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The Building, Growth and Applications of a Model for Holistic Healing Environments
Providence, June 2013
Fiona de Vos Ph.D.Knowledgeable Design by Studio
dVOwww.studiodvo.com
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09.06.2011.2
Studio dVO
Research and consultancyin Environmental Psychology since 1995
Specialized in: Healing Environments
Mission: Enhancing the ‘fit’ between a building and its users
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Agenda
1. Definition HE2. Building of the model3. Growth & applications
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What is a Healing Environment?1
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Reduce unnecessary stress for patients
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Unnecessary stress
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Create an efficient work environment …
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Create a welcoming environment for visitors
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Building the model2
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Rationale original study (2002-2005)
Fragmented literature
A more holistic approach to Healing
Environments
Need for more integrated approach
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Research question
How can a hospital environment approximate the normalcy of daily life?
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Multi-phased research design
I. Develop Charts & Model Literature Analysis Formative Research
II. Apply Model in Case Study Pre- and Post comparison
III. Revise Charts & Model of Healing Environments Implications for Design
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Creating the dimensions
Dimensions of Healing
Related Concepts Design Healing Relationships Further
Reading
Patients 0 to 18 years
Sleep
Getting adequate sleep and restFeeling and being rested. Helps recovery of child. Prerequisite for psychological wellbeing. Create facilities for parents, comfort and quietness, private rooms.
Olds et al., 1987
Basic Physiological Needs
Food
Getting adequate foodMeeting appetite. Helps recovery prerequisite for psychological wellbeing. Increase choice of food and ability to make your own in nearby pantry.
F. de Vos, 2004
Pain
Getting adequate pain reliefAvoid needless suffering. Self-administering of pain medication. Alternatives for pain relief such as place for praying, relaxation, meditation, etc.
F. de Vos, 2004
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Seven dimensions
Patient & Parent(s)
Safety &Security
SocialSupport
Normalized Behavior
Normalized Environment
Distraction & Engagement
Basic Physiological Needs
Agency & Control
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Pre- post comparison
WestchesterMedical Center
Maria FareriChildren’s Hospital
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Methods used
Literature Analysis
Participant Observations (700 hours)
Interviews (N=142)
Behavioral Mapping (40 days x 5 times)
Questionnaires (N=510)
Photography (3,000 photos)
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Basic physiological needs
“Food should be provided for parents as well as the children, so that we as parents don’t have to leave our child’s bedside to eat.”
--A mother
Most parents do not want to leave their child alone even for a few minutes
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Normalized behavior
“Patients are often too sick to get out of bed.”
Not if we create reasons for them to get out of bed
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What about Staff?
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The eightth dimension
Patient & Parent(s)
Safety &Security
SocialSupport
Normalized Behavior
Normalized Environment
Distraction & Engagement
Basic Physiological Needs
Agency & Control
What about Staff?
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Balancing the needs of all users
Balancing needs
Patients & Family Staff
Functionality Efficiency Comfortable
Environment Manageable
Environment
Patient &Parent(s)
Basic Physiological Needs
Safety & Security
SocialSupport
Normalized Behavior
Normalized Environment
Distraction & Engagement Agency &
Control
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Balancing needs
Ease boundaries between families and staff Empowering parents and patients Confidentiality issues staff
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Holistic Healing Environments
Patients
Normalized Behavior
Distraction & Engagement
Social Support
Normalized Environment
Basic Physiological Needs
Agency & Control
Safety & Security
Supportive & Effective Parents
Supportive & Effective Staff
Control
Functionality & Efficiency
Distraction
Convenient & Restorative
Facilities
Family Centered
Care
© F.
de
Vos,
200
5
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Growth and application3
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Growth & adaptation
From children’s hospital
(US)
to
General hospital (NL)
Senior housing
Rehab center
Acute psychiatry
General real estate
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Holistic Healing Environments
Patients
Normalized Behavior
Distraction & Engagement
Social Support
Normalized Environment
Basic Physiological Needs
Agency & Control
Safety & Security
Supportive & Effective Parents
Supportive & Effective Staff
Control
Functionality & Efficiency
Distraction
Convenient & Restorative
Facilities
Family Centered
Care
© F.
de
Vos,
200
5
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ModelHolistic Healing
Environments
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Checklist Patients and Visitors
A Orientation / AccessibilityIn a stressful situation we perceive our environment differently. It is therefore important to create an inviting and easy to find and access location.
Location
A1Does the location suit the client? Safe, green, quiet, shops in the vicinity etc.?
- + A
A2Is the environment safe, also in the evening? Does it feel safe?
- + A
A3Is the building on the ground floor? Is it a low rise building?
- + A
A4 Can one easily find the building, also at night? - + A
A5 Are the signs easy to read, also at night? - + A
A6Can one reach the location by public transportation?
- + A
A7Can one easily locate and find the main entrance to the building?
- + A
Evaluation patients & visitors
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Evaluation Patients & Visitors
A Orientation / Accessibility
Location
A1Does the location suit the client? Safe, green, quiet, shops in the vicinity etc.?
- + A
A2Is the environment safe, also in the evening? Does it feel safe?
- + A
A3Is the building on the ground floor? Is it a low rise building?
- + A
A4 Can one easily find the building, also at night? - + A
A5 Are the signs easy to read, also at night? - + A
A6 Can one reach the location by public transportation? - + A
A7Can one easily locate and find the main entrance to the building?
- + A
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Evaluation Patients & Visitors
Orientation
Food
Patient Room
Environmental Aspects
Bathroom
Treatment RoomsIsolation
Family Support
Distraction
Building Overall
Hotel Services
0
50
100
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Evaluation Staff
Building Overall
Efficiency
Environmental Aspects
Support
CommunicationPatient Room
Facilities
Patient Focused
Facilities Residents
0
50
100
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How to use the building to support strategic goals Market share Less medical errors Less aggression,
incidents, medication Infection control Philanthropic support Volunteer involvement Patient/family
satisfaction Staff satisfaction Staff turnover rates Staff recruitment Community pride ….....
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Knowledgeable Design