rehumanizationthrough healing architecture.

deserves no less attention than other venues such as legislative halls, sports stadiums, libraries, and other important buildings in our lives. Isn’t it disturbing that the design of a casino that screams money provides more life and happiness than a hospital that promotes life? In addition, the casino’s architecture is carefully designed to maximize profi t while rewarding the clients with every pleasurable attraction. Even a society where the values of money and pleasure outweigh health should recognize that the built environment of a hospital can increase profi ts by enhancing the patient experience. I think the overwhelming negative perception of a hospital is a cultural fl aw that was engraved into society when medicine seemed too bloody and cruel for humanity. That era has passed with the advent of modern medical care highlighted by minimally invasive surgeries, improved pain management, and much higher confi dence in a positive outcome. Hospitals need to be re-designed to take their role as the premiere place of healing with architectural lines that contribute to the mental and physical health of the user.

Cor Wagenor, an architectural historian, notes, “A building that deals directly with people’s minds and bodies offers exceptional opportunities to come up with especially interesting solutions.”2 It is my intent to design a small-community hospital that rids itself of these negative perceptions and rather highlights the importance of accommodating the patient’s obvious need of a comfortable environment that is “life-enhancing”.

the idea. Can a space set the basis for an out of body experience? Will a tilted ceiling stimulate brain activity? Can a textured paint spark visual curiosity? When faced with a curved wall will it imply safety? In the grand scale, can a building become the fi rst line of a healing therapy?

This project took into account the psychological impacts of the built environment to establish a healing hospital atmosphere. Alterations were made to areas such as spatial layout, design, and materials to modify the experience of the user. By researching the specifi c attributes of the built environment that can be manipulated, I propose to re-humanize the hospital into a healing environment. The power of architecture can be better utilized in the development of hospitals. Feelings of depression, isolation, and ultimately death are attached to even the parking lots. If visitors don’t feel life, how does one expect the doctors to give life, and the patients to gain life? “Life-enhancing” architecture has to address all the senses simultaneously and fuse our image of self with our experience of the world. Having a sense of self allows the user to fully engage in the mental dimensions of dream, imagination, and desire.1 The architecture of a building should provide an environment for heightened self-awareness because healing is such a personal journey. The hospital architectural experience

3

the process. hospital volunteerneuroscience researchdesign intent defi nitionresearch agendahealth and architecture conferencesite search/selectionmind stimulation via altered spacehybrid program conceptionsite analysisschematic master planfound-object sketch modelsdesign development/sketchessustainable integrationCADrhino modelphotoshop/hand rendering

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the curve.A mock-up version of the curved wall was made as a study investigating the emotional triggers of a modifi ed space. This wall was designed to provide a sense of safety by eliminating power points. A straight line is a very powerful statement in architecture. By bringing two of these together to from a right angel, the effect is doubled creating a super power. The curve modifi es these right angles into a more welcoming angle: obtuse. The obtuse angle gives a sense of embracement. In contradiction to this is the acute angle which releases a sense of hazard. Our mind associates sharp points with danger. The intent of this space was to reduce stress associated with the typical hospital hallways as shown above.

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rural

australia I queensland I gold coast I currumbin valley

the location. Dr. Ulrich’s studies have provided suffi cient evidence that presence of nature in or around buildings can positively infl uence health. More specifi cally, it has been demonstrated that viewing nature on a screen or through a window can reduce stress and pain, while presence of indoor plants can lift people’s mood and reduce self-reported symptoms of physical discomfort. The study also provided solid evidence that ventilation of fresh air can improve self-reported and medically diagnosed health.

Currumbin Valley is the ‘Green Soul’ of the Southern Gold Coast, Australia. The valley is located just 15 miles west from the eastern beaches and is part of the Gondwana Rainforests of Australia. This rainforest happens to be the most extensive area of subtropical rainforest in the world. The Mt Cougal section of the Springbrook National Park, which forms part of the globally recognized Green Cauldron, is a highlight of this ecologically-rich valley. The untouched natural environment provides a shelter for rare and endangered plants, animals and birds. It provides the perfect setting for a healing environment that can capture the essence of its captivating landscape. The Valley is home to The Ecovillage

