregivers of Alzheimer patients tend to suffer from extreme stress, which suppresses the functionality of their immune system according to Kiecolt-Glaser and Glaser (1990, p.28). However, when the health care staff experiences extreme amount of stress, this may lead to a reduction in quality of health care service delivery, thereby negatively affecting the wellness of patients. Ulrich (2010, p.98) reveals that job-related stress is a major problem experienced among many health care staff. This includes stress related to high burnout rates, low job satisfaction level and high turnout rates. The low level of job satisfactions have forced some hospital personnel to resort to strikes while others have sought for legal means in courts to ensure that their demands are met. Poor design of staff areas have been one of the contributors of such stress, thereby leading to job dissatisfaction. However, retaining medical staff is very important in any health care environment. This can be achieved by ensuring that health facilities are conducive for the delivery of quality health care services to patients. Therefore, it is imperative that a supportive design in staff areas is created thereby attracting prospecting employees to the hospital. Consequently, this will lead to increased efficiency and productivity, job satisfaction and reduce labor turnover. Job satisfaction created by the design of good staff areas in the hospital is of great benefits to patients since it results in improved quality of health care service delivery (Kiecolt-Glaser and Glaser 1990, p.28-29). Research shows that the well-being of human beings is enhanced when the physical environment provides a positive stimulation. Stimulation in this case refers to that which is neither too high nor too low. There are a number of design elements that stimulates body reaction namely sounds, colors, lighting, and other elements on the environment. In this regard, if the stimulation level is too high, for instance, due to intense lighting, loud sound, or bright colors, may result stressful experience among patients in the hospital. Prolonged exposure to low levels of environmental stimulus results in boredom , as well as depressive effects. In addition, complete lack of external positive stimulation has the potential of compelling patients to concentrate on their own problems, and stressful thoughts, which reverberates stress among patients. Scientific research regarding the negative consequences of poor design of medical environment has particularly been witnessed among patients exposed to low stimulation in health care environments (Dijkstra 2009). One of the search conducted on the intensive care units in many hospitals indicate that sensory deprivation resulting from low stimulation results in depression, anxiety and other stress related disorders. Ventilation has been one of the major interior design that has been found to have a lot of impact on the stimulation level among many patients. This came out from a research conducted by Ulrich (1984, p.452), which indicated that the recovery of patients in the hospital setting was being affected by whether a patient had a view of a brick wall on natural scene. Evidence shows that lack of windows in a room of a health care facility causes high level of manic disorders, anxiety coupled with high rates of psychosis and delirium as noted by Wilson (1972, p.225). This research also found out that lack of windows increases the harmful effects of sensory stimulations linked to other factors such as repetitive sound and steady lighting and other equipment. Several researches having been conducted in Europe and the U.S. suggests that windowless rooms are disliked as it increases the stress levels among patients thereby adversely affecting their well-being. In this regard, designers of hospital interior design are encouraged to ensure that there are enough windows in every patient room to reduce the stress level thereby promoting recovery process. The Windows should also be large and transparent enough to allow enough light in the room. This is because darkness has also been associated with negatively stimuli among patients likely to interfere with their well- being as noted by Ulrich (2010, p.99). The study of conducted on the effects of window on the recovery of patients in the health care setting led to another study concerning the effect of color on the behavior and recovery process of patients. Some of the research has suggested that color of walls of a health care building also affect the behavior of patients in the hospital (Ulrich 2010, p.99). Despite the fact that no proven evidence has been documented, most psychologists believe that the color of a patient’s room greatly impacts on their well-being and the recovery process. This has seen some hospitals designers consider painting rooms in accordance with the patients who are expected to stay in a given room. The Vidar Klinik is an example of a hospital where designers painted the interior walls based on the, an Australian theoretician, Rudolf Steiner’s principle regarding colors healing powers as noted by Moore (2000, p.33). The interior walls of patient’s rooms in this hospital are painted blue of pink. Moore (2000, p.33) notes that pink color was chosen based on the belief that it healthy for spirits while blue is believed to alleviate migraine. What is noted is that Vidar Klinik mostly deals with the treatment and management of patients suffering from depression and cancer according to Moore (2000, p.35). Accordingly, patients in this hospital are allocated rooms with a particular color based on the disease they are suffering from. Despite this being the case, a significant number of designers are still skeptical as to the impacts of human behavior in response to the environmental factors. Therefore, a majority still continue to choose colors based on their preferences, notwithstanding the fact that attempts are still ongoing among many researchers in an attempt to unearth the effects of colors on the psychological system, as well as human behavior within the laboratory environment (Moore 2000, p.35). In fact, a look at the quadriplegic patients reveals that color affects the behavior of patients in the hospital, which also impacts on their well-being. Color has also been seen to have an impact