Biophilia for Healthcare Environments

Presented by Studio SHIFT, Spring 2022 Design + Environmental Analysis

Biophilia is the human “love of nature,” a phenomenon rooted in our shared evolutionary history. We have innate sensory preference for organic environments, and the implicit and

design is the intentional integration of these characteristics into the built environment; the following document serves as a guide book for the application of biophilic design in the interior healthcare environment.

Nature in the Space

Nature in the space refers to the addition of outdoor aspects within an interior domain, and the corresponding effects this has on human physical and psychological well-being. Implementation of biophilia creates direct contact with nature from inside workplaces and healthcare settings, creating diverse multi-sensory interactions with outdoor elements. This pillar of biophillic design is made up of visual and non-visual connection

presence of water, dynamic and diffuse light, and connection with natural systems.

Photo on the left is the underside of a wood mushroom

1a

Visual Connection with Nature

OVERVIEW

sounds: implementing elements of nature, from bodies of water, to plants, to materials, so that humans have direct visual access to it (whether they are true natural elements or simulated).

1b

SIGNIFICANCE

This pattern has been shown to create “reduced stress, more positive emotional functioning, and improved concentration and recovery rates.

eye muscles and to, therefore, temper cognitive fatigue when interacting evolutionarily preferred view is looking down a slope to a scene that animals, indications of human habitation, and bodies of clean water. ² Repeated viewing of real nature, such as the scene described, does unlike non-natural views. ³

APPLICATION TO HEALTHCARE ARCHITECTURE

a healthcare setting. It is an approach to healthcare design that is growing in popularity in order to provide some psychological rest to patients who are most likely in high levels of stress. For example, “when patient rooms have high-quality outdoor views, postoperative stays are typically shorter, patients require less pain medication, and recovery requires less time.” 4 Some common approaches to implement this pattern in healthcare are:

• Hanging landscape paintings throughout the facility

• Placing monitors playing videos of natural scenes

• Adding plants and/or a fountain to waiting rooms or exam rooms

• Increasing the number and size of windows throughout healthcare facilities

• Adding more variability in the texture, materials, and colors of healthcare facilities •

1. 14 patterns of biophilic design. Terrapin Home - Terrapin Bright Green. (2014, September 12). Retrieved May 3, 2022, from https://www. terrapinbrightgreen.com/reports/14-patterns/

2. Orians, G.H. & J.H. Heerwagen (1992). Evolved Responses to Landscapes. In J.H. Barkow, L. Cosmides, & J. Tooby (Eds.), The Adapted Mind: Evolutionary Psychology and the Generation of Culture (555-579). New York, NY: Oxford University Press.

3. Biederman, I. & E. Vessel (2006). Perceptual Pleasure & the Brain. American Scientist, 94(1), 249-255.

4. Biophilic Design in Healthcare. Quiet Earth Moss. (2021, October 14). Retrieved May 4, 2022, from https://www.quietearthmoss.com/biophilic-design/ biophilic-design-in-healthcare/

View of plants/ greenery

Access to view nonthreatening animals

Visual (and potentially auditory) water element

STYLELINE 85 AQUARIUM SET, OASE

Aquarium Features

This image is depicting the StyleLine 85 Aquarium Set from Oase. It provides a sleek, modern approach to implementing a visual connection with nature, and would even be feasible in spaceIt provides an ever-changing, the dynamics of nature, as opposed to a more stagnant approach, such as a plants. Additionally, this is a low-maintenance option compared to caring for plants.

Implementing Natural Materials

The photo above is a conceptual healthcare project. According to the designers, “the gallery aims to distract, diffuse and comfort through sensory stimulation, providing a sanctuary for people in emotion turmoil.” 5 This idea is translated through the Visual Connection to Nature pattern through their use of a green wall, wood, and curvilinear structures that mimic shapes found in nature.

Use of natural materials (wood)

Green wall provides visual connection to plants and simulates nature scenes

Curvilinear design mimics familiar landscapes, such as mountains or rivers

5. Sensory gallery horsham. IDEA 2022. (n.d.). Retrieved May 4, 2022, from https://www.idea-awards.com.au/2015/sensory-gallery-horsham/

SENSORY GALLERY HORSHAM: SMITH + TRACY ARCHITECTS, 2015

Quaint, corridorfree design provides patients with a cognitive break from the long corridors of the facility

Skylight provides access to view the changing sky

Use of plants to relax the eye and to provide a dynamic landscape

Nature and Psychiatry

utilizes the pattern through the construction of an indoor garden. This is a space where patients are free to roam by themselves, free of outside control or power. By encouraging independece through the use of nature, the construction and preparation for patients to return to the outside world. 7 The skylight could alternatively be technologically simulated if the space does not allow for a window. 7. ÖSTRA Hospital Acute Psychiatry Ward. White Arkitekter. (2021, March 11). Retrieved May 4, 2022

ÖSTRA HOSPITAL ACUTE PSYCHIATRY WARD, GÖTEBORG, SWEDEN WHITE ARKITEKTER 2009

LUMINOUS SKYCEILINGS, SKY FACTORY

Simulated Nature and Revenue

This dental facility project by Sky Factory sought to soothe patients through convenient, projected views of the natural world rather than traditional televised content. The overall calmness and addition of nature in this design creates a therapeutic and positive response in patients, which makes them eager to return. As a result, the brand also mentions that “by providing superior comfort to your patients, you gain a loyal clientele.” 6 Thus, the biophilic design element increases both the patient experience and the company’s revenue.

Convenient, ergonomic viewing access

Dynamic, changing landscape of the sky as well as views of greenery

Curvilinear shape

Encourages patients to pass time by looking at the skylight rather than the traditional television (which typically requires awkward contortion of the body)

Overall illumination from natural light

2a

Non-Visual Connection with Nature

OVERVIEW

The 2nd pattern of biophilic design, Non-Visual Connection with Nature, utilizes auditory, haptic, olfactory, and/or gustatory stimuli to intentionally call upon the qualities of living systems and natural processes; consider introducing sounds, aromas, and textures that elicit the feeling of being out in nature¹.

