NO APPOINTMENT NECESSARY instilling healthcare institutions with preventative wellness programming
Rebekah Nerad January 28, 2018
MI
ME
MOV
THREE ENE LANGHANA SAMA
IND
EAL
VEMENT
ERGETICS ANA BRAHMANA
CONTENTS
THESIS STATEMENT + QUESTIONS RESEARCH stress in america
evidence-based design yoga levels of consciousness yoga energetics
surveys narratives
PRECEDENT ANALYSIS
park royal hotel alfred caldwell lily pool galter lifecenter swedish covenant hospital
IMPLEMENTATION
concept diagram key definitions movement sequence
study models
RESOURCES
THESIS STATEMENT + QUESTIONS
Current healthcare institutions, underlined by isolation and stress, primarily cater to illness and death. Strategically surrounding preventative and passive wellness programming around medical centers transforms the medical typology into holistic sanctuaries that promote daily health and well being. By implementing phenomenological design strategies, new spaces will engage nutrition, meditation, and fitness.
Can small scale architecture help redefine the U.S. Healthcare industry? Can hospitals be better integrated into their surrounding communities? Can spatial design improve preventative healthcare?
RESEARCH
My research methodology is supported by literary reviews into current U.S. healthcare perceptions/efficacy, evidencebased design, and the yoga energetics/consciousness. The surveys and narratives were developed out of the base research. As I move forward, the research will also influence the context, site, and building analysis of my chosen prototype hospital - Swedish Covenant Hospital in Chicago, IL.
STRESS IN AMERICA surveys from 2007-2017, american psychological association
AVERAGE STRESS LEVEL (2017) Scale of 1 - 10, 1 is low stress and 10 is high stress
SOURCES OF STRESS (2017)
SYMPTOMS OF STRESS (2015)
6.2 6.0 5.6
5.5
5.4
5.3 5.4
5.4
5.2
5.1 5.1
5.0 4.8
2007
63%
2008
62%
2009
2010
2011
61%
57%
Household income less than $50K
2012
4.7
2013
Household income more than $50K
2014
51%
47%
46%
future of the nation
money
work
current political climate
violence + crime
health concerns
family responsibilities
37%
35%
34%
32%
32%
42%
33%
irritable/ angry
nervous/ anxious
lack of motivation
fatigued
depressed/ sad
lying awake
unhealthy eating
STRESS IN AMERICA surveys from 2007-2017, american psychological association
STRESS MANAGEMENT (2014) prevalence + effectiveness
HEALTHCARE PERCEPTION (2013) prevalence + effectiveness
48%
56%
listen to music
71%
62% 43%
exercise/ walk
19%
) describe their health care as good quality
42%
40%
29%
surf the internet
33%
watch tv (2+ hrs)
39%
70%
49%
read
07%
07%
get a massage
meditate/ yoga
12%
13%
09%
describe their health care as focused on education
describe their health care as focused on prevention
describe their health care as focused on mental health
“Fifty-three percent (53%) of adults say they feel good about themselves after exercising, thiry-five percent (35%) say it puts them in a good mood, and thirty percent (30%) say they feel less stressed.”
“Despite the connection between behavior and disease prevention, only ten percent (10%) describe their health care as focused on behavior or lifestyle issues that can impact their health.”
EVIDENCE-BASED DESIGN evidence-based environmental design for improving medical outcomes roger s. ulrich, phd
ENVIRONMENTAL PROPERTIES FOUND TO AFFECT OUTCOMES
HEALTHCARE ENVIRONMENT DESIGN WILL PROMOTE IMPROVED OUTCOMES IF ORIENTED TO FOSTER:
1. noise 2. music 3. windows 4. sunny rooms and view 5, single rooms vs multi-bed units 6. flooring material 7. furniture arrangement
1. sense of control and access to privacy 2. social support 3. access to nature and other positive distractions
7 LEVELS OF CONSCIOUSNESS
silence
vaishvaanara
deep sleep
unmani
dreaming
taijasa
waking
aladani
breath
prajna
senses + actions
turiya
ENGLISH
SANSKRIT
latent
active
conscious mind
body
unconscious mind
divine
THREE ENERGETICS
SAMANA neutralizing equalize inhalation + exhalation
twists + core
LANGHANA reducing lengthen exhalation forward bends
BRAHMANA expanding
lengthen inhalation
backbends
------ to have a balancing effect on the human mind, body, and spirit
------ to have a calming effect on the human mind, body, and spirit
------ to have an energizing effect on the human mind, body, and spirit
SURVEYS a sample of the results gained in a survey meant to gather data on the intersections of the five human senses and the three energetics.