of people’s emotions that stimulates the body resulting in psychological response. This was shown by Kenneth Edwards (1979, p.746), who stated that in case someone is affected by a particular color in they are in good condition, then there is high likelihood that they would be affected greatly by color when they are sick. It is then that Carpman (1993, p.15) concluded that painting the walls using the right color scheme may enhance patient’s recovery. Another research psycho neurology study conducted by Kurt Goldstein supported Carpman’s assertion, revealing that color affect a person both physically and mentally. He stated that a given color stimulation leads to specific response in all living things as noted by Birren (1961, p.44). In one of the study, Goldstein noted that one of the women who had been suffering from cerebellar disease fell quite often and could not walk steadily. Her conditions were seen to worsen when she wore a red dress. Nonetheless, the research also noted that the woman tended to restore steady state when she wore a blue of green clothe according to Birren (1961, p. 145). Based on the literature on the effect of color on the well-being of a patient in the hospital, it is imperative for designers to consider the choice of colors used in any of the rooms in the hospital. This is by ensuring the color response of every patient is taken into consideration to avoid worsening the conditions of patients in the hospital. Doing this will improve the recovery of patients thereby enhancing their well-being (Carpman 1993, p.18). As earlier stated, noise is one of the leading cause of stress in a hospital setting. Noise is any type of sound not considered music and causes annoyance. There has been a growing research on the effects of noise on patient’s recovery process in the hospital, particularly in an intensive care unit. A majority of this research have found out that noise adversely affects some of the vital care outcomes among patients. For instance, noise has been found to increase sleeplessness among patients. In addition, it also increases the patient’s rate of heartbeat since it interferes with the patient’s comfort. In addition to patients, noise also cause a lot of stress for staff administering treatments to patients. This, in turn, negatively affects their performance as far as delivery of quality health care is concerned (Birren 1961, p. 145). Based on the evidence regarding the negative effects of noise on patient outcome, it is imperative of the designers of the health care building to consider using techniques that reduces the levels of noise. For instance, the designers may consider buildings that only allow little sound to pass through from one room to another. This implies that the interior design should not be left much exposed to passage of sound either from outside as this will increase sleeplessness thereby negatively affecting the well-being of patients in a hospital. Light has also been a major feature that has been found to affect the outcome of patients in a hospital setting. Patient rooms facing sunshine, instead of drab conditions have been seen to promote positive outcome among patients. A study conducted by Beauchemin and Heys (1998, p.352) in one of hospitals in Canada found out that patients whose rooms were facing the direction of sunlight showed positive outcome than those whose rooms were facing the cloudy or darkness. In one of the research, it was found that patients admitted for manic disorders had shorter stays if they were admitted in rooms facing the direction of sunshine instead of darker rooms. The study indicated that viewing of the sunshine alleviate depression thereby resulting in short stay in such rooms (Beauchemin and Heys 1998, p.354). The second study also confirmed the findings of the first research indicating that the death rates of patients suffering from myocardial infarctions were lower for those admitted in sunny rooms compared to those assigned non-sunny rooms according to Beauchemin and Heys (1998, p.354). With regard to staff, the study showed that health care practitioners also prefer window view illuminated by sunlight as opposed to drab conditions. Based on such revelations, it is imperative for designers to consider constructing hospital buildings that are well illuminated by sunlight. This implies ensuring that all rooms have enough access to sunshine by constructing large windows with transparent rather than opaque glasses to allow the light to pass through and enable the staff also to have a good view of the natural surroundings. Doing this will certainly improve the recovery level of patients in the hospital as well as improve the morale of the staff to administer quality health care to patients (Ulrich 2010, p.101-103). Flooring materials has also been found to have a great impact on the patient’s response to treatments, as well as treatment outcome. Currently, there are increasing body of research attempting to uncover the benefits associated with the different types of flooring materials used in designing the interior part of the hospital facilities particularly the carpets and glossy materials such as linoleum and vinyl. Of the materials, carpet has significantly outperformed hard materials with regard to epidemiological concerns and other health-related conditions of the environment (Wilmott 1986, p.121). Many patients have widely supported the use of carpets on the floor based on a number of reasons. The elderly patients, for instance, expressed a huge support or the use of carpet in flooring the hospital rooms because they can easily walk on them without skidding, as is the case in glossy materials such as vinyl that are very slippery thereby endangering the elderly. Wilmott (1986, p.121) argues that elderly patients, as well as patients who have become weak as a result of a disease cannot walk effectively on slippery floors. Therefore, carpeting is the best flooring design for such patients since it is secure and non-slippery. In addition, carpets are warmer compared to cement or vinyl surfaces that in most cases are very cold. The coldness of the flooring surface adversely affects the health condition of patients thereby hindering the recovery process. A recent research conducted by Harris (2000, p.41-44) of rehabilitated patient revealed that many