HEALING SPACES: For Better Treatment

Ravi Chandra Nunna

Subject: Seminars and Technical Writing
114AR0011., Department of planning and architecture, NIT Rourkela
Email:chandraravi144@gmail.com

Abstract: This report is intent to explore how architecture can provide healing spaces that can help in faster healing of a person.
This further leads to a study on why these spaces are required and what all measures to be taken to provide a proper healing
atmosphere through architecture. We learn about healing and how it is done through architecture and how it reduces the stress
and anxiety of patient, visitors as well as staff. Further, a review is done on different parameters and elements involved in healing
architecture to enhance various spaces with respect to the need. It is learned that social support and social improvement play a
very vital role in healing and faster treatment. The functions, materials and textures, and details contribute a lot in this healing
process. Various physical elements and parameters are discussed and their importance is described with their effect on healing
process.
Key words—healing, hospital, architecture, function, nature, design

I. INTRODUCTION1- HEALING SPACES

T HE ambiance of a space has an effect on the people using the space. The hospitals these days have a very institutional setup, not
suitable for the patients. This also results in direct cause to anxiety, stress, frustration and generally prolonged hospitalization of the
patients. This not only effect the patients but also the family/visitors and the staff. The hospital architecture should be in such way, that
it increases the healing nature of that building, which can reduce stress, tension, fear and give relief for faster healing of the patients. It
should also satisfy the professional requirements. Hence, the physical environment of a healthcare facility should be harmless and
provide healing facilities. The surrounding environment, daylight, nature, access, etc., has a healing effect on the patients. This leads to
faster recovery which reduces the rehabilitation time which in turn reduces the stay time in hospitals.

II. AIM AND OBJECTIVE

The aim is
• To understand about the physical aspects in hospital design and that these play an important role in producing a healing
environment for patients.
• Acknowledging the critical experiences of patients, visitors and staff.
• Focusing on the importance of daylight in hospital architecture with proper ventilation and lighting into the building.
• To promote social support and interactions during hospitalization.
• Connecting the building with the nature.

III. LITERATURE REVIEW

A. What is healing?
Healing is the process of re-establishing harmony within the organism. Healing can be accessed by inclusion of all the factors i.e., the
self, the family, the community, the environmental context. It is possible to conceive and create structures that heal.
Optimal healing environments can be achieved by
• wellness - balance and wholeness in body, mind and spirit,
• efficiency – providing quick and accessible care, and
• sustainability – environmental friendly architecture.

1 Figure 1Optimal healing environment

 B. What is healing architecture?
The human well-being and healing is influenced by the well-designed architectural surroundings. The healing and improvement of the
health attained through architecture and design through physical and social aspects effecting the hospital environment is known to be as
healing architecture.
The architectural environment surrounding the patients, families and staff should support the treatment in friendly welcoming and
accommodating environments. The elements of this architectural environment can be,
• Creating homely atmosphere or hermitage - like original healing modalities, spiritual guidance, and spaces that reduces stress
such as spa, yoga centre, meditation centre, etc., and all these should be in relation to natural built environment.
• Keeping a connection with nature – by using different elements like providing natural views through windows, healing gardens
which are accessible to patients, artwork that enhances the senses, providing daylight into the spaces, internal courtyards,
quiet spaces, music, maintaining the quality of air, landscaped courtyards, floor to ceiling high windows, therapeutic benefits,
front porch (to sit and relax), gardens at the entrance, plazas (paved urban plaza), roof terrace, roof gardens, water bodies,
wide walkways to garden areas, etc. These places also attract birds and creates very soothing environment.
• Building a social structure – like green lawns for social improvement, innovative mazes for children, covered sitting spaces
within the hospital commons as well as in the green areas, study rooms with varying occupancies.
C. Social support
The physical surrounding has potential to have ideal settings where common areas are constructing both initial contact and developed
social relationships. In this contrary the social space may be seen as intersection between a public space and a homely environment. If
we improved these social spaces then the healing power will also get increased and may even considered as an influential element in
regard to healing architecture. These social spaces have to be inviting, attractive and sensory.
The social support during hospitalization is experienced in varies levels of intensity – the need, the promotion and finally the
development of social interaction. The social spaces can be an interaction between public spaces and homely environments.

