International Academy for Design and Health

International Academy for Design and Health
Alan Dilani Ph.D. Architect
Professor
Research Center Design and Health
NOVUM Science Park
Stockholm - Sweden
www.designandhealth.com
dilani@designandhealth.com
Available
Publications
How should Health be defined?
To be able to;
Work, Love and Play (Peter Hjort)
A generally accepted
definition of Health
according to WHO:
”Health is a state of
complete physical,
psychological and
social well being; not
only the absence of
illness!”
Theory Model for Psychosocially Mediated Disease
L. Levi, 1972
Physical
Physical Environment
Environment
Social
Social
Organization
Organization
Structure
Structure
and
and
Function
Function
Psychosocial
Stimuli
+
Psychobiological
program
Earlier
Environmental
influences
Mechanisms
e.g.
Stress
Precursors
of
disease
Genetic
factors
Interacting variables
Disease
To build for
promoting health
rather than preventing illness!
Pavilions planned in the green park of the city:
Access to the therapeutic benefits of nature.
Functionalism and the industrialisation of hospital planning
Industrial model: high
priority given to functional
efficiency, thereby
environmental qualities of
buildings that could
promote the health process
were largely neglected.
The large hospitals look like modern
industrial buildings and are presented as
factories for the production of Health care.
Hospital in Aachen,
Germany
Nucleus model
Montonous and institutional
MacMaster Hospital Ontario
Typical environment for patients in the 60s/70s
Meals industrially produced and sent on conveyer belts.
The pathogenic perspective of healthcare philosophy
From pathogenic perspective to salutogenic perspective,
Paradigm shift from risk factor to wellness factor.
Daylight and lighting as wellness factor
Interaction between form, color and light:
Architecture for senses, enjoyment, and admiration
Meals should be an
integral part of the
healing process
”Good eating habits”
to promote health
National goal for public health, Act 10
Example of good design for
high-tech environment with
no possible access to
daylight.
Art facilitates the healing process
Art contributes to the healing process and reduces the use of drugs!
”The new Hospital is old fashion! Tromsö- Norway
Hospital director; Knut S chröder
Tromsö Hospital
opened in 1991
The new proposal
In 1992
-Size of the ward
-Staff organization, care model
-Internal and external connection
-Sense of control
-Orientation
-Walking distances
-Other functions
Ward
Ambulatory care
Treatment,
surgery
Underground connection
Dining
lounge
Patient
Patient
Patient
Patient
Work station
Utility
room
Teaching
Patient
Patient
Patient
Patient
Examination/
treatment
Year 1998
Year 2014
Hospital with human dimension!
Norrtälja Hospital S tockholm
Design to catch the light
and foster health processes!
Typical ward:
24 patients
3 groups
Culture and Health
Place to relax and recover!
Music
and Health
Inviting entrance that foster a sense of control!
-Form, space
-Daylight
-Access to nature
-Harmony with music
-Sound of fountain, water
-Sense of orientation
-Reduce stress
Creating places for
”meeting” and ”Contemplation”
Creating square where people could meet easily
are an important way to increase the social support and to promote health.
Creating socially supportive environment; (National act for public health)
Place to ”meet” and place for ”contemplation”
”Place for social interaction and
networking”
The sound of
nature!
”Access to green areas for recreation”
National goal for public health, Act 6
Place for ”senses” and place for ”contemplation”
Access to green areas for contemplation
Being close to pets will
- increase physical activities
- increase social support
- provide contact among people
- prevent stress
- affect pulse, cortisol level,
- stimulate emotional development
for children
- create sense of control
Pets stimulate emotional development
Place for relaxation and thought!
Psychosocially
Supportive Design
Poetry and Proof
The Human
Experience
What does it cost to run a
Hospital?
ƒ Salaries 80%
ƒ Other costs 10%
ƒ Building 10% (counted as rent)
Cost of better design
ƒYearly costs:
ƒ running the hospital
100 units
ƒ costs of the building
10 units
ƒ planners and builder
1 unit
ƒ better Design
0,1 unit
ƒ Savings of better Design
5%
Poetry and Proof: Environmental Findings
Dr. Bruce Rabin, University of Pittsburgh, found surgery patient
recovering in rooms with ample natural light took less pain medication and
had drug costs 21% less than equally ill patients in darker rooms. (2004)
More Light Means Less Meds...
4.1
Dim Room
5.1
Total Stay
Day after Surgery
3.2
Sunny Room
3.7
0
1
2
3
4
5
6
Average Milligarams of Pain Reliver taken per hour by Surgery Patients
Swedish Cancer Center
NBBJ
Bunkers
Radiation Entry
Cancer Centre
Main
Entry
Skylights
Bunker Under
Construction
Entr y to Cancer Treatment Bunker
Cancer Treatment Bunker, Thunder Ba y Regional Health Sciences Centre
Inboard Toilet
Corridor
Staff
Family
Patient
Outboard Toilet
Staff
Corridor
Family
Patient
Corridor
Side-by-Side Toilet
Staff
Patient
Family
Solution
Corridor
Staff
Family
Patient
A) Activities within the working,
living, recreation
B) Environment of working,
Living, recreation
C) Contribution of healthcare
D) Genetical causes
Causes of Health
Psychosocially Supportive Design
B=20%
C=10%
A= 50%
D=20%
Ingemar Norling
Götenborg University
Actual Causes of Death, U.S. - 1990
Tobacco
300,000
Poor diet/lack of exercise
Alcohol
Infectious agents
Polluants/toxics
Firearms
Sexual behavior
Motor vehicles
Illicit drug use
0
40
0
36
0
32
0
28
0
24
0
20
0
16
0
00
0
00
0
00
0
00
0
00
0
00
0
00
0
00
0
00
0
00
0
12
80
40
0
Source: Mc Ginnis JM Foege WH. Actual causes of death in the United States,
JAMA 1993; 270:2207-12. (1990 data)
Preventive Healthcare
Biology 27% (6.9%)
Environment
19% (1.5%)
13 most
important
Causes of death
Healthcare 11% (90.6%)
Life-style 43% (1.2%)
% = Distribution of causes of death
(%) = Distribution of public budget
Dever, 1976
Hjort, 1984
Pre-Evaluation
Stage I
Design Process from idea to reality
Stages
Analysis and
Investigation of
activities, The vision
Master Plan
Decision
Stage II
Sketch proposal min. 3
Evaluation, time plan and
Investment program Analysis,
The main function program
Decision
Stage III
Executive design
construction building
in use
Decision
Post-Evaluation
The planning model
Viosione
L’Ospedale nel
Terzo Millennio
Co
Ev nti n
al uo
ua u
tio s
n
Long term
Changing Process
Result
Result
Result
Exsisting Problem
Ongoing activity