2b

SIGNIFICANCE

Such spaces feel fresh and well-balanced, their ambient conditions perceived as complex and variable, yet familiar¹. Research asserts that such uses of sound, scent, touch and possibly even taste to engage the individual may have a mental health. The inclusion of non-visual biophilic design elements are associated with reduced systolic blood pressure and stress hormones,2 5 improved cognitive performance6 7, and perceived improvements in mental health and tranquility8 10 .

2c

APPLICATION TO HEALTHCARE ARCHITECTURE

This pattern may be accomplished via prioritization of natural sounds over urban sounds, accessibility for daily engagement, combination with other patterns of biophilia, and interventions that may be experienced in multiple, novel ways. These sensory phenomena can be experienced is compounded if multiple senses are consistently engaged together.

• Audio system playing recordings of river sounds, waves crashing, or audio from ¹

• Diffusers with essential or plant oils, as used in many traditional medicinal practices, have calming and energizing psychological effects¹

• Olfactory exposure to herbs and phytoncides [essential oils derived from trees,], via herb gardens, indoor plants, or essential oil diffusers have a positive effect on the healing process and human immune function¹

• Opportunities to participate in gardening and horticulture activities, an experience associated with many olfafctory, haptic, and often even gustatory sensations, improve environmental stewardship among children, reduce selfperception of pain among senior populations with arthritis¹

• Including real plants in interior healthcare environments, and thus the opportunity to touch and interact with real plant life, versus synthetic plants, has also shown to ¹

1. Terrapin Bright Green (2012). The Economics of Biophilia. New York: Terrapin Bright Green llc. pp40.

2. Park, B.J., Y. Tsunetsugu, T. Kasetani, T. Morikawa, T. Kagawa, & Y. Miyazaki (2009). Physiological Effects of Forest Recreation in a Young Conifer Forest in Hinokage Town, Japan. Silva Fennica, 43 (2), 291-301.

3. Hartig, T., G.W. Evans, L.D. Jamner, D.S. Davis, & T. Gärling (2003). Tracking Restoration in Natural and Urban Field Settings. Journal of Environmental Psychology, 23, 109–123.

4. Orsega-Smith, E., Mowen, A. J., Payne, L. L., & Godbey, G. et al., (2004). Interaction of stress and park use on psycho-physiological health in older adults. Journal of Leisure Research, 36(2): 232-256.

5. Ulrich, R. S., Simons, R., Losito, B. D., Fiorito, E., Miles, M. A., & Zelson, M. (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology, 11, 201–230.

6. Mehta, R., R. Zhu, & A. Cheema (2012). Is Noise Always Bad? Exploring the Effects of Ambient Noise on Creative Cognition. Journal of Consumer Research 39(4), 784-799.

7. Ljungberg, J., G. Neely, & R. Lundström (2004). Cognitive performance and subjective experience during combined exposures to whole-body vibration and noise. Int Arch Occup Environ Health, 77, 217–221.

10. Stigsdotter, U.A. & P. Grahn (2003). Experiencing a Garden: A Healing Garden for People Suffering from Burnout Diseases. Journal of Therapeutic Horticulture, 14, 38-48.

Glossy white wall treatment for a tranquil overall environment

Array of wall-hung planters for visual engagement and maximization of the vertical plane

Range of fragrant herbs for olfactory engagement and exploration

Natural, wideplank wood embracing, organic feel underfoot

INDOOR & OUTDOOR LIVING WALL PLANTERS: GARDEN BEET, UNITED KINGDOM

Olfactory Connection with Nature

This kitchen space utilizes an indoor planter system, incorporating a fragrant, fresh herb garden in an informal interior environment. This potting system transforms blank vertical space into a beautiful and functional green wall with a vibrant, novel olfactory experience.

SALES CENTER NANTONG,

CHINA

Auditory Connection with Nature

The Sales Center in Nantong, China looks to organically integrate interior urban environment. This space uses a textured, mirrored metal ceiling treatment and a soft, wavelike structure to parallel the nearby seascape. These visual elements are accompanied by an audio recording of natural water sounds.¹¹

Irregular rippled metal ceiling surrounding environment

Undulating, curvilinear walls reference the lake and sea beyond this structure, engaging occupants with novel prospect and spatial exploration

Recordings of soft, natural water noises and/or melodic, drawing occupants in from afar and engaging them in an immersive, tranquil, multisensory environment8

Smooth, earth-tone wall treatment and natural materiality connect visually to nature Polished, warm-tinted concrete

Curved lighting strips simple, intuitive navigation and sensory engagement

11. Alvarsson, J., S. Wiens & M. Nilsson (2010). Stress Recovery during Exposure to Nature Sound and Environmental Noise. International Journal of Environmental Research and Public Health, 7 (3), 1036-1046.

Environmental Psychology, 31, 373-382.

Clerestory window panels for diffused natural lighting

Raw wood joists joining ceiling to wall at a soft angle

Offset, non-linear partitions create a more organic, exploratory, and layered path through the corridor

Soft, highly textured cork wall treatment engages physical tactility

Unpolished wooden rails embedded in the wall treatment serve as an accessible, haptic guide through the space

Panels of braille communicate important messages about navigating to occupants with reduced visual or auditory sensation

HAZELWOOD SCHOOL: ALAN DUNLOP ARCHITECTS GLASGOW, SCOTLAND

Haptic Connection with Nature

The photo above is a corridor at Hazelwood, a school for blind and deaf students aged 2 to 18 in Glasgow, Scotland. Designed by Alan Dunlop Architects, this structure uses a natural cork wall treatment and panels of extruded, tactile paths and braille messages for students as they move through the school. This space promotes independence, safety, and a connection to nature via engaging haptic textures and organic materiality.¹²