at Currumbin, which is where I have pinpointed my building to develop. The Ecovillage has won 29 International, National, State and Local awards ranging from UDIA National - Award For Environmental Excellence to United Nations Assoc World Environment Day Awards for its leadership and excellence in Sustainable Living Developments. This type of standard sets the stage for an eco-friendly design. Hospitals have become one of the highest pollutants with its hazardous waste. Using an ecovillage as my site forces a higher level of sustainability. The area poses exceptional potential for a highly sustainable building through passive design strategies. The ecovillage abides by a fairly detailed set of codes stipulating environmentally sustainable design. These same codes will be applied to my design. The average comfortable temperatures allow for a strong sense of indoor/outdoor spaces. Rainfall is plentiful in the area and an important tool to take advantage of throughout the healing process conceptually. One of the most important aspects of this site is the year round sunshine. Sunlight is the key factor to diminishing the SAD building syndrome. It will create great opportunities to promote a healing environment.

urbanization

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main levela. main entranceb. lobbyc. receptiond. dininge. kitchenf. patient room

g. nurse’s stationh. conference roomi. consultation roomj. visiting loungek. libraryl. bathm. nursery

n. obstetricso. respiratoryp. gymq. physical therapyr. cardiologys. orthopedicst. radiology

u. interior courtyardv. emergency roomw. surgeryx. scrub-in roomy. obstetrics surgeryz. lab1. public parking

2. staff parking3. hydrowallupper level2a. linens service2b. equipment storage2c. female locker room2d. male locker room

2e. staff offi ce2f. on-call room2g. bath2h. staff lounge2i. roof top garden2j. open to below

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patient experience.As a patient the circulation route throughout the building is designed as a form of treatment in itself. The entrance is framed by the main dining area to focus views on the pleasure of eating and social interactions involved with the task. From the lobby area there are two options for access into the building. One responds to those in need of treatment and the other for interaction with existing patients. As a new patient the journey begins with a modifi ed hallway that re-introduces the natural environment. The walls curve in response to the human fi gure and establishing a sense of safety and embracement for the treatment following.

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The design of the patient healing rooms is specified for maximum comfort to the patient. The overall cluster is to ensure direct views into each room from the nurses station as well as a shorter distance from one room to the next. The door into the room is varied to give a sense of personalization and individuality. Upon entering the room the first section of space is defined by the curve of the wall. It is shaped as a more open space to provide room for the staff to treat the patient.

As you move deeper into the room the geometry changes to define the bed as a private space. The ceiling over this space corresponds to the limitation of the patient. The glass ceiling allows for the patient to be laying in bed indoors but able to see directly to the exterior sky. The sloping of the ceiling serves two purposes. It allows the rainwater to act as a visual stimulant while being captured into a cistern. It also provides a forced perspective towards the natural environment. The ceiling drops in height over

publicpublic

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the bed to inform a more intimate area. This change in elevation allows for the use of clerestory windows. The light transferred through these provide natural art with intriguing shadows projected onto the wall being viewed from a sitting position in bed. The bathroom walls are lowered to let the light protrude into the space.

The patient has the option of opening or closing the curtain to a semi-private lounge. This area is designed for personal visitors as well as an area to place personal belongings. This nook then leads to the private decks. These decks are enclosed within the form of the building to act as a barrier from complete exposure to the natural elements.

The rendering process was a combination of three techniques. An initial computer model was built using Rhino3D, followed by a hand drawn sketch adding a layer of texture. The render was fi nished with Photoshop bringing color and life into the space.

of the southern light. The offi ces are equipped with views of the interior courtyard for further inspiration with diffi cult cases.

When circulating from the staff entrance to the nurse’s station a different mood is achieved. The experience is meant to relax but stimulate the mind to prepare for working with the patients. The glass wall of the restricted corridor frames the interior courtyard full of natural elements. The wall itself begins as a dynamic waterfall. It is a hydro wall that serves multiple uses throughout the building. It acts as a water cistern to collect the rainwater runoff. This water can then be used as grey water throughout the building as well as for irrigation purposes. The interior side of the wall is a glass facade so the water fl ow is visible providing a mesmerizing stimulant. The opposite side of the wall is open to the elements and is thus formed out of fi berglass to allow for water overfl ow to run down into the courtyard without damage to the structure itself. As you continue down the hallway the hydro wall transforms into transparent glass allowing a full view of the green space. This encounter with the natural environment releases anxiety and stress before interaction with the patient. The geometrical shape of the hallway is designed to allow maximum interaction with the outdoors. The curve in plan distorts the line of sight to refocus on your surrounding elements. Each alteration to the space eliminates the typical institutional feel of a long corridor.

