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Hospital development team considers patient needs

In an age in which more holistic approaches to medicine are being normalized, new research is being devoted to the effects of physical hospital environments on patients’ recovery. During a panel discussion offered by Café Scientifique on October 29, entitled “Healing by Design,” three members of the McGill University Health Centre (MUHC) Redevelopment Project led a discussion on health care design and the uses of hospital space.

Robert Hamilton, an associate architect at Lemay Associés Architecture-Design and member of design and management teams for the MUHC Redevelopment Project, spoke of a need to go back to basics when designing hospitals.

“We’re bombarded by complexity and knowledge, but our objective is to be simple [and] healthy,” Hamilton said.

The two other panelists – Imma Franco, senior planner for the MUHC, and Micheline Ste-Marie, pediatric gastroenterologist and associate director of Professional Services at the Montreal Children’s Hospital – both emphasized patient-centred directives.

“It’s really about people,” Franco said. “People are coming to facilities who are not well…so the environment has to alleviate some of that concern and stress.”

To improve on this, patient choices and preferences are continually being incorporated into hospital planning. Franco assured the audience that patient representatives have been involved in MUHC’s redevelopment project from the initial planning stages, conducting surveys to better understand a patient’s perspective. She also emphasized that different patient populations have different priorities.

“One of our challenges is to bring together multiple populations. We have children and their families, we have elderly [patients], we have mothers who are delivering, so we have a variety of clientele,” Franco said.

Ste-Marie used the example of a hospital survey conducted in Victoria, British Columbia that showed patients ranked a window in their room looking out onto the corridor as the most important environmental feature.

“When you’re a patient and you’re vulnerable, you just want to know where your caregiver is and how to reach him or her,” Franco said.

One audience member, an acoustical consultant, brought up the effect of noise on patient healing. He cited the work of a Swedish doctor who installed sound-proof ceiling tiles in his ward, and reported a 40 per cent decrease in average time spent in the ward, as well as fewer patient relapses. The audience member urged the panel to take this information into consideration, suggesting that noise – which is often overwhelming in hospitals, especially in urban areas – clearly affects patient well-being and recovery.

Hamilton agreed that this is an important issue: “The acoustic environment gets underrated and gets undersold so often, and not just in hospitals. It has a very important influence on the way you feel, and in health care settings, how you heal.”

In addition to these features, hospitals also need to be constructed with possible future needs in mind.

Montreal’s hospitals are aging and health care is changing – issues that must be addressed. Hamilton pointed to a need for generic spaces that serve a variety of uses, ensuring that hospitals are structurally built to accommodate future architectural change, and creating so-called “soft-spaces” that can be easily transformed if need be.

“There are a lot of strategies to make a building more flexible…. In health care, like in other fields, the degree of change is important,” Hamilton said.

Montreal hospitals have been transforming over the years and will continue to change. In the fifties, for example, many more patient beds took up space in hospitals, and much of that space has since been transformed into clinics and treatment areas.

In addition to the structural space that surrounds the patient, healing by design includes the safety of the hospital hallways, resources and space for patient family members, soothing colour schemes, and accessibility of hospital staff.

In the end, hospitals must cater to their patients. The health care setting should be a calm and relaxing environment that helps patients recover.

“[Our goal] is to synthesize all those requirements so at the end of the day, you have a place at which you can feel whole,” Hamilton said.