12. Terrapin Bright Green (2012). The Economics of Biophilia. New York: Terrapin Bright Green llc. pp40.

Non-Rhythmic Sensory Stimuli

The fourth pattern of biophilia, Non-Rhythmic Sensory Stimuli, refers to probabilistic, unpredictable elements in and around a space.1 While not necessarily perfectly random, such elements must be stochastic and ephemeral.2

wind, the sun warms our faces. Small, peripheral distractions soothe us and help us refocus. Monotonous, repetitive stimuli like a ticking clock can be annoying, but any minute change in routine can bring people joy.1 When employed correctly, non-rhythmic sensory stimuli have been shown to reduce stress and improve productivity. 2

APPLICATION TO HEALTHCARE ARCHITECTURE

Non-rhythmic sensory stimuli can be either mechanical or natural. It is “20-20-20 rule”: stimuli must occur about every 20 minutes, for at least 20 seconds, and from a distance of at least 20 feet away.2 However, what is most important is that the element is both random and temporary. In architecture, it is most common to implement mechanical stimuli aurally, visually, and spatially. Natural stimuli such as open windows and living creatures are possible, but less common in healthcare contexts.2

• Recordings of nature sounds such as birdsong or rushing water

• Non-rhythmic 2-D patterns on walls

• walking pattern

•

• Multiple varieties, sizes, and shapes of plants

• Modular furniture that can be rearranged throughout the day for varying purposes3

• 4

2. Browning, W., C, R., & J, C. (2014, September 12). 14 Patterns of Biophilic Design. Terrapin Bright Green.

3. DEA 6550 Innovations in Healthcare Research and Design. (2022). (rep.). 2022 Innovation (Strategy 3.2.2). Ithaca, New York.

4. DEA 6550 Innovations in Healthcare Research and Design. (2022). (rep.). 2022 Innovation (Strategy 3.3.2). Ithaca, New York.

Wooden planks create shapes that are visually similar yet nonrepetitive

A clear view of the leaves outside the window allows through Plain walls and clean shapes prevent the space from becoming overwhelming plan allows people to come and go freely5

Planks create changing shadows as the day progresses

Static Mechanical Stimuli

“maximizes the relationship between the inside spaces and its natural wildlife setting.”4 that comes in, throwing shadows that change throughout the day.

Dynamic Mechanical Stimuli

The Cascade Coil brand drapery found in the lobby and rooms of the W Boston Hotel provides movement and interest to a room without overwhelming it.

the light in the whole space and can be moved by guests to personalize the area 6 movement and adds visual interest

Coil drapery responds to resident movements shifting ways

6. W Boston Hotel and Residences. (n.d.). William Rawn Associates. Retrieved May 3, 2022, from https://rawnarch.com/wboston_hotel_residences

CASCADE COIL DRAPERY AT THE W BOSTON HOTEL, 2014 BOSTON, MASSACHUSETTS

Grow lamps care for plants while keeping a healthy amount of light for the people who inhabit the space 7

Dimming system adjusts the throughout the day 8 Foliage creates natural shapes, adding interest to the space

Benches placed throughout the garden to provide guests with the option to rest

Plants rotated frequently (every two weeks) by staff 7

Natural Stimuli

a two-story garden built to give patients and caretakers a moment of respite nurtured by grow lamps in the ceiling.

7. Family Connections - For the Family. (n.d.). Dana Farber Cancer Institute. Retrieved May 3, 2022.

8. Dana-Farber Cancer Institute. (2014, May 19). How a healing environment helps. Retrieved May 3, 2022.

9. Ferenc, J. (2014, November 5). Bringing nature indoors. HFM | Health Facilities Management. Retrieved May 3, 2022.

STONEMAN HEALING GARDEN, YAWKEY CENTER FOR CANCER CARE, 2014 BOSTON, MASSACHUSETTS

4a

Thermal & Air ow Variability

OVERVIEW

4b

undulations in temperature and to cultivate a diverse and . Preferences that biophilic design appeals to a variety of stimuli and prevents stagnant to ¹, as well as productivity and concentration. The key component to this pattern is variety, and the ability for individuals without creating over-stimulation². These subtle changes emulate natural patterns of nature.

SIGNIFICANCE

APPLICATION TO HEALTHCARE ARCHITECTURE

in a variety of ways. Window placement and treatments create diverse lighting and heating experiences with sunlight throughout the day. Positioning of apertures, windows, and openings serve to throughout the facility, allowing for ventilation to cycle out pathogens. Materiality different tactile experiences for visitors.

• Window treatments, blinds, and curtains shield inhabitants from excess light and

• Window placement in relation to the sun will direct how daylight and heating work through the interior space throughout the day.

• Incorporating natural elements helps to regulate heat, humidity, and moisture within a space. Plants and moss are most effective in clusters.

• 4 •

transitions across seasons.

1. Heschong L. (1979). Thermal Delight in Architecture. Cambridge, MA: MIT Press.

2. de Dear R. & Brager G. (2002). Thermal comfort in naturally ventilated buildings. Energy and Buildings, 34, 549-561.

3. Kaplan R. & Kaplan S. (1989). The Experience of Nature: A Psychological Perspective. Cambridge: Cambridge University Press.

4. DEA 6550 Innovations in Healthcare Research and Design. (2022). (rep.). 2022 Innovation (Strategy 3.1.1). Ithaca, New York.

Aluminum

curtains; daytime transparency, 5 Curtains become opaque as daylight diminishes

breeze, billow6

Glass panels provide cooling tactile experience

THE FOUR SEASONS: PHILIP JOHNSON, 1982 NYC, NY

Window Treatments

Window treatments allow access to outdoor light and warmth, but also block out the excess. This is not only cost effective, but stimulates natural variations in lighting and temperature. Operable windows allow inhabitants . 7

5. Heschong L. (1979). Thermal Delight in Architecture. Cambridge, MA: MIT Press.

6. de Dear R. & Brager G. (2002). Thermal comfort in naturally ventilated buildings. Energy and Buildings, 34, 549-561.