Access to the treatment rooms is designed with a focus towards functionality. Proximity of spaces determines where each type of therapy will occur. The ER rooms are located next to the surgery rooms; the physical therapy connects to the small gym. The obstetrics area takes into account the elevated noise levels produced from labor by being tucked furthest from the relaxing therapies The treatments that evoke higher stress levels are relieved through views to the surrounding nature or water features of the interior courtyard.

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staff experience.If you are a staff member, your entrance is separate and hidden from the public. Upon entering the building you face an interior courtyard to maintain a seamless transition from outside to inside, bringing nature into the building with you. From here you can choose vertical circulation to the staff facilities (1); a direct route to the nurse’s station (2); or immediate entrance to the treatment rooms (3). Each circulation path varies to correspond to the fi nal destination. The circulation is an experience in itself.

When you go up to the private staff corridor, the hallway is modifi ed to maximize social interaction. The space expands and contracts in areas to create niches and nooks. The path then becomes a continuation of the staff lounge. The actual lounge faces south to take advantage

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sustainabilitysustainasection cut through courtyard demonstrating hydro wall and hallways connection with nature

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sustainabilityfi berglass modular panel systems collects rainwater from roof

undulating surface accommodates planters and cisterns

spigots on exterior allow for drainages

lobby dinningstaff hallway

rooftop garden

HYDROwall

the presentation.

The thesis presentation was displayed as an interactive experience. A scaled mock up of the curved wall was included to test the initial hypothesis of “mind-altering spaces” allowing the audience to physically enter the space. A view of the hallway was projected onto the wall bringing a perspective into the third dimension.

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1. Anthes, Emily. “Building Around the Mind.” Scientifi c American, INC. (2009): 52-59. Print.2. Asmussen, Erik. “Living Architecture: the Rudolph Steiner Seminar in Sweden.” Kindred Spirit. (May 2005).3. Castro, J.M. (2009, August 8). Health care in australia. Retrieved from http://www.expatforum.com/articles/health/health- care-in-australia.html

4. Coates, Gary. Erik Amussen, Architect. Byggforlaget, 1997.5. David Peters, Ed. Understanding the Placebo Effect in Complementary Medicine. Churchill Livingstone. 2001.6. Faulkner, Waldron. Architecture and Color. New York: John Wiley & Sons, Inc., 1972. Print.7. Fell, David. “Stress reducing properties of wood visual surfaces in the built indoor environment.” FPInnovations.8. Jencks, Charles. “Nature talking with Nature.” Architectural Review. Jan 2004: 66.9. Jencks, Charles. The Garden of Cosmic Speculation. China: Kwong Fat Offset Printing Co. Ltd, 2003. Print.10. Juhani Pallasmaa. “An Architecture of the seven Senses.” A+U. (July 1994), pp.29, 41.11. Osgood, Charles. “A Cross-Cultural Study of the Affective Meanings of Color.” Journal of Cross-Cultural Psychology. 4.2 (1973): 135-156. Print.

12. Pallasmaa, Juhani. The Eyes of the Skin: Architecture and the Senses. John Wiley & Sons, 1996. 13. Skolnick, Curtis. “Evidence Based Design Primer.” Providing Comprehensive Facility Solutions. KLMK Group, LLC, n.d. Web. 28 Oct 2010.14. Stokols, D. and I. Altman [Eds.] (1987). Handbook of Environmental Psychology. New York: Wiley. 15. Taylor, E.M. (2009). 2009 survey of design research in healthcare settings; the use and impact of evidence-based design. 16. Retrieved from http://www.healthdesign.org/chd/research16. Ulrich, Roger, Ph.D. “Effects of Healthcare Environmental Design on Medical Outcomes.” International Academy for Design and Health17. Verderber, Stephen. “Architecture for health--2050: an international perspective.” The Journal of Architecture. (Autumn 2003). 18. Von Karolyi, Allen. Hospital Planning Handbook. John Wiley & Sons, Inc. 1976. Print19. Wagenaar, Cor. The Architecture of Hospitals. Rotterdam: NAi Publishers, 2006. Print.

bibliography.