Figure 2 Intensity towards social support Figure 3 Public space + homely atmosphere

1) Public space elements

Giving the possible privacy with some social spaces, the hospitals can be made patient and family friendly. All the spaces and activities
used by patients daily should never make them feel like they are hospitalized and should progressively widen the social context. There
we should shape the rooms, or shape rooms within rooms, make small niches or seating areas of varied character where people can take
a pew. But these places must still make people feel encompassed and secure. Public activity can be created inside the private spaces,
like providing a well-lit Amphitheatre space near natural elements which is also enclosed to give a sense of protection. These kinds of
spaces encourage social participation and elective seclusion and gradual expansion of personal sphere.
Sociofugal and sociopetal spaces – arrangements that discourage social interaction are
sociofugal spaces and the spaces that encourage and enforces the development of
communication are sociopetal. So, the change in arrangement of furniture in a
sociopetal manner will help in increase of social interactions. Layout of furniture plays
a very crucial role in enhancing the social interaction suppose if the chairs are placed
back to back then the place automatically turned into sociofugal spaces. however, if the
layout of the chairs is immediately changed they are face to face then the place changes
to sociopetal spaces. In some situations, sociofugal setup would be preferred, like
studying and reading. Then people would like to have their own personal space. So, the
spaces must be designed in accordance to the physical space and intended function and
the diversity should be maintained between different spaces to give the people their
choice of privacy depending on the situation and their mental mind. Figure 4 Difference - sociopetal and sociofugal

Detail designing – small details in furniture arrangement can change the character of the space that is used. The personal distances
influence many details in the planning of social spaces. The size of the furniture, the orientation and the layout are also very significant
in social interaction. The placement of the furniture is also quite important. Seating environments along the inner facades of common
spaces or the transition zones/in-between spaces between two areas are preferable.
The spaces for social support in hospital environments is an intersection between the public spaces and physical environments with a
comfortable, homely atmosphere.

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 2) Homely atmosphere
The usual institutional setup in hospitals are far from familiar and unknown. Here the general freedom of choice is strictly limited.
These spaces can be made recognizable and friendly by transforming the design of hospital dayroom of patient into an inviting and
homely manner that leads to a better social support.
The homely environment can be reflected through details and arrangement of furniture. The size of the room, furniture orientation and
the room accessories like artwork, greenery, lighting, etc., are also equally important that should be appraised in order to design a
holistic social space. It is difficult to replicate a homely atmosphere as it is in a hospital, as our home is usually very personal and
individual. But by executing three fundamental characteristics: functions, materials and textures, and details, we can make the hospital
environment friendlier.

a) Functions
We often see uninspiring and unattractive spaces in hospital which is not used by the patient. A patient should have choice between
social and private space, ideally a gradual transition between them. The space used can be either private, passive or social, and the
patient should have other choices of options. These have the optional functions like social interactions, dining, cooking, etc. These
social spaces should invite to participation and should be welcoming, and at the same time have privacy. The functions should change
the pathogenic place into a salutogenic place.

b) Materials and textures

The materials and textures used also have a significant role in the way
we feel. A deliberate choice of materials for any room, i.e. the visual
surface and the tactile perception, are often under prioritized. the high
demands for hygiene, cleaning and durability are usually decisive
factors when considering materials in both bed rooms and common
areas. the spaces often appear clinical and institutional, with standard
equipment and furniture, acoustic ceilings, white plaster walls, etc., all
together defining the space as inhuman and basically unfit for social
interaction.
People attracts people, if the social area remains unattracted then
physical environment remain empty all the time. Therefore, there
should be a balance between the homely expression and the rational
clinical demands. For instance, provision of an alternative seating
arrangements in domestic scale and familiar materials, use of tactile
materials and textures in the seating arrangements and other places for
homely and comfortable atmosphere.
Figure 5 Fundamental characteristics for social support
c) Details
Small details may change our use and perception of any space we use. The overall scale of the room should be familiar in size and easy
to overview. The design of details and furniture should therefore contemplate the intended social concept in the common areas. the
placement and orientation of furniture in public places influence the specific use. Seating environments along the perimeter of the room
is usually preferred, where the individual exposure is limited, and it is possible to create a comfortable overview of the surroundings.
Details in the orientation of the furniture may even define the social status of the room, where a face-to-face layout facilitates a
sociopetal behavior and the back-to-back arrangement is creating a sociofugal, private space. Ideally the patent ward should provide
both private spaces (sociofugal), passive observational spaces and social spaces (sociopetal) - although not necessarily in the same
room.
Details like light fitting, acoustic regulators, blankets, cushions and other equipment are all important details. by bringing focus to
these significant details as well, the future design for social spaces may become a holistic design solution creating a homely and
inspiring atmosphere promoting social interaction and support.
D. SOC (Sense of coherence) factors
Sense of coherence arosed from the salutogenic approach, that is, the search for the origins of health rather than the causes of disease.
Accordingly, the strength of one’s sense of coherence is determined by three key factors:
1. comprehensibility
2. manageability, and
3. meaningfulness.
1) Comprehensibility
The surrounding world makes sense and is predictable. The design qualities that strengthen comprehensibility are,

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 ▪ Way finding - There should be clear organization and simple circulation within the building to ease the patient and staff use.
Common console for spaces that can be used commonly to decrease the circulation pattern for efficient use. Organic spaces
create fluidity and provides free flow.

Figure 6 Simple circulation system Figure 7 Use of color highlighting the lighting
▪ Colors - The colors used plays with the emotions of the people in the space. It also effects the lighting.