7. Alex Beam, (n.d.). The Development and Decline of the Four Seasons, the High Temple of Restaurant Design. Boston Society for Architecture.

Wood walls retain more heat in comparison to 8

Materiality

Variations in materiality and surface variations as well as different experiences (ie: marble creates a cooling sensation while wood retains more heat).9

Metal door handle creates cooling tactile sensation tactile experience

8. Postell, J., & Gesimondo, N. (2011). Material Properties and Performance Characteristics. In Materiality and interior construction (pp. 29–43). essay, John Wiley & Sons.

9. Nos projets | Reality & Fantasy Design. (n.d.). Retrieved May 3, 2022, from http://www.rfdesign.fr/projets-retail-tertiaire-architecture-interieurcommerciale/

LE HAVRE DENTAL CENTER: RF DESIGN, 2018 LE HAVRE, FRANCE

Open ceiling replaces need during day¹0

Panels lined with LED lights for nighttime

Breaks the visual barrier between visitors and the outside

Light and warmth above waiting area; welcoming experience ¹¹

of natural light. High windows “distribute light more evenly, control thermal load, and allow light to penetrate large buildings”¹².

10. Parkinson T., de Dear R. & Candido C. (2012). Perception of Transient Thermal Environments: Pleasure and Alliesthesia. In Proceedings of 7th Windsor Conference, Windsor, UK.

11. Boubekri, M., Cheung, I. N., Reid, K. J., Wang, C. H., & Zee, P. C. (2014). Impact of windows and daylight exposure on overall health and sleep quality of

12.. Portfolio: Bring the Outside In. OpenCeilings. (2021, May 6). Retrieved May 3, 2022, from https://openceilings.nl/en/portfolio-openceilings/

Natural Elements

Plants absorb heat, moisture, and humidity to regulate indoor spaces (most effective in vertical gardens or clusters). Some indoor ¹³. Moss walls provide the same ¹4 ¹5 .

Moss wall helps regulate humidity and temperature, low maintenance

13. Riley, E. (2018, September 18). The Best Air-Purifying Plants. Healthline.

14. Society, T. F. P. (2021, July 30). Moss Walls Versus Living Walls. Medium.

15. Preserved Plants & Faux Plant Walls: Uber Austin. Articulture Designs. (n.d.).

Hanging planters also regulate temperature

Soft fabric chairs create warmth,

UBER LOUNGE: ARTICULTURE DESIGNS, 2020

5a

Presence of Water

5b

OVERVIEW

The presence of water can create stimulating and/or calming spaces through the seeing, hearing, or touching of water.1 It can also be tactically embody the qualities of water.

SIGNIFICANCE

The presence of water evokes positive health responses by providing soothing relief from cognitive fatigue and promoting relaxation.2 These

APPLICATION TO HEALTHCARE ARCHITECTURE

Incorporating water in architecture allows for unique multisensory experiences 4ing nature of water also creates continually changing experiences of the 5

• Paintings of water/landscapes with water/abstract representations of water

• Banners/curtains with water graphics

• Interior zen garden/meditation garden

• Stone channels or river rocks simulsting water

• Decorative glass panels with water-like textures

•

interiorarchitects.com/did-you-know-there-are-14-phases-of-biophilic-design/

graphic of ripples on water placed at eye-level to mimic views of a large-body of water along length of corridors to maximize immersion

5

Paintings of Water

Using a pool of water allows for a non-distracting presence. This can be applied to smaller scale interventions such as imagery of waterwould provide.

blue privacy curtains resemble views of an ocean landscape

Transition between tones occurs at a creating an artificial horizon line

Porous ceiling panels resemble spots of light moving water “stalks” similar to reeds growing next to bodies of water are underlit

seating geometry reminiscent of river stones

8

Interior Zen/Meditation Garden

the built environment by combining views of green spaces and bodies of water with interior spaces can be utilized by incorporating indoor zen gardens. presence of water to encourage contemplative feelings

Stone Channels

Beds of river stones can be used to line corridors and walls of large spaces to create the impression of streams of water. These installations can be inset to exaggerate depth.

Inset perimeter stone “beds” create a “pool”near the circulation path

Basin of river stones imitates riverbed

orbs inspired by pearls

visually similar to small ocean waves

Small undulating ripples create more subtle imitation of waves or a frozen body of water with more directionality imply movement of water

12 13

Decorative Glass Panels

to spaces and creating visual stimuli that reduce patient stress. 14

water

Acoustic & Ceiling Panels

panels create a stimulating experience by modulating the ceiling height and creating wave-like movement of water

screens imitate ripples in water while letting light pass through

6a

Dynamic and Di use Light

OVERVIEW

natural luminance changes throughout the day. Sunlight creates brightness as well as shadow; the relationship between the two is expressed through dynamic light in the built environment.

6b

SIGNIFICANCE

APPLICATION TO HEALTHCARE ARCHITECTURE

Dynamic lighting in an architectural space is achieved through the use and creating visual depth. Strategies to consider in architectural lighting

• Access to daylight improves health outcomes and plays an important role in the circadian rhythm of staff and patients.3

• visual depth to a space which creates visual intrigue and a pleasant user experience.1 Different lighting solutions might

• •

• dimmable lights

• circadian color referenced lights

• accurate color qualities that improve user comfort.

