George Washington University graduate students Julie Melear, Janet Conroy, and Mary Sper’s landscape design for HARVEST HOME, a Wounded Warrior home built for a veteran, has won the Gold Award in outdoor design from the Association for Professional Landscape Design (APLD). The house was designed and built by college students competing in the U.S. Department of Energy’s Solar Decathlon, which challenges collegiate teams to design solar powered houses that are cost effective, energy efficient, and attractive.
July 25, 2014
August 5, 2013
In our earlier post on HEALTHCARE DESIGN 2013, we didn’t list specific sessions because they hadn’t been published yet. So here’s an update, with sessions that may be of particular interest to our Network members. Keep in mind that many other sessions will probably cover access to nature in one way or another; these are just the ones that mentioned it specifically.
First, here’s the HCD13 blurb:
“Shaping the Future of Healthcare Facility Design”
The Healthcare Design Conference is the premier event devoted to how the design of responsibly built environments directly impact the safety, operation, clinical outcomes, and financial success of healthcare facilities now and into the future. With roughly 4000 participants at the 2012 Healthcare Design Conference, this is the industry’s best-attended conference where attendees can earn up to 24 continuing education credits, network with peers, and influence the direction of the industry as it advances into the future.
For more information and to register, visit www.healthcaredesignmagazine.com/conference/healthcare-design-conference
Now the sessions:
Facility tour of Nemours Childrens Hospital
TAMU First Look Colloqium—Therapeutic Landscapes: Tools for Successful Design and Outcomes
Naomi Sachs, Founding Director, Therapeutic Landscapes Network; Mardelle McCuskey Shepley, DArch, FAIA, FACHA, EDAC, LEED AP, The Skaggs – Sprague Endowed Chair in Health Facilities Design, Director, Center for Health Systems & Design, Texas A&M University.
Access to nature in the healthcare environment is increasingly accepted by designers, healthcare administrators, staff, and the community as an important element in the environment of care. As demand grows, designers need solid research, specific guidelines, and good existing examples to inform their work. Guidelines with clearly defined metrics can be translated into an evaluative tool for “apples to apples” comparisons. All of these strategies help stakeholders to understand the role and importance of access to nature. This understanding and knowledge ensures that spaces—and elements within those spaces—provide the best possible outcomes for patients, visitors, staff.
July 18, 2012
HEALTHCARE DESIGN Conference
November 3 – 6, 2012
Early bird registration ends 7/27
Click HERE to register and for more details
The annual HEALTHCARE DESIGN Conference looks great this year, with a plethora of education sessions related to access to nature, including one with me and two awesome colleagues:
Tuesday, 11/6 from 8:00 a.m. – 9:00 a.m.
Environmental Standards Council—The Case for Access to Nature in the 2014 Guidelines for Design and Construction of Healthcare Facilities
Naomi Sachs, ASLA, EDAC, PhD Student in Texas A&M’s College of Architecture in the Center for Health Systems & Design
Jerry Smith, Owner and Principal, SMITH\GreenHealth Consulting, LLC
Alberto Salvatore, Principal, Salvatore Associates
Through recommendations for the 2014 ‘Guidelines for Design and Construction of Healthcare Facilities,’ The Center for Health Design’s Environmental Standards Council (ESC) proposed language and substantiating evidence for incorporating access to nature as one of the key elements in the Environment of Care. Quantitative and qualitative research indicates access to nature is an essential design component to the health and well-being of patients, visitors, and staff. This presentation will include an overview of the Guidelines and a look at proposed revisions to the Guidelines that will allow regulatory agencies to more strongly support the inclusion of meaningful outdoor spaces in future projects.
Listed below are all of the other sessions, in chronological order, that look like they would be of interest to TLN members. These are just sessions that jumped out at me as I scanned the list. Others may also touch on access to nature, so look at the full program to go into more depth. If you see any I’ve missed, please leave a comment.
April 30, 2012
Community Built Association Conference: May 30-June 2, 2012
The Community Built Association (CBA) will hold its annual conference in Portland, OR, May 30 – June 2. The interdisciplinary gathering is open to all those interested in community engagement through the lenses of art, play, nature, and the built environment. The conference features presentations and panel discussions related to play environments, gardens and green spaces, public art, and community-engaged architecture. The conference at Portland’s Tabor Space, 5441 S.E. Belmont Street will include:
- Presentations and discussions from leaders in the field of community-based practice;
- Hands-on workshops that will engage participants’ creativity while they contribute something of lasting value to the local community;
- Tours of local “place-making” sites around Portland, where volunteers have shaped community spaces with their own hands over time; and
- Informal networking and sharing sessions with inspirational community builders from Portland and around the country.
Artists, architects, builders, organizers, gardeners, planners, and others are all welcome. To learn more and register for the conference, visit the CBA Web site: http://communitybuilt.org/conference/portland_2012.
