Rhonda Kerr, Ruby Lipson-Smith, Aaron Davis, Marcus White, Mark Lam, Julie Bernhardt, Juan Pablo Saa, Tianyi Yang
{"title":"Economic Argument for Innovative Design From Valuing Patient-Centered Stroke Rehabilitation.","authors":"Rhonda Kerr, Ruby Lipson-Smith, Aaron Davis, Marcus White, Mark Lam, Julie Bernhardt, Juan Pablo Saa, Tianyi Yang","doi":"10.1177/19375867251327987","DOIUrl":"10.1177/19375867251327987","url":null,"abstract":"<p><p><b>Purpose:</b> This study examines the economic benefits of innovative design in a hospital ward with the capital and operational costs and societal and government benefits. <b>Background:</b> An economic view of health care delivery options considers both the costs and benefits of an intervention for the economy, funders, and patients. Previous studies have focused on the financial costs of capital as an asset class for hospital development. <b>Methods:</b> Four hypothetical stroke rehabilitation units were designed within a larger Living Labs program (the NOVELL project). A standard stroke rehabilitation hospital ward design was compared to three alternative designs. The alternative designs expanded areas for therapy, social engagement, communal activities, and staff wellbeing, included activated corridors and enabled access to outdoor and recreational areas based on clinical evidence and expert advice. <b>Results:</b> The alternative designs are predicted to achieve A$3.3 million in savings annually for rehabilitation ward operational costs (a saving of 26%). Economy-wide benefits from the alternative designs are estimated to be A$12 million plus savings to government of between A$3.93 million and A$5.4 million per ward per annum. <b>Conclusions:</b> Adoption of innovation in design, clinical practice and evidence identification has the capacity to improve clinical effectiveness and patient outcomes. Economy wide benefits and cost improvements for health funders from the adoption of innovative design have been identified through micro- and macro-economic evaluation.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"95-113"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth A Johnson, Tess Carr, Julie Alexander-Ruff, Kaitlyn Benner, Jordan Zignego, Bernadette McCrory
{"title":"The Design Utility of Rural Hospital Community Health Needs Assessments.","authors":"Elizabeth A Johnson, Tess Carr, Julie Alexander-Ruff, Kaitlyn Benner, Jordan Zignego, Bernadette McCrory","doi":"10.1177/19375867251343905","DOIUrl":"10.1177/19375867251343905","url":null,"abstract":"<p><p><b>Objective:</b> A secondary analysis of community health needs assessment data was used to determine access and barriers to primary, specialty and hospital-based care in a rural, frontier-designated Montana critical access hospital (CAH) to establish alignment between the physical healthcare facility infrastructure design approach and community healthcare service needs. <b>Background:</b> The lack of physical infrastructure and integrated equipment/technological resources in CAHs can be a contributing factor in closures when means are absent to be responsive to the needs of an ageing population, updated technology, and heightened acuity level of care. <b>Method:</b> Inferential and predictive analyses of a cross-sectional survey was used to understand the care access based on the community members demographics as well as perceptions of their personal health, the community's health, knowledge of health services, and insurance coverage. <b>Results:</b> Important associations and predictors for the use of primary, hospital-based and specialty care among the rural residents were positive perceptions of health of themselves and their community (60%+) and good to excellent insurance coverage (70%+). Predictive decision tree modeling determined notable variation in access and use of specialty care and current employment status. These results indicate most respondents did not delay care due to transportation, distance, childcare or work. Insurance coverage and its cost were critical in accessing all types of care but especially specialty care. <b>Conclusions:</b> Community health needs assessments are conducted to retain tax status for CAHs, and as such are available sources of stakeholder perspectives that may expedite design approaches and strategic planning.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"125-145"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Human-Building-Technology Interactions in Healthcare Environments: A Guiding Analytical Framework Based on Mediation Theory.","authors":"Jodi Sturge, Wouter Eggink, Omar Martinez Gasca, Geke Ludden, Margo Annemans","doi":"10.1177/19375867251332642","DOIUrl":"10.1177/19375867251332642","url":null,"abstract":"<p><p><b>Objective:</b> There is a need for a more theoretical understanding of human behavior to inform the decision-making related to how technology should be integrated into healthcare environments. <b>Background:</b> Healthcare systems are transforming with more technology embedded within the built environment of healthcare facilities. The placement of these technologies, however, only sometimes considers the needs or workflow of patients, visitors or staff. Despite