• achieved with a daylight should be prioritized for the best results.8

diffuses light while creating visual intrigue Pendants create intimacy and visual interest provide ambient lighting and ample access to daylight

Natural Light in an Urban Setting

effectively uses soft materials to diffuse light the urban center of Bangkok.

on the coffered ceiling and adds visual depth to this space

evoke feelings of “homeyness” and provide dynamic lighting provide ample access to daylight

Transoms allow access to natural light without large windows

Diffused candle lights create intimacy and intrigue light while maintaining visual privacy

Creating Dynamic Lighting

diffuse upward and downward lighting to differentiate spaces and create dynamic lighting for the interior of this spa.

the texture of the walls creating visual depth

Backlit signage improves

Wall sconce creates visual focus to differentiate this space from its surroundings

distorts ceiling height and provides ambient lighting an accent that creates intimacy

light creates a more pleasant user experience

11

Visual Language

relate to architectural elements same visual language as the wood ceiling panels. The cove lighting has the same language as the windows. These relationships create visual depth and

Skylights provide natural ambient light for the daytime

Downward lights for ambient lighting and cast shadows on the walls

ceiling to human scale

Direct light creates shadows that evoke drama

Indirect lighting is diffused and provides ambient lighting

highlights wall texture

Wall sconce as navigational tool

Indirect Lighting

task performance and patient comfort. 13

Using diffused and indirect lighting provides ample ambient lighting that www.healthdesign.org/chd/research/impact-light-outcomes-healthcare-settings

Diffused lighting

Wall sconce makes space more intimate

Connection with Natural Systems

7a

seasonal and temporal changes characteristic of a healthy ecosystem. This connects users to the seasons and changes that occur in the natural life cycle.

7b

The connection with natural systems is thought to enhance positive health responses to an individual by evoking a relationship to a greater whole.

natural systems can promote relaxation nostalgia anticipation in individuals.¹

integrating the pattern into a space. It leads to bringing an awareness of natural properties to the interior environment.²

patients and staff to closely follow a natural circadian rhythm through changes in lighting over time and the reduction of blue light can improve

Window blinds also allow for natural light to enter

Circadian Rhythm Lighting

This hospital uses a circadian rhythm lighting system to aid in health and for better immune functioning, sleep, and lower stress.³

Moon Phases

The hotel room was designed to accommodate having only one lunar phases. The architects connected the room with the human natural cycle and emotions.

changes from a full moon to a crescent between the ceiling and wall inserts indirect lighting similar to the morning sun

Soft lighting to mimic morning mist

Pebble-laid walls

Diffused lighting wall Wood deck

Plant barrier surrounding pool

Natural Patina Spa

time. The renovation of this wellness center utilized the natural local mountain landscape as the primary concept.5

Patina Materials

a nostalgia satisfying the desire for evidence of natural change change-age-and-the-patina-of-time

Stone

Bronze

8

Leather

contributes-to-health-and-wellness/

people to experience the passage of time in the waiting room.

Reclaimed Wood

Wood serves as a de-stressor and can lower blood pressure and heart rates. It makes the environment a space for interaction and ronger emotional connection to the passage of time.

Positive Social Interaction and improved cognitive ability

12

Copper

Utilizing copper alloys such as bronze or brass for high touch surfaces like

Weathered Stone

This psychiatric department was designed to emulate a hotelexperience. The dimmable lights and soft colors along the stone wall create a calming effect that can make patients happier and less aggressive.

Window breaks up a continuous wall natural emphasizing texture of the natural material

Window views from indoors can allow patients and staff to view the outdoors

Barrier provides safety Benches allow for of outdoor relaxation

Wooden pathway

14

Rooftop Gardens

a place to recharge during a shift.15

landscaping-for-hospitals-and-medical-complexes/

Seasonal Plantings

scenery changes depending on the seasonality of the plants. This provides a natural change in landscape through the year.

change with the seasons materials such as wood and stone

Natural Analogues

Natural Analogue patterns focus on the organic, non-living and implied elements of nature in a space. Using the three categories of natural analogue patterns to create an aura of well-being as in the natural world. Using both the simple and complex art found in nature in design elements can trigger our biophilic human link to nature and therefore enhances the human experience.

The photo to the left is of Tafoni sandstone rock.

8a

Biomorphic Forms & Patterns

OVERVIEW

Biomorphic forms are those that represent natural forms. They are often found in abstract contexts, relying on contour, patterns, and textures to draw a connection to nature. Biomorphic patterns are inspired from complex, yet organized and understandable geometries in nature.

8b

SIGNIFICANCE

Symbolic representations within the design of the patterns, shapes, textures or numerical arrangements found in nature. A space with natural forms and patterns feels interesting, captivating, contemplative and absorptive. Research shows that designs that incorporate natural forms result in reduced stress and anxiety, and increased relaxation and engagement² .

APPLICATION TO HEALTHCARE ARCHITECTURE

Biomorphic Forms & Patterns incorporates important concepts such as view preferences and reduced stress due to induced shift in focus¹. Research has proven that humans have a visual preference for organic and biomorphic forms. Our brains consider such patterns as symbolic representations of life, and in fact, exposure to architectural spaces with of interacting with nature itself ² .

• Forms and patterns avoid the harsh edges of right angles and straight lines and instead turn towards a high density of curved edges, high frequency of contrast changes and symmetrical moments of interest and captivation¹

• Decor suggestions include patterned fabrics, carpet, wallpaper designs featuring fractal patterns, Fibonacci series or Golden Mean²

•

are visible regularities of form found in plants and natural systems, including the weather²

1. 14 Patterns of Biophilic Design. Terrapinbrightgreen.com, 12 Sept. 2014, www.terrapinbrightgreen.com/reports/14-patterns/#biomorphic-forms-andpatterns.

patterns-how-they-affect-us-in-any-interior/#:~:text=Whether%20used%20in%20a%20functional,healthy%20life%20balance%20and%20enhancing.

Juxtapositing texture contributes to a dynamic interpretation of cultural and geographic diversity3

Represents the North Saskatchewan River flow3

Mixed media artwork spaning 30 ft of mosaic tiles

EVERYTHING FLOWS, NOTHING STANDS STILL: ERIN PANKRATZ, 2011 ALBERTA, CANADA

Nature Landscape Murals

This mural at the Edmonton International Airport Terminal celebrates the calming effect of natural forms and the ever-present landscape of the North Saskatchewan River, which both bisects and connects the city of Edmonton.

