Published: 06/05/2004, Volume II4, No. 5904 Page 39

From greenery to plasma screens, certain environments can heal patients faster. Sally Mesner explains

The idea that the healing environment should appeal to the senses has long been recognised in healthcare design.

As far back as the 12th century, sitting under a willow tree in hospital gardens was considered therapeutic for convalescing patients.

Healthcare architects Nightingale Associates has researched the effects of what it calls 'sense-sensitive' design for the last five years. It has put together a body of evidence that it says proves the healing effects of lighting, views, smells, colours and sounds on patient recovery.

Nightingale Associates director of design for healthcare Richard Mazuch claims: 'If You have got a view of greenery, you get better quicker. Within three minutes of seeing a tree, your systolic rate drops. It is a proven fact.

'We have linked up with universities in Sweden, New York, Italy and the UK to research the senses. It has been proven that wounds heal quicker the less stress a patient is subject to.'

This information, says Mr Mazuch, could be invaluable to the NHS. 'A wound that is open for 10 days to two weeks longer because the patient is in a stressful environment is going to cost more, ' he says.

Mr Mazuch's research has unearthed a range of evidence that demonstrates the benefits of sense-sensitive design. Preterm babies, for example, are encouraged to feed by the smell of vanilla and the colour orange makes new mothers lactate. Children recover more quickly if they are played Stravinsky rather than Mozart; blue filters in lighting and the smell of newborn babies reduce aggressive behaviour; and views and natural light lift the mood.

It has also been proved that patients with burns heal quicker if screens with artificial views of icebergs and glaciers are used in their rooms.

'A lot of these things have been used for years by designers but in a very haphazard way, ' says Mr Mazuch. 'But we want to be more scientific about it and use an evidence-based approach.'

Nightingale has used sense-sensitive design in hospitals for the last three years and NHS Estates' building notes for children's wards have incorporated the principle.

Now it is in discussion with NHS Estates about carrying out a£100,000 study at De Montfort University, where full-size mock-ups of multi-bed and single-bed wards would be used to test sense-sensitive design ideas.

Mr Mazuch has also used his growing body of evidence to come up with a new concept called 'emotional mapping'.

The technique involves identifying the emotions that are experienced and the functions that are carried out in different rooms and departments in a hospital, and coming up with a 'design prescription' for each environment.

'The emotion in a resuscitation room would be one of major trauma; in a waiting room you would feel restless and frustrated, in accident and emergency you might feel tense or even hostile, ' says Mr Mazuch.

'Then we look at the patient's condition and put all the variables into a spreadsheet that produces a design prescription.

'Sometimes It is just using a particular colour of paint, or it could involve using an aroma machine to produce comforting smells like baked bread or fresh coffee in ventilators or on fabric and wallpaper.'

Nightingale is using emotional mapping in the London Clinic, Harley Street, where two office buildings are being gutted and refurbished for outpatient services.

Mr Mazuch says: 'When you're in a bed, you spend days and days looking up. At the London Clinic We have got plasma screens on the ceiling so when you look up you see all sorts of weird and wonderful images. We use lightboxes on the walls and ceilings, with artificial views of landscapes. We also use an audio system in the chairs and beds, so patients can choose the music or sounds playing in their room.'

Further information

www. nightingaleassociates. com

Health Facilities Management Association www. hefma. org. uk/refbook03/03036. htm