ARCH12 Architecture / Research / Care / Health Perspectives on Nordic Welfare Environments

The Nordic countries, as many other EU countries, are entering a period of major investments in new Health Care Architecture. The reason for this is rapid and dramatic changes in the health care system according to a profound focus on patient centred care and organisational development towards open clinic structures instead of inpatient hospital care, which in turn claims a strong support from an adapted physical environment. The hospital environment is traditionally structured out from a strong medical perspective when it comes to diagnosis, technical devices and traditional working organisation. The often loudly pronounced ambition of a person centred care is seldom obvious in the planning of the physical environment, even though the well-known relation between placement of patient bed, views from the patient room, access to nature, illumination, sounds, furniture and private spaces, and the quality of performed and perceived care by staff, patient and the family. In addition studies demonstrate significant relationships between the physical environment in health care and stress reduction, safety, wellbeing and participation in care both for the patient, the family and staff. Advanced technological and specialized medical interventions are concentrated to a limited number of large size hospitals. Community health care matters are dealt with in smaller local hospitals and health care centres often on an out-patient basis, and, increasingly so, in the home environment. Due to these tendencies, regulators, providers and commissioners in healthcare are forced to put high pressure on the quality of healthcare delivery. In order to spatially accommodate these health system changes, architectural innovations are needed along with users’ experiences of these innovations. Healthcare Architecture can play an important role in this transformation.

This wave of new construction therefore provides a great opportunity to create better buildings by using the growing research knowledge concerning how the design of healthcare physical environments can improve patient medical outcomes, improve patient safety by reducing falls and the spread of infection, and play an important role in increasing efficiency and making buildings better places for staff to work. Just as medicine has increasingly moved toward evidence-based medicine -- where the decisions by the inter-professional health care teams are informed by research -- healthcare design internationally is increasingly informed by quality research that links design approaches to medical, safety, and efficiency outcomes, and is moving rapidly toward evidence-based design.

The amount and quality of research on Health Care Architecture has grown rapidly in recent years. However, there are still many questions for which good knowledge is lacking. The commission therefore both is to make existing international research knowledge available as well as carrying out research projects focusing more specifically on the health care situation in a variety of contexts.

In Evidence based design the focus has accordingly much been on compiling the research base and evaluating the strength of the evidence, not so much on how research based knowledge can be implemented into the design process. Construction projects in Healthcare are increasingly complex and have many stakeholders involved. Healthcare is developing rapidly and therefore continuously altering its specifications. At the same time real estate perspectives with long-term goals and sustainable interests must be monitored. Consequently, today there is a strong need to develop methods in the design process of Health Care Architecture to better incorporate evidence based knowledge.