3. Biophilic design: What is it? Why it matters? And how do we use it? | Building Design + Construction. (2018, November 19). Bdcnetwork.com. https:// www.bdcnetwork.com/blog/biophilic-design-what-it-why-it-matters-and-how-do-we-use-it

Healthcare Lighting Design

neurons. The enticing and dynamic piece is meant to create interest as you enter the lobby of this modern healthcare space4

Naturally-occurring forms and patterns and engaging arrays point of focus for the eye to engage visitors4

4. Bob Bové Neuroscience Institute. (2019). Yellow Goat Design. https://yellowgoatdesign.com/project/bob-bov%C3%A9-neuroscience-

BOB BOVÉ NEUROSCIENCE INSTITUTE: YELLOW GOAT DESIGN & DEVENNY GROUP, 1994 SCOTTSDALE, ARIZONA, US

Texture of undulating balconies and glass inspired by the movement of water5

The tower was imagined as a vertical landscape made up of hills, valleys, and pools6

Unique shape of balconies helps minimize wind shear and shade interiors and neighboring apartments

AQUA TOWER: STUDIO GANG ARCHITECTS, 2009 CHICAGO, ILLINOIS, USA

Biophilic Facade

The Aqua Tower features contoured balconies along the building’s façade that each vary in shape, incorporating characteristics of terrestrial topography. The

5. Aqua. 2022, www.architecture.org/learn/resources/buildings-of-chicago/building/aqua/.

6. “Aqua Tower.” Studiogang.com, 2018, studiogang.com/project/aqua-tower.

Forms and Surfaces

This 120 ft. long, two-story interior curtain wall in University Hospital overlooks the lobby and waiting rooms. The vibrant, abstract mural was inspired by the make-up of DNA to create a beautiful installation.

Curtain wall in ViviGraphix Spectra glass in with custom graphic interlayer. This helps “laminate” the imagery, protecting and preserving the integrity of the art7

Graphics inspired by shapes of DNA8

Nature-related artwork helps reduce visitor and staff stress

7. “University Health System - University Hospital.” Forms+Surfaces, 2022, www.forms-surfaces.com/projects/university-health-system-university-hospital.

8. Weill Cornell, DEA 6550, Innovations in Healthcare Research and Design, 2022

UNIVERSITY HOSPITAL CAPITAL IMPROVEMENT PROGRAM: PERKINS+WILL & RVK ARCHITECTS, 2014 SAN ANTONIO, TX

9a

Material Connection with Nature

OVERVIEW

of life. By utilizing natural materials or elements that resemble the local ecology or geology, the design could induce a sense of familiarity and comfort to the space.

9b

SIGNIFICANCE

Material Connection with Nature calls for exploration of materials’ texture, color, touch-temperature, and their similarities with objects found in nature. By recreating these patterns from nature, the designed space can aid its inhabitants generate positive cognitive or physiological responses.

should aid the design to maximize the effects of biophilic design while serving the space its intended function, all to serve the well-being of the inhabitants¹.

APPLICATION TO HEALTHCARE ARCHITECTURE

Interior materials in healthcare environments require special properties like antimicrobial, odorless, and safe to touch. Biophilia design should fully embrace these functionalities while arranging a set of materials that can decoratively embody unity and healing. These materials could be traditionally processed or extensively altered. These notes include some key points in the material selection of healthcare environments:

• A lot of sense stimulations come from the material’s texture, both visually and biophilic design.

• Sustainable and regional materials could help cut cost while granting the locals connection to the environment.

• Incorporating instances of the color green may help enhance creative environments².

• intended function of the space¹.

• Provide natural materials and calming, natural interventions in exam rooms to decrease patient stress³.

• furniture³.

• Use colors in the exam room that are in the same color family as other patient areas³.

• Use copper or other antiviral materials for high-contact surfaces such as doorknobs to guard against surface transmission4

1. Browning, W., Ryan, C., & Clancy, J. (2014, September 12). 14 patterns of biophilic design. Terrapin Home - Terrapin Bright Green.

2. This is what biophilic design looks like in Real life. TerraMai. (2018, October 26).

3. DEA 6550 Innovations in Healthcare Research and Design. (2022). (rep.). 2022 Innovation (Team 2, Strategty 1.1.3, 1.5.1, 1.5.2; Team 4, Strategty 1.1.3). Ithaca, New York.

4. Etkho. (2021, October 26). Biophilic Design in hospitals: The importance of natural light in the health of patients. ETKHO Hospital Engineering.

Wood grille module ceiling solution provides guest area better acoustics5

tiles are easily maintained and provide a good grip

CEDARS-SINAI VENTANA CANCER CARE CLINIC, 2020 TARZANA, USA

Facility surfaces are coated with antimicrobial material to minimize surface transmission6

Purpose Driven Materials

The function of the space should be the priority. Materials’ physical properties like abrasion resistance, chemical inertness, surface friction, and thermal conductivity can all contribute to a safer and easier to maintain healthcare environment.

6. Cedars-Sinai Ventana Cancer Care Clinic - work - ZGF. 70 Years of Designing for People

5. Walker, T. (2021, August 17). Photo tour: Cedars-Sinai Ventana Cancer Care Clinic - HCD Magazine. HCD Magazine - Architecture & Interior Design Trends for Healthcare Facilities.

and Place.

Sustainable and Regional Materials

Regional materials provide the local patients textures and colors they are familiar with. This sense of connection generates comfort. All-natural and sustainable

The wooden structure in organic form enbraces the lougue area7

Insulated glass panels prevent heat loss

Copper is used in high-contact surfaces8 The abundance of color green gives the space a natural accent

8. DEA 6550 Innovations in Healthcare Research and Design. (2022). (rep.). 2022 Innovation (Team 4, Strategty 1.1.3). Ithaca, New York.

