The power of Nature in Healthcare Environments

Session Outline Introduction Research Evidence based design Post occupancy evaluations Design User group needs Garden program and details Case studies

We do more than parsley around the meatloaf

What is a Healing Garden? gardens that have a tendency to foster restoration from stress and have other positive influences on patients, visitors, and staff or caregivers. (Ulrich)

Nature is but another name for health... - Henry David Thoreau

What makes a garden Healing? Reduces Stress Elevates Immune System Better Response to Treatment Improved Medical Outcomes

Riverside Medical Center Kankakee, Illinois

Who benefits from a Healing Garden? Visitors Admin Staff Patients

Tabor Hills Naperville, Illinois

What are the economic benefits? Reduced cost of patient care Reduced cost of medical error Increased staff job satisfaction Less staff turnover Great marketing and public relation opportunities

Wings of Hope Garden Naperville, Illinois

Session Outline Introduction Research Evidence based design Post occupancy evaluations Design User group needs Garden program and details Case study Butterfly Garden on a Roof

What research has been done? Roger Ulrich, Ph.D. Professor of Architecture Center for Healthcare Building Research at Chalmers University of Technology in Sweden He is the most cited researcher internationally in evidence based design Adjunct Professor of Architecture Aalborg University in Denmark B.A., University of Michigan (Human/Behavioral Geography) MA, University of Michigan (Human/Behavioral Geography) Ph.D., University of Michigan (Economics)

What research has been done? Clare Cooper Marcus Professor Emeritus in the Department of Architecture and Landscape Architecture University of California, Berkeley B.A., University of London (Cultural and Historical Geography)) MA, University of Nebraska Urban Geography) MA, University of California, Berkeley City and Regional planning

What make a garden Healing? 1. Provides restoration of physical, psychological and emotional well being 2. Provides spaces to foster social support 3. Contains prominent amount of real nature (Plants, water, wildlife, nature sound) 4. Can be experienced actively or passively 5. Includes positive distractions voluntary and involuntary 6. Provides choices and challenges 7. Helps improve medical outcome Dr. Roger Ulrich Texas A&M University

Marianjoy Labyrinth Garden Wheaton, Illinois

Theory of Supportive Design Social Support Control Movement & Exercise Natural Distraction s Stress Restoration and Buffering Improved Health Outcomes Dr. Roger S. Ulrich Effects of Gardens on Health Outcomes. In Marcus, C. Healing Garden

View Through a Window May Influence Recovery from Surgery patients with a nature window view had shorter postsurgical hospital stays, tended to have fewer minor postsurgical complications, and required far less injections of potent narcotic pain drugs. Research study: Gall bladder surgery patients recovery

Evidence of negative patient responses to ambiguity acute emotional stress may make many patients vulnerable to detrimental, stressful reactions to certain abstract or ambiguous visual elements in art and design. Research study: Uppsala University Hospital in Sweden

Recent Studies of Note: Dr. Joann Westphal: Limited access to a garden for Alzheimer's patients. Gardening as a Mental Health Intervention: A Review Jane Clatworthy, Joe Hinds, and Paul Camic. Mental Health Review Journal (2013) 18(4), 214-225 The Benefits of Gardening for Older Adults: A Systematic Review of the Literature Donna Wang & Thalia Macmillan. Activities, Adaptation and Aging (2013) 37(2), 153-181 Comparing responses to horticultural-based and traditional activities in dementia care programs Jarrott, S.E & Christina M. Gigliotti, C.M (2010). American Journal of Alzheimer's Disease and Other Dementias 25(8) 657-665 Developing the therapeutic potential of embodied cognition and metaphors in nature-based therapy: Lessons from theory to practice Corazon, S.S., Schilhab, T.S.& Stigsdotter, U.K. Journal of Adventure Education and Outdoor Learning 11(2) 161-171

Recent Studies of Note: Horticultural therapy for patients with chronic musculoskeletal pain: Results of a pilot study Rra, M.L.,; Angst, F., Beck, T., Lehmann, S. Brioschi,R. Schneiter, R. & Aeschlimann, A. (2012). Alternative Therapies in Health & Medicine 18(2) 44-50 Nature-assisted therapy: Systematic review of controlled and observational studies Annerstedt, M. & Wahrborg, P. (2011). Scandinavian Journal of Public Health 39, 371-388 Primary-care based participatory rehabilitation: Users' views of a horticultural and arts project Barley, E.A., Robinson, S. & Sikorski, J. (2012). British Journal of General Practice 62(595) 127-34 The psychological benefits of indoor plants: A critical review of the experimental literature Bringslimark, T., Hartig, T. & Patil, G.G. (2009). Journal of Environmental Psychology 29(4) 422-433 Therapeutic gardens and horticultural therapy: Growing roles in health care Horowitz, S.(2012). Alternative & Complementary Therapies 18(2) 78-83

Session Outline Introduction Research Evidence based design Post occupancy evaluations Design User group needs Garden program and details Case study Butterfly Garden on a Roof

Serenity Garden Restorative Garden Sensory Garden Spiritual Garden Memorial Garden Respite Garden Contemplation Garden Therapeutic Garden Enabling Garden Veteran Garden Meditation Garden Healing Garden Hospice Garden Universal Design Rehabilitation Garden Memory Support Garden Cancer Garden Labyrinth Garden Wander Garden Types of Healing Gardens

Applications User Groups Hospitals Outpatient Centers Senior Living Communities Others? Patients* Visitors Staff... * There is a wide range of patient types, each with specific needs

Micro Vs Macro Sherman Hospital Replacement Facility

Friendship Village Schaumburg, Illinois

Incorporating Universal Design in Healing Gardens

Edward Heart Hospital Naperville, Illinois

Social Support

Control

Movement & Exercise

Natural Distractions

Natural Distractions Positive or negative?

Infection control in Healthcare Environments

Healing Garden Characteristics Flexible spaces * Programmed activities Improved accessibility Well defined perimeters Recognizable place making Choices and challenges Positive distractions Public and private areas Lush plantings Seasonal interest * Recognizable/familiar features Generous walkways Tinted pavement * Sense of mystery and discovery Unambiguous design elements Protection from elements Moveable furniture Elements that engage the senses * Landmarks and destinations Distinguishable wayfinding Indoor and outdoor relationships Transition from indoors * * Examples shown on next slide

Flexible space Seasonal interest Engaging the senses Tinted pavement Transition from indoors Moveable furniture

Hope Children s Hospital Oak Lawn, Illinois

Things to Avoid Poisonous plants Busy paving patterns Rigid, rectilinear forms No access to shade Ambiguous art Busy shadow patterns

Original dropoff layout Revised dropoff layout Hope Children s Hospital Oak Lawn, Illinois

Hope Children s Hospital Oak Lawn, Illinois

Session Outline Introduction Research Evidence based design Post occupancy evaluations Design User group needs Garden program and details Case study Butterfly Garden on a Roof

Butterfly Garden on a Roof

Before

After

St. Patrick s Residence

OSF Milestone Building Design by CANNONDESIGN

Existing Conditions Notice window reflection on EDPM liner

Existing Conditions Life flight issues

THE PLAN Buffers, accessible area limited to 100 from the exit, avoid life flight path

THE PLAN

Light Weight Materials Craned and hoisted into position, set on shims to level

Finished work Notice gravel strip next to building

Finished work Ipe decking, GFRC walls, metal shade trellis

Finished work Integrated light and bench

Finished work Dedication

Design Central Baptist Village

Perspective rendering

Finished work

Design

(almost) Finished work

Thank You!