similarities, evidence-based design, smart building design and human-building interaction research rarely intersect. However, each relies on multi-disciplinary insights to enhance these fields. In this paper, we contextualize human-building interaction with building technology through an analytical framework inspired by mediation theory. <b>Methods:</b> Based on five case examples from previous studies and site visits, we present the interaction and explain how mediation theory provides insight into the interaction. <b>Results and Conclusions:</b> Looking at human-building technology interaction from the lens of mediation theory, it is apparent that the specific decisions taken in spatial and technological design impact the behaviors of building occupants. This paper provides examples of how technology in healthcare environments is used unintendedly, resulting in adapting the use to meet the user's needs. Mediation theory provides a framework to contextualize such encounters which will allow researchers to anticipate user needs and avoid disruptive building technologies in the future.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"198-212"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Understanding the Influence of Window Views, Plantscapes, and Green Décor in Virtual Reality Hospital Rooms on Simulated Acute-Care Patients' Stress Recovery and Relaxation Responses.","authors":"Courtney Suess, Jay Maddock","doi":"10.1177/19375867251344626","DOIUrl":"10.1177/19375867251344626","url":null,"abstract":"<p><p>Window views, indoor plants, and room décor can potentially improve restoration and healing in a hospital room environment. Preferences for these attributes and their individual effect on physiological and cognitive outcomes remain understudied. This study investigated the extent to which visible green nature in window views, plantscapes, and green colored decor in virtual reality hospital rooms, affected restoration outcomes of simulated acute care patients. First, 12 room environments were developed in virtual reality where window views, plants, and green-colored room decor variables relevant to Stress Recovery Theory were systematically manipulated. Next, participants in a simulated patient acute-injury scenario (<i>N</i> = 188), which induced an external stress process, rated the environments on how much they perceived the room contributed to their sense of feeling relaxed and ability to clear their mind of stressful thoughts. Ratings for each environment were aggregated and used in full-profile and moderated conjoint analyses. Indoor plants produced the highest utility score on <i>physical relaxation</i>, while nature window views had the highest utility score for <i>mental clarity</i>. Utility scores for indoor plants were significantly higher on physical relaxation and mental clarity for the respondents with higher scores of acute cognitive stress, induced from the external stressor process. The verdant elements (e.g., green nature views, indoor plants, and green room décor) were associated with the highest restorative utility. Buildings obstructing nature views were associated with negative utility scores on the restoration outcomes. Findings highlight the individual and combined effects of: (1) indoor plants; (2) unobstructed views from the window of green nature; and, (3) green-colored décor in hospital room design.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"165-183"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saman Jamshidi, Seyedehnastaran Hashemi, Dieu-My T Tran
{"title":"Costs and Effects of Ineffective Wayfinding in US Hospitals: A Survey of Hospital Staff.","authors":"Saman Jamshidi, Seyedehnastaran Hashemi, Dieu-My T Tran","doi":"10.1177/19375867251317240","DOIUrl":"10.1177/19375867251317240","url":null,"abstract":"<p><p><b>Purpose:</b> This article assesses the magnitude and impact of wayfinding problems in US hospitals as perceived by staff. <b>Background:</b> Problematic wayfinding in healthcare facilities is a persistent issue, leading to frustration, stress, fatigue, physical aggression, wasted time, and a negative organizational image. Despite anecdotal evidence, few studies have quantified the impacts of wayfinding problems. <b>Methods:</b> This descriptive cross-sectional study used an online questionnaire to gather data from hospital staff in the United States. The questionnaire targeted (1) wayfinding for hospital staff, (2) wayfinding for hospital visitors, (3) the impact of wayfinding problems on staff, and (4) the importance of addressing wayfinding problems. Data from 301 questionnaires were analyzed using descriptive and nonparametric statistics. <b>Results:</b> Staff found it easy to navigate their own departments but more difficult to navigate other departments. Staff's responses indicated that wayfinding was relatively difficult for visitors. Each staff member spent about 30 min per week on helping others with wayfinding. The five locations in which users needed the most assistance were the cafeteria, restrooms, elevators, exits, and main lobby. Staff commonly escorted people to a point from which they could independently reach their destination. Wayfinding difficulties could distract staff from their main duties and cause frustration. Nearly 44% of the participants experienced incivility from users who had become frustrated by wayfinding problems. Participants rated addressing wayfinding problems as very important. <b>Conclusions:</b> Despite the extensive literature on the environmental factors that influence wayfinding, this study finds that hospital visitors in the United States still struggle with wayfinding, which indicates a potential gap between design research and practice.