MAGGIE’S LEEDS CENTRE, 2020 HAREHILLS, UNITED KINGDOM

Wall paint and wallpaper uses natural colors and organic texture9

Different materials used to create a division in space

Partitions to seperate inhabitants, providing them privacy10

PRINCESS MARGARET CANCER CENTRE, 2020 TORONTO, CANADA

Sense Stimulations from Materials

Visual stimulations from the natural earth tones and organic textures from the material decrease patient stress. Tactile texture and touch temperature offers the inhabitants another layer of protection.

10. DEA 6550 Innovations in Healthcare Research and Design. (2022). (rep.). 2022 Innovation (Team 2, Strategty 1.5.1). Ithaca, New York.

9. Walker, T. (2021, September 13). Photo tour: Princess Margaret Cancer Centre - HCD Magazine. HCD Magazine - Architecture & Interior Design Trends for Healthcare Facilities.

Sherwin-Williams

• Low-Emitting/Low-VOCs

• Antimicrobial

• Latex paint

ECO SPEC PAINT

Benjamin Moore

• Zero-VOC

• Acrylic paint

• Higher sheen (eggshell, semi-gloss, • Lower sheen (matte, satin) for light

DUNE PANELS

modularArts

• Organic form • Glass reinforced gypsum) with lightweight class a foam core

Wall Paint and Wall Paper

Material examples.

11. Sherwin-Williams. (n.d.). Paint shield™ microbicidal interior latex paint - sherwin-williams. Paint Shield Microbicidal Interior Latex Paint. 12. Benjamin Moore. (n.d.). Eco Spec Paint - Primer. Eco Spec. 13. Dune™ panels. modularArts.

Low-emitting/Low-VOCs

compliant

SMOKY BROWN PEAR ANTIMICROBIAL

High Pressure Laminate

Antimicrobial

LEED compliant

High abrasion resistance

RECYCLED MARBLE COLLECTION

Sustainable product

Zero-VOC

Familiar material to local patients

Highly durable

LEED compliant Material examples.

Flex Kaki. Material Bank.

Smoky Brown Pear Antimicrobial. Material Bank.

Recycled marble collection. Material Bank.

• Loop pile tile carpet

• Natural color pallete • Low-emitting/Low-VOCs

• Contains pre-customer and post-customer recycled content • Cradle to Cradle • LEED compliant

FOUNDRY

Tarkett J+J Flooring

• Natural color pallete and soft texture • • Textile composite modular carpet tiles • ADA compliant for accessible routes • ADA compliant for slip resistance • Cradle to Cradle • LEED compliant

PRAXIS ALDER

Zandur

• Heavy duty modular cork tiles • Natural material

• Slip resistant • 96% rapidly renewable/recycled cork • Antimicrobial • LEED compliant Material examples. 17. Loop Stitch. Material Bank.

Foundry. Material Bank.

Praxis Alder. Material Bank.

GARDENS WITH LICHEN MOSS

Garden on the Wall

• Preserved Foliage

• Natural greenery introduced into the interior environment

•

Low-emitting/Low-VOCs • May contribute to LEED credits

• Easy to maintain

• Preserved Foliage

• Natural greenery introduced into the interior environment

• Low-emitting/Low-VOCs

• May contribute to LEED credits • Easy to maintain

Garden on the Wall Acoustical Surfaces

• Natural material • Sustainable product • Low emitting/Low-VOCs • Great acoustic feature • •

LEED compliant

GARDENS WITH FOLIAGE ENVIROCOUSTIC WOOD WOOL Soft Wall

Ceiling and Amenity

WAVE MORPH BESPOKE

Impact

Acoustic

• Organic form • Natural colors • Acoustic absorber made from up-cycled plastic bottles • Low emitting/Low-VOCs • Cradle to Cradle • LEED compliant •

ULTIMA+ DB

Zentia CAMA

Modular lay-in ceiling tiles • Acoustic feature • Humidity resistance • Cradle to Cradle •

CAMA BED CHAIR

Ofters patient’s visiting family member a place to rest • Same height level as bed

Material examples. 23. Impact Acoustic AG. Wave morph bespoke. Wave Morph Bespoke | Impact Acoustic. 24. Zenita. Ultima+ DB. Zentia Ceiling & Grid Solutions. 25. Cama Bed Chair. CAMA.

10a

Complexity & Order

OVERVIEW

This concept adapts the rich sensory effects of geometries found in nature. Patterns like the Fibonacci sequence or fractal patterns with a scaling factor of three are most effective1

10b

SIGNIFICANCE

A space that is engaging and information-rich decreases anxiety and increases view preference and place attachment2 Stress levels reduce by as much as 60% when looking at fractal patterns3 Nonfractal patterns or overly complex patterns can inversely induce stress and at times even nausea4 .

APPLICATION TO HEALTHCARE ARCHITECTURE

concept, patients will feel more relaxed and comfortable in the space. It is important to balance between engaging and complicated to alleviate mental stressors and avoid amplifying them

• Storage closets to conceal unused equipment to reduce clutter5

• Using patterns with appropriate complexity, with a scaling factor of 3

• Repeating patterns at different scales and complexities

• Interior elements with patterns derived from naturally existing geometries (Fibonacci Golden Spiral, Branching Fractals etc.)

1. Salingaros, N. A. (2000). The structure of pattern languages. Architectural Research Quarterly

2. Terrapin Bright Green, LLC. (2022). www.terrapinbrightgreen.com

3. Mohawk Group. (2019). Fractal Vision: A Stress-reductive Approach to Design

4. Hägerhäll, C.M., T. Laike, R. P. Taylor, M. Küller, R. Küller, & T. P. Martin (2008). Investigations of Human EEG Response to Viewing Fractal Patterns.