visitors of the patients preferred spending time with patients in carpeted rooms to rooms floor with vinyl. This finding has indeed pointed to the possibility that carpets might have the possibility of enhancing the health outcomes of patients through the effect of increasing the social support. The research by Harris also suggests that a majority of patients prefer carpeted floors to floors made of vinyl due to the fact that it is more comfortable, slip resistant, and produces less noise to the surroundings that causes stress. This revelation implies that designers should ensure that floors of health care buildings are floored using materials that patient’s likes most as this with improve their health outcome as pointed out by Harris (Harris 2000, p.44). As pointed out, designers should endeavor to ensure that once the building has been constructed, a carpet is laid in order to prevent patients from sliding, and noise thereby improving their health outcomes. Layout is also another important factor that needs to be considered when designing the building of a hospital environment. This is after a body of research indicated that the rates of infection in critical care units were higher in open wards compared to single rooms. This is because an open ward usually harbors many patients with different conditions thereby resulting in a widespread of infections because of congestion. For example, a study conducted by Shirani and his colleagues (1986), indicated that hospital rooms with multi-beds had high prevalence of infection occurrences. This revelation suggests that hospitals rooms should be designed for single occupancy rather than creating a room with multiple beds. In addition, proponents of single rooms argue that single rooms give them high degree of privacy free of interference from other patients. This improves their health outcomes with regard to recovery from diseases (Shirani 1986, p.18). Further, single units are preferred by some patients because it does not expose patients to seeing other problems facing other patients in the room that is likely to affect them psychologically resulting in poor recovery from disease. Opponents of single room, on the other hand, argue that sharing rooms is good for patients since it gives them the opportunity to socialize and get emotional support from one another. Those in favor of double rooms also argue that it is cost effective than single room units. Based on the different positions held by different patients in a hospital setting as regards the design of the building whether double of single units, it is imperative for the architectures to take the arguments into consideration before designing the rooms for patients. For instance, in order to satisfy all the patients’ needs, designers may consider constructing different rooms with some single and others double to ensure that patients are admitted in rooms in accordance with their preference. This will certainly improve quality of health care delivery, as well as the health care response among patients in a hospital setting (Edwards 1979, p.748). Importance of nature elements Nature has been recognized as being very helpful in reducing stress levels among patients in a hospital setting. Nature in this case involves responses to smells, and sounds, as well as visual things. However, as Ulrich (2010, p.102) notes, a majority of studies has looked at nature elements with regard to viewing of natural features in the surrounding. In this regard, it has been found that viewing of natural elements such as water, trees, and other landscapes tend to restore or promote patient’s recovery from stress. This has been the widely held notion that dates but to early 19th century. In fact, the stress-reducing effects of viewing of nature elements are what led to the establishment of the famous Central Park in New York. In modern times, there has been an increasing research aimed at confirming the old notion that viewing of nature reduces stress or restores its influence. For instance, a recent study conducted on non-patient students revealed that nature viewing significantly enhances the recovery from stress related disorders (Coss 1990). The research found out that many nature elements such as water, trees and landscapes promotes stress recovery because they enhances positive feelings while at the same time reducing the negative thoughts such as sadness, anger, anxiety and fear among people. In addition, another research on nature viewing suggested that nature contents promote faster restoration from stress related disorders. Further, another research involving the study of the electrical activity of the brain showed that many people feel more relaxed and comfortable during nature viewing as noted by Ulrich (1981, p.68-70). With regard to health care environment, findings have shown that patient’s little contact with nature promotes recovery from stress related disorders (Coss 1990). This was noticed during a research in which patients in a hospital were exposed to nature viewing for a short duration of time. A research conducted on patient anxiety in a dental clinic by Heerwagen and Orians showed that patients experienced considerably reduced degree of stress on days a large mural was hanged on their waiting room showing a natural scene. However, the patients experienced increased stress of days that the wall was blank with no natural scene hand on the wall. On the same note, the research also established that there was a significant decrease in the rate of heartbeat among patients on days that the mural was hangs on the wall compared to the days that the wall was completely blank (Coss 1990). These studies indeed show how important nature is important as far as patient recovery and restoration from stress is concerned. The importance of nature elements in a hospital setting was also revealed in a study conducted by Katcher and his colleagues on patients who were preparing to undergo dental surgery (Katcher et al. 1984, p.20). During the study, it was noticed that contemplation of different nature sceneries particularly a picture with fish reduced discomfort and anxiety among patients while at the same time increased their compliance level during surgery. Similarly, another study conducted by Coss (1990) on the effects of showing a variety of ceilings mounted