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"463-479"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Salutogenic Architecture, Non-Therapeutic Environments and the Health of the Elderly: A Systematic Review.","authors":"Zohre Rakhshani, Mehdi Khakzand","doi":"10.1177/19375867251313980","DOIUrl":"10.1177/19375867251313980","url":null,"abstract":"<p><p><b>Background:</b> Despite a lot of studies that have been conducted on the effects of the built environment on the health of the elderly and environmental salutogenic factors, a limited number of studies have investigated the architectural physical factors clearly. <b>Purpose and Aim:</b> This paper investigated the architectural elements in the non-therapeutic built environment that can achieve salutogenic goals for the elderly. It also aimed to provide an answer to the question of how architectural design might be used to physically bring salutogenic theory to life. <b>Method:</b> In this review study, data were collected systematically using the PRISMA checklist. The three lists of keywords used for the initial search were \"built environment\" or \"architecture,\" \"elderly,\" and \"health,\" and were supplemented with synonyms for a second search in four databases: Scopus, Science Direct, Web of Science, and PubMed, in the period from 2000 to 2024. By applying inclusion and exclusion criteria, 26 articles were selected for review and data extraction. The data were then qualitatively analyzed, and two reviewers independently verified the analysis. <b>Conclusions:</b> This study found that architectural elements can be salutogenic by supporting the comprehensibility, manageability, and meaningfulness. Porches, Stoop, above-grade entrances, and balconies are key elements in the home that support the sense of coherence. In assisted living facilities, walls were recognized as the only physical factor supporting the sense of coherence due to the creation of a personal, distinct, meaningful, comprehensible, and manageable space.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"255-281"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Daylighting and Patients' Access to View Assessment in the Palestinian Hospitals' ICUs.","authors":"Deema Amleh, Abdelrahman Halawani, Muhannad Haj Hussein, Laith Alamlih","doi":"10.1177/19375867251317242","DOIUrl":"10.1177/19375867251317242","url":null,"abstract":"<p><p>Daylight and access to a view out are vital factors in improving patients' wellness, side by side healthcare providers' satisfaction and productivity in intensive care units (ICUs). Unfortunately, insufficient attention was paid to this issue in Palestine resulting in many ICU designs lacking the required daylight and access to view, which, in turn, negatively affects patients' wellness, increasing delirium incidence and sleep disorders. This study aims to assess the Palestinian hospitals' ICUs in terms of daylight and patients' access to view by conducting daylight measurements and field observations. The results show that the available ICU designs in Palestine do not provide adequate daylight and access to view for patients.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"425-446"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Design-Driven Approach Exploring Therapeutic Building-Nature Integration Strategies in Healthcare.","authors":"Liheng Zhu, Dan Hu, Sarah Javed Shah, Xiao Hu","doi":"10.1177/19375867251313990","DOIUrl":"10.1177/19375867251313990","url":null,"abstract":"<p><p><b>Objectives:</b> This paper focuses on the three representative hospital projects conceived by Herzog & de Meuron, which transcend the conventional function of healing facilities by embracing a holistic conception of care. Through a thorough examination, complemented by illustrative drawings, it delves into the design strategies that set these projects apart from conventional practices observed in general hospital settings. <b>Background:</b> In response to the rising concerns about environmental sustainability and human well-being, architects, urban planners, and landscape designers are beginning to realize how crucial it is to use \"natural\" components in design. Particularly in healthcare institutions, carefully designed healing gardens like courtyards, with their appropriate spatial arrangement and material composition method, aim for high-quality spaces to promote health and well-being. <b>Methodology:</b> A qualitative study was conducted through design-driven evaluation, with photographic documentation, drawings, and sketches to show how these designs achieve therapeutic integration. The strategies were thoroughly analyzed from three main perspectives: context and space, garden and building, and material and environment. <b>Results:</b> The investigation demonstrates that key design elements for improving the healing effect of hospitals include nature integration, spatial sequence, daylight exposure, and material composition. Specifically, it involves incorporating nature through courtyards, allowing daylight to enter indoor spaces, using clear architectural markers for easy wayfinding, and applying tactile timber finishes both inside and outside the building. <b>Conclusions:</b> The research highlights significant strategies and approaches that establish a framework for designers and decision-makers to assess hospital health promotion aspects to guide future design projects.