5. DEA 6550 Innovations in Healthcare Research and Design. (2022). (rep.). 2022 Innovation (Strategy 2.1.6 ). Ithaca, New York

Access door inside room for quick access

Access outside room for restocking

CoreSTOR Nurse Server tucked in walls between rooms

De-cluttering

Storage unit keeps supplies out of sight in the patient room. It extends fully outside the room for restocking, reducing patient exposure and interruptions.

6. DONNEGAN SYSTEMS, INC. CoreSTOR Nurse Server: Patient Care Supplies Storage. (2020)

7. DEA 6550 Innovations in Healthcare Research and Design. (2022). (rep.). 2022 Innovation (Strategy 2.1.6 ). Ithaca, New York

Modulararts Ansel™ wall panels with fractal relief

3Form Bear Grass pattern can be read as bunches of grass put together, to individual blades of grass, to the veins on each blade of grass.

3Form Varia can be used as partitions, wall features, doors, privacy screens etc.

Patterns with e ective scaling

Patterns with a scale factor of 3 have the most appropriate level of complexity to achieve positive psychological effect8 8. Salingaros, N. A. (2000). The structure of pattern languages. Architectural Research Quarterly

MODULARARTS AND 3FORM MATERIALS

Ceiling panels with wavy silhouette

Feature wall with wavy relief

Partitions featuring frosted architectural glass with organic grass patterns

Repeating Patterns

By incorporating similar organic patterns throughout the space, a complex interconnectivity can be read, generating an engaging space10

10. Salingaros, N.A. (2012). Fractal Art and Architecture Reduce Physiological Stress. Journal of Biourbanism

KAISER PERMANENTE CARMEL VALLEY MEDICAL OFFICES: HANNA GABRIEL WELLS ARCHITECTS, 20139 SAN DIEGO, CALIFORNIA

Design that mimics eye movements that occur when viewing natural lanscapes11

Patterns generated using a compuerized growth process11

Pattern derived from microscopic image of neurons11

Fractal patterns

A line of tiled carpet designs based on study of fractals. Patterns stimulate similar eye movement and engagement people have with natural sceneries and are optimized for maximum stress reduction11

11. Mohawk Group. (2019). Fractal Vision: A Stress-reductive Approach to Design

RELAXING FLOORS: 13&9 & MOHAWK GROUP & FRACTALS RESEARCH, 2019

Nature of the Space

Nature of the space refers to the architectural layout of the space and how its environmental qualities affect us as humans. We have evolved to

Photo to the left is of brain coral

11a

Prospect

OVERVIEW

11b

long views

spaces from a point of perceived safety. These views allow the individual to take in information about the environment sense of the space.

SIGNIFICANCE

appealing to the brain’s natural exploration system. Views of over 30 meters reduce perceived vulnerability when in unfamiliar environments¹

Prospecting also reduces boredom, irritation, and fatigue

APPLICATION TO HEALTHCARE ARCHITECTURE

open as possible while still maintaining individual comfort. This involves:

• Low height partitions

• would be restorative)

• space

• Exposed staircases and glass-encased stairwells

•

• Have bridges connecting large open areas to allow expansive vistas.

Windows placed parallel to circulation path

Leads visitors to a focal point contributes to an corridor

Improving Sight lines

glass doors as a focal point.

implications of places create desire for exploration

end of the path provide natural

from the small apertures in the roof6 space and increases the depth space and increases the depth simpler cognitive wayfinding7 elements as well

Open Atrium and Passageways

This health care facility’s atrium is an example of a prospect as it provides multiple views of the space from different points which creates a versatile user experience. The open space and layout allow visitors to understand the space identify circulation routes and possible threats.

APPLICATION TO HEALTHCARE ARCHITECTURE

there are suitable divisions of space that allow for protection while still maintaining the ability to prospect.

• low height partition

• High Backed Chairs

• place making the rest of the room • diversity of environments • Dividing spaces

are further separated by partitions a sense of privacy almost immediately and then return to a communal space

all body types preferences

Spatial Division

spatial division.

Protection and Socialization

room provides both refuge and prospect in actual spaces can face each other to enable social interaction for those that want to socialize.

protection on the provide potential social interaction Partial partitions allow for prospect

13a

OVERVIEW

mystery draws people through the space.

SIGNIFICANCE 13b

¹ and “adventure therapy” has a statistically 2 correlated with various health outcomes.3 into the healthcare environment we can create positive experiences for experiences.

APPLICATION TO HEALTHCARE ARCHITECTURE

To implement mystery we recommend the use of partial sensory information, • partial screening • alluring sensory stimuli • •

The sound of a lobby or the smell of a cafeteria could draw in patients in a fun exploratory way • distant viewpoints which foster a sense of intrigue4

effectively provide visual privacy between visitors and can control noise levels

Partial views are a beneficial factor in hospital between space add individual privacy and are effective well as comfort

Interesting Screens

collection. The screens divide the space while partially hiding views of the room

Biophilic Divisions

biophilia. The plants are”spaces

way to divide the space while adding greenery which serves as a decorative element

The plant boxes and the spaces between draw visitors towards the partition and Plant based partitions freshen the air and remove particulate matter

leads the eye to an outside section

the viewers to explore the space further

Intriguing Light and Lines

Material Choices and Customization

Plant divider wall provides mystery seats enables a space more for more people10 external spaces room divider.

14a

Risk / Peril

OVERVIEW

SIGNIFICANCE 14b

implied threat with a very clear safeguard. This allows for the experience of exhilaration. meant to experience in nature. perceived control is more dominant than the perceived threat.1

APPLICATION TO HEALTHCARE ARCHITECTURE

treatment so this principle must be very understated when incorporated Peril in very subtle ways. • below if they desire • double height spaces • glass elevator • Have overhead •

patient’s attention focused on an outside environment when windows views

Floor to Ceiling Views

windows provide

Large-scale Images

Element of playfulness and animals a younger age group5

foster a sense of intrigue and experimentation

landscape

Glass and clear materials allow for a full 180 degree view because of exposure

Glass Materials