Figure 8 Access to nature Figure 9 Creating refreshing environments

▪ Nature - Provision of floor to ceiling height windows at waiting areas, lounge areas to give natural views to the visitors to stay
calm and peaceful. Green entrance and landscaping in a systematic pattern arouses a sense of control among the patient and
visitors, which realizes the patient a sense of security ultimately increases the coherence factor among the staff and patient.
▪ Perception - The interior design gives an insight to the people whether the space is holistic or not. A welcoming fountain,
reception, etc., are some examples.

Figure 10 Use of a huge baby sculpture to create a central space Figure 11 Lounge area in a hospital
▪ Landmark - Landmark is something that is the centre of attraction in a building that is easily perceived and noticed and makes
a vital part in hospital social space.
▪ Pleasure - Spaces that are ideally for relaxation and stress-free time, like, small cinema, lounge area, spa, etc.
2) Manageability
The ability or perception that one can cope and meet challenges. The design qualities that strengthen manageability are,
▪ Aesthetic elements - Elements that really add up to beautify the hospital environment and making it more inviting.

Figure 12 Use of aesthetic elements near entrance Figure 13 Natural light = faster recovery
▪ Natural light - Sun is the natural source of light and use of this natural light in hospital environment makes it more healthy and
sustainable. A space that is naturally lit makes it interesting. This light is more pleasurable and calming than the artificial

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 lights. We can get ample amount of light into the building by keeping the building in north-south direction, and provision of
skylights and windows.
▪ Green environments - Green spaces give a sense of control and deceases the stress and anxiety among the patients. It helps in
enhancing social support. It provides access to nature and other positive distractions. It gives a sense of personalized
environment to oneself.

Figure 14 water fountains at the entrance Figure 15 Positive psychosocial stimuli and restoration
▪ Stimuli
▪ Interior design
▪ Restoration
▪ ergonomic design
3) Meaningfulness
The scene of feeling that life is worthy of commitment and engagement. The design qualities that strengthen meaningfulness are,
▪ Social support - The arrangement of furniture that is more sociopetal enhances social support and improvement.

Figure 16 Waiting area in a sociopetal arrangement Figure 17 Tree of life installation

▪ Music - Pleasant music often can reduce anxiety and stress levels and also help some patients to cope with pain.
▪ Art - Artwork that is used is not only aesthetic but also has an influence on one’s behavior and provides an environment that is
not sterile with respect to the thoughts. It should be sensitive to the location and patient demographics. The choice of
elements, their size and placement also effect the space.
▪ Culture
▪ Gym (autonomy/freedom)
▪ Pets friendly environments
▪ Views - Views to vegetation, water and other lively places gives peace and enhances the mind. Most natural views apparently
elicit positive feelings, reduce fear in stressed subjects, hold interest and may reduce stressful thoughts. This can be achieved
by large windows and openings towards appealing views and roof gardens and terraces.

Figure 18 View into green spaces Figure 19 Small temple and green areas outside the hospital
▪ Comfort
▪ Positive distractions - Some kind of attractions to take away the institutional look from the hospitals, like food court, healing
gardens, lounge areas, cafeteria, green lawns, temples, etc., distract the mind into a relaxed mode. Even artworks act as
positive distractions.

IV. CONCLUSION
Architecture has an ability to heal the mental and physical illness with different planning parameters and elements that can enhance
healing. The ability of all the patients to be outdoors in a good environment, without compromising on the needs. The institutional

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ambience has to be reduced and create such Salutogenic design which will shift the pathogenic approach.
Patients can use different parts of the environment, both indoors and outdoors depending on the stage of the recovery process they
have come to. Outdoor spaces are always with lusting green and the sound of water to heal their agitation. Indoor is more towards the
sunlight that enhance the healing and the ventilation to give the patient high level of conformability.
There are four connections that has to be consciously dealt with, while designing.
1. The connection with the personalized environment, 2. The connection to sensory, 3. The connection with Light, 4. The connection
with the City

ACKNOWLEDGMENT
I would like to convey heartfelt gratitude to Prof. Thirtankar Sarkhar for constant guidance throughout the report. I am also thankful to
the professors of the Department for their kind help and suggestions. I would also like to thank my fellow mates who have critically
analyzed the content and have helped us improve it.

REFERENCES
[1] Dipesh Anand, Student at guru gobindh singh university , d.t.c Follow. (2017, January 19). HEALING ARCHITECTURE FOR
HOSPITAL DESIGN. Retrieved September 22, 2017, from https://www.slideshare.net/DipeshAnand1/healing-architecture-for-
hospital
[2] Karenatskw Follow. (2015, December 08). Healing Spaces: Elements of Environmental Design That Make an Impact ... Retrieved
September 22, 2017, from https://www.slideshare.net/karenatskw/healing-spaces-elements-of-environmental-design-that-make-an-
impact-on-health?qid=e86c487d-653c-4b71-958f-d975f5a14059&v=&b=&from_search=3