HEWI MAG / Knowledge

Healing Architecture - How architecture contributes to healing

A guest article by Prof. Hans Nickl and Prof. Christine Nickl-Weller

When talking about the central quality criteria of a hospital or care facility, the environment or equipment of the facility plays an important role in addition to patient care. Find out here what the so-called Healing Architecture does for patients, relatives and staff and how it supports the recovery process.

Health is a state of complete physical, mental and social well-being and not just the absence of disease or infirmity. This is how the World Health Organization (WHO) formulates the concept of human health. In hospitals and care institutions, i.e. where health is to be restored or maintained, this holistic concept of health is still all too often reduced to the purely physical condition.

Prof. Hans Nickl and Prof. Christine Nickl-Weller

Healing Architecture gains topicality

However, we recognise a change in thinking that has already found its way into the architectural discussion with the arrival of environmental psychology in the 1970s, and which has become more topical in recent years under the catchphrase Healing Architecture.

A growing number of studies worldwide that investigate the influence of built space on interaction and behaviour, on physical and psychological well-being, can support this thesis of healing architecture.

The actual well-being of patients as an indicator of health and recovery is only one aspect of this. The discussion also revolves around issues of safety and hygiene and, in relation to clinical staff, work efficiency, error prevention and communication behaviour.

The patient room: well thought-out architecture protects against infections

Let us take a closer look at the question of how design can have a favourable effect on the indicators described above, using the example of the patient's room. At first glance, the standard bed room in a German hospital leaves the planner little room for manoeuvre.

Bed, bedside table, wardrobe, chair and wet room - these are the recurring elements of the patient room. However, significant health-related factors are already at play when it comes to the question of whether single or double rooms should be planned. Apart from the obviously better privacy, single rooms are also the clear favourite from a hygienic point of view, as they significantly reduce the risk of nosocomial infection, i.e. infection within the hospital.

Accommodation in a single room can also help to improve doctor-patient communication. During the visit, doctor and patient can exchange ideas in a more concentrated and unbiased way. Two-bed rooms, on the other hand, are more advantageous from the point of view of social interaction and mutual control, for example in the event of a fall. The discussion could be continued in this way.

The influences of natural lighting and a view of the countryside are often cited as factors that promote recovery. In fact, a relationship between recovery and access to daylight can be established and demonstrated. Patients also rate their well-being and satisfaction better when they experience positive distraction from the view of nature. 

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How the design of patient rooms promotes recovery

The consideration of the patient room could be continued from the furniture over the acoustic room design up to the light planning. We architects are called upon to incorporate scientific findings into the design process and to enter into a dialogue with industry in order to implement design ideas in suitable products.

An important component of the patient's room is the wet room. Although here too experts advise individual sanitary areas for each patient, the reality in German healthcare facilities is the shared bathroom per double room. This makes hygiene and infection prevention measures all the more important, which can be implemented, for example, using sensory fittings.

In addition, planners in the sanitary area are particularly concerned with issues of fall prevention and accessibility. Recent research has focused primarily on the needs of specific vulnerable groups. For example, we are now in a position to respond to the special needs of people suffering from dementia or to use products that have been specially developed for suicide prevention - a good example of successful cooperation between planners, research and industry.

Far-reaching advantages in the implementation of the "Healing Architecture" architectural approach

Healing Architecture can ultimately benefit everyone involved in Care. For patients and their families, Healing Architecture means improved conditions for getting and staying well. For the staff in health care facilities, more efficient processes and a safe, stress-reducing working environment.

The calculation also works out for the operators of health care facilities, because higher acceptance and satisfaction, both on the part of the staff and on the part of the patients, will represent a weighty advantage in view of the shortage of qualified nursing staff and the increasing competitive pressure among the homes.

The authors

Hans Nickl studied architecture at the Technical University of Munich. In 1979 he founded his own architectural office and in 1989, together with his wife, Prof. Christine Nickl-Weller, the architectural partnership Nickl & Partner. Hans Nickl was appointed to the professorship of "Constructive Design" at the University of Applied Sciences Erfurt in 1992 and taught as a guest in the department of "Design of Hospitals and Healthcare Buildings" at the Technical University of Berlin from 2004 to 2017.

Christine Nickl-Weller studied architecture at the Technical University of Munich and joined the architectural partnership Nickl & Partner in Munich in 1989. It designs and realises buildings for health, research and teaching in Switzerland and abroad, as well as development and master plans. From 2004 to 2017, she held the professorship in the field of "Design of Hospitals and Healthcare Buildings" at the Technical University of Berlin.

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