pictures to patients experiencing acute stress showed that patients exposed to nature sceneries had lower blood pressure compared to patients not exposed to any picture. This study also reveals the extent to which nature sceneries are important in a hospital setting and should be taken into consideration by designers so as to help improve the health outcomes of patients. This can be achieved by creating designs that exposes patients to nature view at all time. In fact, research has also showed that prolonged exposure of patients of nature by patients through the window have a lot of benefits for patients. For instance, a survey of patients recuperating from a surgery of gall bladder showed that patients whose windows faced a tree instead of a building showed positive postoperative response as noted by Ulrich (1984, p.101). In this regard, the research found out that patients whose rooms were overlooking the window exposing them to a clear view of the nature elements had a shorter postoperative stays in the hospital. Such patients also showed little post-surgical complications such as nausea, and headache (Ulrich 1984, p.101). In addition, such patients the findings also revealed that patients who were exposed only to wall views required more narcotic drugs compared to patients exposed to nature view in a hospital setting. The importance of nature in the hospital setting was also revealed through a study by Ulrich (2010) on patients exposed to nature scenarios consisting of pictures of water. In this regard, the study found out that patients exposed to water sceneries experienced mild postoperative anxiety compared to those exposed to other pictures. Therefore, designers should take these aspects into consideration when designing the interior part of a health care environment. In addition, it will also be advisable for designers to position the windows of the patient rooms to nature such as trees, water, and landscape as opposed to buildings (Ulrich 2010, P.99). Doing this will certainly enhance the recovery process among patients, as well as improve their response levels to treatments being administered. Impacts of health care environment on staff The European Health Management Association (2006, p.6) notes that the design of a building has a huge impact on staff in a health care organization. He argues that the building design is capable of either increasing the risk of committing errors or experiencing stress. For instance, research show that a decentralized wards with several nurse stations improves the satisfaction level of patients in a hospital, which in turn improve patient care. This is because there are enough nurses to cope with the work available in the hospital, which reduces the burden of having to attend to many patients single handedly. Consequently, this reduces the stress level among staffs. Research also shows that noisy and chaotic environment coupled with inadequate patient contact results in high nurse turnover as having been witnessed in the U.S. according to Minckley 1968, p.33). Another study conducted recently in the U.K. discovered that the design of a hospital has a huge impact on the recruitment, selection, retention, and performance of NHS staff as noted by CABE/PWC (2004). In this study, it was realized that the design of a hospital influences the choice of health care institution that nurses are willing and ready to work for at any given time. It was also noted that many health care practitioners want to be incorporated in design decisions. In this regard, many nurses were willing only to work in a hospital with good design of its internal environment as most of them pointed out that they were not willing to work in a hospital with poorly designed internal environment. There are quite a number of issues that are important for nurses that needs to be taken into consideration during designing of hospital internal environment. They include shops, banks, cafes and creches, socialization places for nurse, visible security and enough workspace with sufficient doors. Others include flexibility designing that allows for changes to be made in patient care when there is need. The European Health Management Association (2006, p.6) notes that all this issues affect the performance of hospital staff and should be taken into consideration by designers. Conclusion It is apparent that the interior design of a hospital impacts hugely on patients and staff. This implies that the designers should be very cautious and ensure that the interior design of health care institutions is designed in a manner that favors the recovery and well-being of patients. This is because research has indicated that a good design of a medical environment reduces the stress and recovery level of patients in the hospital as indicated by the presence of windows, light, color, and nature. In addition, the design should also consider the needs of the staff in that it should be capable of motivating staff to work for the institution and provide quality health care to patients in the health care institution. References Beauchemin, K. M. & Hays, P. 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(2000), Environmental Quality and Healing Environments: A Study of Flooring Materials in a Healthcare Telemetry Unit. Unpublished doctoral dissertation, Department of Architecture, Texas A&M University, College Station, TX. Katcher, A. Segal, H., & Beck, A. (1984), “Comparison of contemplation and hypnosis for the reduction of anxiety and discomfort during dental survey,” American Journal of Clinical Hypnosis, 27: 14-21. Kiecolt-Glaser, J. & Glaser, R. (1990), “Chronic stress, and immunity in older adults.” Paper presented at the International Congress of Behavioral Medicine, Uppsala, Sweden, June 27-30. Malkin, J. (1992), Medical and Dental Space Planning. New York: Van Norstrand Reinhold. Minckley, B (1968), A study of noise, and its relationship to patient discomfort in the recovery room, Nursing Research, 17, 247-50. Moore, J. D. (2000), Designed to heal: architecture of Swedish clinic is about more than medicine. Modern Healthcare. 30(47): 32-34. Race, M. 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(1986), The effect of a vinyl floor surface and carpeted floor surface upon walking in elderly hospital inpatients. Age and Aging, 15: 119-120. Read More