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How good building design can help people heal, learn and reform

March 07, 2017

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From prisons to schools to public housing and hospitals, there is a growing body of research suggesting that space, light, color, noise control and natural views can dramatically shape how an institution helps people learn, heal, reform or simply live.

Traditional, poorly conceived hospital designs are making people sicker than they need to be, argues a prominent physician in a recent op-ed for The New York Times, which addresses a wide range of reforms that he argues could save money and lives in hospitals.

"But as hard as it might be for doctors to rest in the hospital, it’s infinitely harder for patients," wrote Dr. Dhruv Khullar, a resident physician at Massachusetts General Hospital and Harvard Medical School.

Khullar argued that more conscientious design could produce better patient outcomes, ranging from privacy and noise to the arrangement of bathroom facilities to the view out the window.

"Even just images of nature may be beneficial," Khullar noted, pointing to research showing that "psychiatric patients tend to require far fewer medications for anxiety and agitation when photos of landscapes hang on hospital walls compared to walls adorned with abstract art or left bare."

In his critique of hospitals, Khullar cited a variety of design changes that could reduce serious falls, but he also points to noise and privacy as overlooked concerns that can have serious repercussions.

Some of these findings are counterintuitive. For instance, one study suggested that bacterial infections that result from sharing hospital rooms may result in higher costs, through secondary illnesses, than if hospitals placed patients in private rooms.

And related research has found that bipolar patients needed less time in the hospital if they had natural morning sunlight and other studies showed that images of nature or watching videos of nature could have similar effects.

What's true of healing in hospitals appears to also be true of learning in schools. Last year, researchers at the University of Illinois did a study assigning students to rooms with either a natural view or a barren view and tested their performance on a series of academic skills.

"The results are striking," the Deseret News reported, "While students were focused on the work, there was no difference in performance. But students with the green view rooms showed a 17 percent increase in attention performance after the break, while those in the barren view and windowless rooms gained no benefit from the break at all."

“If you take a dose of Ritalin, you’d expect to increase your performance on the type of test we did by 15 to 20 percent,” said Bill Sullivan, one of the researchers. “So a 10-minute break with a window with a green view was equivalent to taking a potent attention deficit disorder drug.”

Sullivan has done similar work demonstrating that children in Chicago public housing projects did better on attention, impulse control and delayed gratification tests than those in barren-view apartments.

A South Korean study published last year found not only that lighting mattered in school performance, but also that different types of light on the "warm to cool" Kelvin scale were better for different activities.

"The researchers concluded that the 3500 K warm lighting may provide a relaxing environment to support recess activities," the Huffington Post reported, "whereas the 5000 K 'standard' lighting may be applied for reading activities, and 6500 K dynamic lighting supports students’ performance during intensive academic activities."

Similar work is being done on the reform of prisoners, with growing evidence suggesting that prisoners offered something as simple as nature videos are less likely to require discipline.

This month, the Deseret News examined new directions in prison design and management. "The radical theory of the new prisons," The Deseret News reported, "is that inmates who live in a normal environment adjust more quickly to normal life upon release. It begins with architecture — including the experiences of light, sound, color, better noise control and more natural views in yards and through windows."


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