January 31, 2012
Call for Papers: The Architecture of the Psychiatric Milieu
The editorial team of Facilities, a peer reviewed journal, are pleased to announce a call for papers for a special issue dedicated to an exploration of evidence based approaches to establish the most appropriate architecture for the psychiatric milieu.
Facilities for psychiatric care have a tradition of standardization in design and treatment dating back to the moral treatment paradigm of the 1850s. As normative approaches to psychiatric care have changed, so too do the facilities used to house, treat and manage patients. The shift to evidence-based design (EBD) in hospital
architecture means that the psychiatric milieu must follow suit. The search for evidence to model psychiatric facilities is an important endeavour. But psychiatric illness is not like orthopaedics or cardiology, where the needs and satisfaction of staff and patients can be relatively easy to assess and evidence can be easily measured. Mental illnesses are a heterogeneous group of disorders, and there is a risk in categorizing all psychiatric illnesses together and treating them alike. Environmental influences that exacerbate one condition frequently assist with another. As such, Facilities is soliciting approaches that are specific to:
- geriatric psychiatry
- mood disorders
- the non-affective psychotic spectrum
- psychiatric emergencies
- substance-related disorders
- facilities for forensic psychiatry
This list is not exhaustive… and interested authors are encouraged to contact the Guest Editor with alternative proposals. Please kindly take note of the following requirements if you wish to have your paper
considered for this special issue:
January 19, 2012
This week on the blog, “The Patron Saint of Architecture,” Angela Mazzi features therapeutic landscapes through an interview with me. She asked some excellent, thought-provoking questions that get to the heart of what therapeutic landscapes are, how they function, why they’re necessary, and what designers and healthcare providers can do to make sure that they get incorporated into their projects.
Angela is an architect who specializes in healthcare. Her blog explores all sorts of aspects of healthcare-related design, including (of course) design, as well as business strategies, communication techniques, and “thoughts on how to get and stay inspired as a designer.”
Here are a couple snippets, but I encourage you to read the full post on The Patron Saint of Architecture blog.
What does landscaping mean to you? Most likely, not nearly enough. Too easily, we view it as decorative, a “nice to have” part of a project. However, as we learn more about salutogenic design and the effects of the environment on wellness (everything from healing to better job performance), landscape starts to become a critical element, one which should form the basis of design. With this in mind, I asked Naomi Sachs, Founder and Director of the Therapeutic Landscapes Network (TLN) to share some insights on the power of nature.
What is the difference between landscaping and a garden? Is it only about habitation?
In general, I would say that a “landscape” is any outdoor space, wild or designed, and a “garden” is a designed space. A restorative landscape is simply an outdoor space that makes you feel good when you’re in it. To me, “landscaping” implies decorative elements like a lawn, shrubs, some trees, and is not necessarily intended for interaction. A therapeutic (or healing) garden is a space designed for a specific population (children, cancer patients, people with Alzheimer’s) and a specific intended outcome (stress reduction, positive distraction, rehabilitation). This is not to say that landscaping isn’t important. Well-designed and maintained landscapes communicate to patients and their families that they will receive a high level of care, and this can happen from the moment you cross the property line. Even areas such as parking lots can utilize landscape to provide and reinforce the overall image and mission of the facility.
Maintenance is always a concern when it comes to landscaping- I’ve actually worked with healthcare clients who wanted nothing but grass in the areas they “had” to landscape for ease of maintenance. What kind of recommendations can you make to landscape skeptics about using plantings?
Access to nature just makes good business sense. Studies by Roger Ulrich, confirmed by others, have demonstrated less need for pain medication, improved patient satisfaction, faster recovery rates, and many other examples of improved outcomes for patients and staff. When you really look at the benefits of providing access to nature, the return on investment (ROI) justifies the initial cost and lifetime maintenance. Hospitals need to see landscaping as a strategic investment in the same manner they would the purchase of a new MRI.
Visit The Patron Saint of Architecture to read the full article. Thank you, Angela, for a great conversation and post!
September 20, 2011
I’ve been meaning to write this post all summer, and of course now it’s fall and here in the northeast, shade doesn’t seem as important anymore. But plenty of the country is still baking (if not on fire), and half of the world is just now headed into summer. I asked the TLN Facebook group to rate the importance of shade, on a scale of 1-10 (10 being the most important). Two people responded “11,” and one member, from TX, responded with 15. So here we go:
The importance of shade in the healing garden
I’m so tired of seeing “healing gardens” with no shade, or too little shade. I’ve seen many designs that are successful except for this one crucial element. I don’t know about you, but on a hot, bright day in August, the last place I want to be is outside in the sun, sweating and squinting. It’s gotten to the point where lack of shade doesn’t just make me sad, it makes me angry. Because while it’s a nice amenity in any public space, in the healthcare setting, shade truly is a matter of health.
