Evolution of Access to Nature in Healthcare Environments

Sahar Mihandoust (Texas Tech University)

Visual and physical access to nature in healing environments has changed throughout history. This presentation discusses the evolution of physical and visual access to nature from ancient Greek healing gardens to patient centered care in twenty first century and envisions the future changes in healthcare spaces. Historical events, scientific discoveries and theoretical frameworks are responsible for changes in physical and visual access to nature in healthcare spaces. This paper studies the physical and visual access to nature in seven major healing space phenotypes: Abaton in Epidaraus, roman military hospitals, medieval hospital gardens, pavilion hospitals, moral treatment models, Monoblock models, and the patient centered care model.

According to literature access to nature in healthcare environments is associated with positive health outcomes for both patients and caregivers. Exploring the examples in this study suggests that phenotypes with direct visual and physical path to nature in healing environments always occurred after periods of minimum access to nature. The cycle of evolution of access to nature in history and successful healing space phenotypes, provides a guideline to envision the necessity for biophilic design guidelines in designing healthcare environments.

This study analyzes the floorplans for the seven major healing space phenotypes, and addresses rest areas (R), transition areas (T), and outdoor spaces(O), and builds a table for comparing visual and physical access to nature in these healing spaces. Based on this analysis this study suggests that short transition depths to outdoor natural environments will be the next step in designing healthcare environments.

We have studied biophilic design and its effect on patient wellbeing, nurse stress, and nurse burnout for four years during the PhD studies in Environmental and interior design program in Texas Tech University. Visual and physical connection to nature is an important design factor that influences both patient and nurse wellbeing and leads to positive health outcomes. Studying the examples from the past also sheds light on the importance of visual and physical access to nature in healing environments, and introduces short transition paths (T) as the biophilic and sustainable healthcare design model.