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"282-300"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Do Green Spaces Mitigate Mental Health Disorders in Tehran? Evidence from 358 Neighborhoods.","authors":"Mojtaba Shahabi Shahmiri, Pouria Boujari, Zeynab Sadat Fazeli Dehkordi, Seyed Mahdi Khatami","doi":"10.1177/19375867241304004","DOIUrl":"10.1177/19375867241304004","url":null,"abstract":"<p><p>BackgroundWith a prevalence of mental disorders affecting 18 out of every 100 Iranians and a rising urban population, it is crucial to examine the impact of built environments on people's well-being.ObjectiveWhile some studies have conducted individual-level surveys in Iran, this research aims to investigate the potential impact of green spaces on mental health at the neighborhood level in Tehran.MethodUsing secondary data from 358 neighborhoods in Tehran in 2011, a linear regression analysis was conducted to investigate the correlation between four green space indicators and three mental health metrics.ResultsThe results indicate that green space indicators have the potential to mitigate mental disorders in Tehran, with accessibility to green spaces emerging as the most impactful factor among those studied on mental disorders and anxiety. However, no significant association was found with depression when considering intervening variables. The study also found that other green space indicators, such as the ratio of green space in neighborhoods and satisfaction with green spaces, did not show significant effects, underscoring the importance of accessibility over size or quantity of green spaces per person. Additionally, our findings suggest that higher levels of unemployment in neighborhoods have a more pronounced impact on mental disorders among sociodemographic factors.ConclusionUrban planners and designers should prioritize equitable access to green spaces within neighborhoods, rather than focusing solely on size or per capita availability. Additionally, policymakers should recognize that addressing both environmental and socioeconomic factors-rather than just one-can effectively alleviate residents' mental health issues.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"480-497"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oystein Tronstad, Irene Szollosi, Dylan Flaws, Barbara Zangerl, John F Fraser
{"title":"Are ICU Bedspaces Based in Evidence, and Do They Support Patient Sleep? A Narrative Review.","authors":"Oystein Tronstad, Irene Szollosi, Dylan Flaws, Barbara Zangerl, John F Fraser","doi":"10.1177/19375867251317239","DOIUrl":"10.1177/19375867251317239","url":null,"abstract":"<p><p><b>Objective:</b> This narrative review summarizes some of the evidence guiding current intensive care unit (ICU) design, focussing on environmental factors impacting on sleep, and compares available evidence and recommendations to current ICU designs and builds. <b>Background:</b> The importance of sleep for recovery after illness is well known. However, hospitalized patients frequently experience poor and disrupted sleep. This is especially true for patients admitted to the ICU. There are many factors negatively impacting on ICU patients' ability to sleep. Some relate to their illness or pre-existing sleep problems; others relate to patient care activities. While the ICU bedspace may facilitate 24h care, there is growing awareness of the detrimental impact the bedspace environment (especially suboptimal lighting and excessive sound/noise) has on sleep quality, and important questions raised regarding how this may impact on recovery and health outcomes. Multiple guidelines and recommendations exist to guide ICU bedspace design. However, questions have been raised whether contemporary ICUs are evidence-based, and whether the available evidence is effectively translated into the built ICU. <b>Methods:</b> A comprehensive literature review was conducted, exploring the evidence supporting current ICU bedspace design and the impact of ICU design and environmental factors on patient sleep. <b>Results and conclusion:</b> This review summarizes the impact of the ICU bedspace environment on patient outcomes and describes features of the ICU bedspace design that may not adhere to best evidence and contribute to poor sleep. Suggestions on how ICU bedspaces can be improved to optimize sleep are provided.</p>","PeriodicalId":47306,"journal":{"name":"Herd-Health Environments Research & Design Journal","volume":" ","pages":"397-411"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}