SAMANA
balancing
LANGHANA
calming
BRAHMANA
energizing
SIGHT
SMELL
SOUND
TOUCH
TASTE
winding path through a garden with elevation change.
pile of leaves.
waves lapping on the shore.
thick bark on an old oak tree.
cured scotch.
dribbling water. birds nest. gnarled tree trunk.
crisp leave in the fall. reeds in the summer.
trees rustling. snow crunching.
sand between toes. grass under your feel.
hot tea. chocolate. red wine.
tall monument. steep angles.
air rolling off a white-cap lake.
large waves.
hot sidewalk.
coffee.
SURVEYS a sample of the results gained in a survey meant to gather data on the intersections of the five human senses and the three energetics.
SAMANA
balancing
LANGHANA
calming
BRAHMANA
energizing
SIGHT
SMELL
SOUND
TOUCH
TASTE
symmetry. natural light.
cedarwood. rosemary.
gong. wind.
linen. mix of materials: stone + wood, brick + metal.
salty mixed with sweet.
crisp lines. uncluttered. windows.
lavendar. vanilla.
running water. yoga music. fire crackling. rain.
cool surfaces. book.
bread.
bright colors. high ceilings.
lemon. orange.
metal. ice cracking.
hugs.
lime.
NARRATIVES a sample of the personal narratives gathering when discussing positive and negative attributes of current the U.S. healthcare industry.
THOMAS KONG architect saic interior architecture chair
PAUL ALT, AIA NCARB healing environment architect alt architecture + research associates
ANGELA WEISHAUPT retired hospital technician
“I go Northwestern Memorial Hospital because it’s cafeteria has a restaurant with the best Vietnamese food in the area.”
“You notice a lot when you are waiting in a hospital, especially as a designer. Noise level, privacy, how people move through the space, but what you notice the most are the obvious things that overlooked - like how the check-in desk was not designed for someone with a traumatic brain injury, in a unit that specializes in this type of injury.”
“It is important to address all the senses in a hospital. It always smelled like cleaning solutions, which was not pleasant for anyone, especially patients. A soft blanket, a room with a window to let the sun shine in, and music always made my patients feel better. I also found that artwork that had a pathway comforted people. It let them ponder their future, that they would not be in the hospital forever.”
PRECEDENT ANALYSIS
This precedent analysis focuses on two main areas of study movement sequences and implementation of the senses in the spatial design.
PARK ROYAL HOTEL 2013 - woha architects singapore
TYPICAL MOVEMENT SEQUENCE, HOSPITALITY
arrival
check-in
image source : https://inhabitat.com/park-royal-tower-wohas-stunning-vertical-urban-park-opens-in-singapore/
wayfinding
length of stay
check-out
exercise
nutrition
knowledge
relaxation/ meditation
departure
PARK ROYAL HOTEL 2013 - woha architects singapore
SENSE ANALYSIS
SIGHT
natural daylight plants vertical wood metal rails stone floor
SMELL
plants natural air wood surrounding smells
SOUND
wind footsteps talking
TOUCH
textured stone wood metal plants
TASTE
not evident
ALFRED CALDWELL LILY POOL 1936 - alfred caldwell (redesign) chicago, illinois
TYPICAL MOVEMENT SEQUENCE, OUTDOOR GARDENS + PAVILION
arrival
image source : https://www.gardenvisit.com/gardens/alfred_caldwell_lily_pool_lincoln_park
wayfinding
length of stay
wayfinding
exercise
contemplation/ meditation
nutrition
social engagement
departure
ALFRED CALDWELL LILY POOL 1936 - alfred caldwell (redesign) chicago, illinois
SENSE ANALYSIS
SIGHT
natural daylight lily pond surrounding green rough-cut stone natural wood
SMELL
water lilies wood grasses trees
SOUND
water wind footsteps birds talking
TOUCH
rough-cut stone wood grass/plants water
TASTE
not evident