Why provide shade?
1. Sun protection, from UV exposure and glare
For burn patients; the elderly; people with cancer; AIDS; traumatic brain injuries (TBI); psychiatric illnesses which require medications that increase photosensitivity (sensitivity to the sun); and other conditions where direct sun (UV) exposure is hazardous, shade is paramount. In addition, colored concrete is often recommended for outdoor healthcare environments because it reduces glare. This is one of the reasons why we have embraced Scofield as a Wonderful Sponsor.
2. Heat mitigation
Shade provides a cooling effect, thus facilitating use of outdoor space for as much of the year as possible. This is particularly important in regions where high temperatures discourage people from venturing outdoors.
February 9, 2011
In 2005, Dr. Luis Vasquez visited Yantalo, Peru – his mother’s birthplace – for the first time. Though he had grown up in Lima, about 500 miles southwest of Yantalo, he had never seen his mother’s hometown. A retired cardiologist, Luis was struck by the need for medical care in the community. So Luis did what many of us dream of doing: He created the Yantalo Foundation, setting the wheels in motion to build a health clinic that would serve the people of the region.
Ground has now been broken, and work is well underway on the construction of the Adelina Soplin Yantalo Clinic & Diagnostic Center, the first green clinic in South America. The 16-bed International Clinic will be equipped with telemedicine, solar power and intelligent water use to decrease negative environmental impact and to lower operating costs. The Clinic will serve everyone in the region, regardless of their ability to pay, while also serving as a training center for Peruvian medical students and physicians. International physicians, dentists and other health care professionals will examine and treat patients who otherwise have no access to proper medical attention.
Gina Cangialosi and Lauren Garza designed all work related to the architectural plans of the clinic. Principles of evidence-based design (EBD) were used throughout. The faculty, students and professional friends of the NewSchool of Architecture and Design in San Diego, CA, donated their time and expertise to the Foundation (their renderings are pictured in this post).
And a week from today, I will be in Yantalo, doing the same – donating my time and expertise for landscape design of the clinic and surrounding site.
From a landscape perspective, there are some very exciting things about this project:
- The clinic has been designed with several interior courtyards as well as exterior spaces for patients, visitors and staff. The opportunity to work on a design where access to nature as a restorative element is a “given” is very exciting.
- The clinic is on land that was cleared a long time ago – the disappearing Amazon forest is a major problem in Peru, and the government has a strong REforestation program in place. The Yantalo Foundation is proud to be part of that program; they have planted almost 200 trees already, with plans to plant 3,000-4,000 by the end of the project.
- A local association of retired senior citizens are very active with the project, and many of them have extensive horticultural knowledge – about what grows well where, and also what plants can be used medicinally. I’ll be working closely with them on the design of the healing gardens in and around the building.
- We will definitely be exploring the use of medicinal plants, something we don’t often get to do in the United States. In Yantalo, one of the goals is to nurture and maintain cultural traditions. Whether medicinal plants are used symbolically or for actual harvesting and use, they will be part of the design.
I leave on Saturday and will be there for a week. Where is Yantalo, exactly? In the Amazon jungle, 648 miles (405 km) south of the Equator. Here’s a map. Bye-bye, winter, hello, summer! I’ll do my best to send updates while I’m there – the best way to keep track of goings-on will be through Twitter and the TLN’s Facebook page, and will go more into detail once I’m back home.
For more information, and to make a donation to the Yantalo Foundation, visit their website: www.yantalo.org.
July 8, 2010
Like most people, I’ve had my fair share of unpleasant experiences in doctors offices and hospitals. And looking back, I realize that many of my most worst memories had to do with the way the place looked. The one that took the cake was a doctor’s office in a windowless clinic with one potted plant in the waiting room. And that plant, a Poinsettia from Christmas-time (this was in February) was dead. Even if only on a subliminal level, we perceive that something is wrong with this picture: “If they can’t even take care of one houseplant, how the heck are they going to take care of me?” I have heard many people, when talking about the gardens in a hospital, clinic, or nursing home or other place of healing, express the opposite sentiment: “They take such good care of the gardens, and that reassures me that they will take good care of me, too.”
I’m reading an article from an old (2008) issue of Healthcare Environments Research & Design Journal (HERD), titled “Ambulatory Facility Design and Patients’ Perceptions of Healthcare Quality,” which completely reinforces what we all know in our hearts to be true: That places of healing work better when they look and feel like…places of healing. And I’m talking, of course, about a more holistic idea of healing than just “isolate, sterilize, and medicate.” Squeaky white linoleum floors that reflect buzzing fluorescent lights attached to low ceilings in long, windowless corridors is an old model that has been proven to be anything but good for our health.
So, let me just share a few nuggets from this article. First, its conclusion, as stated in the abstract: “This study is consistent with other studies that examined the relationship among the physical attractiveness of healthcare settings, patient satisfaction, and quality of care.” Patients reported better care, service, and staff and doctor interactions in the more attractive waiting rooms. The authors cite several other related studies about patient satisfaction: Leitner and colleagues (1998) found that “patients in hospital units where nurses felt that their work was meaningful were more satisfied with their hospital stay” and that “…patients on units where nurses felt more tired and more frequently expressed their intention to quit were less satisfied with their care.” Mallak, Lyth, Olsen, Ulshafer, and Sardone (2003) found that “…job satisfaction [among healthcare providers] and patient satisfaction were significantly and positively correlated with culture strength and ratings of the built environment.” They also cite interviews with patients and families about what they want. Douglas and Douglas (2004) “found that patients reported the need for personal space, a homey welcoming atmosphere, areas for visitors, access to external areas, and provision of facilities for recreation and leisure.” Gardens in places of healing can fulfill many of these criteria, and a well-designed garden should address all of them.
I once got an email from someone recommending that his local hospital’s healing gardens (Woodwinds Health Campus, pictured above) be added to the TLN’s list of exemplary gardens in healthcare facilities. The gardens made a strong positive impression on him, and influenced how he felt about the entire hospital. And it probably provided a great incentive for him to visit for regular check-ups rather than waiting for emergencies. Think about how much people’s health would improve if they adhered to the preventative care model!
The article mentioned above explores the role of the built environment in influencing patient (consumer) satisfaction. Another article, which I’ll blog about soon, discusses the role of the built environment in influencing patient health and safety. There are so many reasons for healthcare providers to focus not just on the medicines and the machines, but on the places that house what all that stuff is there for: The patients and their families. All of those places have outdoor space – be it a parking lot and drop-off area or a designed “healing garden,” and all of those outdoor spaces could and should be considered as part of the aesthetic package that influences patient satisfaction, health, and well-being.
Becker, Franklin, Bridget Sweeney, and Kelley Parsons (2008). “Ambulatory Facility Design and Patients’ Perceptions of Healthcare Quality.” Healthcare Environments Research & Design Journal (HERD), Vol. 1, No. 4, pp. 35-54.
Douglas, C. H., and M. R. Douglas (2004). “Patient-friendly Hospital Environments: Exploring the Patient’s Perspective.” Health Expectations, Vol. 7, No. 1, pp. 61-73.
Leiter, M. P., P. Harvey, and C. Frizzell (1998). “The Correspondence of Patient Satisfaction and Nurse Burnout,” Social Science Medicine, Vol. 47, No. 10, pp. 1611-1617.
Mallak, L. A., D. M. Lyth, S. D. Olsen, S. M. Ulshafer, and F. F. Sardone (2003). “Culture, the Built Environment and Healthcare Organizational Performance.” Managing Service Quality, Vol. 13, No. 1, pp. 27-38.
December 10, 2009
Five years ago, Susan Rodiek embarked on a project to create a series of DVDs about providing better access to nature for older adults. Rodiek, a professor at Texas A & M University’s Center for Health Systems & Design, specializes in senior populations, and access to nature has long been a focus for her research and teaching.
Those years of hard work have paid off. I received my “Access to Nature for Older Adults” DVDs last week and I’m truly impressed. The three-DVD series is not just instructional – it’s downright inspiring. With beautiful imagery, compelling research and interviews, easily digestible information, and a lot of real, practical solutions to common problems, it’s a must-watch and a must-have for architects, landscape architects, planners, educators, and any care provider who works with seniors in continuing care retirement communities, assisted living facilities, nursing homes, hospices, as well as acute care general hospitals.
Session One, The Value of Nature, describes how access to nature may benefit the health of seniors, from the perspective of experts and available research – addressing the role of programs, policies, and design issues.
Session Two, Improving Outdoor Access, explores how the layout of the building itself can either encourage or discourage outdoor access, and how specific areas – such as indoor-outdoor connections – can be successfully developed.
Session Three, Safe and Usable Outdoor Spaces, highlights the main outdoor features that are reported by residents to impact their outdoor usage, and how these can be improved. Seating, shade, and walkways are among the outdoor elements illustrated.
The Access to Nature website is also chock-full of good information. Some of it is accessible to everyone, and some of it is only accessible if you have the DVDs. So go ahead and buy them! You won’t be sorry.
Receive a 10% discount: Between now and the end of January 2010, Therapeutic Landscapes Network members and readers of this blog will receive a 10% a discount when you buy any or all of the Access to Nature DVDs. Just enter this promotional code in the checkout section on the Access to Nature website: TLNA2N.