GALTER LIFECENTER swedish covenant hospital chicago, illinois
TYPICAL MOVEMENT SEQUENCE, HEALTH + WELLNESS CENTER
arrival
wayfinding
image source : https://www.google.com/maps/galterlifecenter
locker room/ waiting
length of stay
locker room
sauna/steam/ meditation
personal exercise
private class/ group class
nutrition
departure
GALTER LIFECENTER swedish covenant hospital chicago, illinois
SENSE ANALYSIS
SIGHT
classmates artificial light hard surfaces mirrors building systems
SMELL
classmates class tools cleaning solutions
SOUND
breathing movement quiet chattering instructor building systems
TOUCH
wood floor mirror glass gysum wall class tools
TASTE
not evident
SWEDISH COVENANT HOSPITAL 5145 n california ave chicago, illinois
TYPICAL MOVEMENT SEQUENCE, HOSPITAL
arrival
wayfinding
image source : https://www.google.com/maps/swedishcovenanthospital
check-in
waiting
appointment
diagnosis
treatment
departure
SWEDISH COVENANT HOSPITAL 5145 n california ave chicago, illinois
SENSE ANALYSIS
SIGHT
natural daylight plants fireplace aquarium
SMELL
plants fireplace cleaning solutions
SOUND
fireplace aquarium vocal chattering footsteps
TOUCH
stone wood textile terrazo glass
TASTE
not evident
IMPLEMENTATION
This section includes the preliminary stages of design work, based upon the research outlined in the previous sections.
CONCEPT DIAGRAM
movement
architecture of experiential wellness
three energetics + phenomenology
meal
health institution
mind
KEY DEFINITIONS
HEURISTIC APPROACH ------ enabling a person to discover or learn something for themselves ( merriam-webster.com )
PHENOMENOLOGICAL DESIGN
------ implementation of sensory design to create specific user experiences ( Holl, Pallasmaa, Pérez-Gómez )
EVIDENCE-BASED DESIGN ------
well-designed physical settings play an important role in making hospitals safer and more healing for patients, and better places for staff to work ( Roger S. Ulrich, PHD )
LOCAL COMMUNITY ------
not to live in isolation but in the company of others who share similar values and interests, and interact for mutual benefit ( merriam-webster.com )
PROPOSED MOVEMENT SEQUENCE
treatment
diagnosis
appointment
arrival
wayfinding
length of stay
wayfinding
exercise
contemplation/ meditation/ social support
nutrition
departure
SENSORIAL MODELS
STUDY MODEL ONE
STUDY MODEL ONE
STUDY MODEL ONE
RESOURCES
HEALTH, WELLNESS + YOGA PHILOSOPHIES
PHENOMENOLOGY + EVIDENCE-BASED DESIGN
PRECEDENTS
VA Healing Environment Design Guideline : Paul Alt
Ann Berger, MD : Chief of Pain and Palliative Care, NIH
Yoga in Practice : Edited by David Gordon White
Yoga - the poetry of the body : Rodney Yee
The Death and Life of Great American Cities : Jane Jacobs
The Geography of Bliss : Eric Weiner
Place and Placelessness : Edward Relph
Evidence Based Environmental Design for Improving Medical Outcomes : Roger S. Ulrich, PHD
Health Benefits of Gardens in Hospitals : Roger S. Ulrich, PHD
Healing Environment : A Review of the Impact of Physical Environment Factors on Users. Building and Environment Journal. E.R.C.M. Huisman, E. Morales, J. van Hoof, H.S.M. Kort
The History of the Senses : Diane Ackerman
Atmopheres : Peter Zumthor
Questions of Perceptions, Phenomenology of Architecture: Holl, Pallasmaa, PĂŠrez-GĂłmez
Swedish Covenant Hospital. https://swedishcovenant.org/
Galter LifeCenter. https://galterlifecenter.org/home
Stress in America Surveys 2007-2017. American Psychological Association.
A Review of the Research Literature on Evidence-Based Healthcare Design : Roger S. Ulrich, PHD
Park Royal Hotel. https://inhabitat.com/park-royal-tower-wohas-stunning-vertical-urban-park-opens-in-sin gapore/
Alfred Caldwell Lily Pool. https://www.gardenvisit.com/gardens/alfred_caldwell_lily_pool_lincoln_park