Therapeutic Design is the concept of introducing inspiring designs and landscapes in order to improve the well-being and behavioral feelings of visitors and occupants. In healthcare design, therapeutic design can be used in a variety of areas including interior and exterior applications. For exterior applications, therapeutic design is synonymous with gardens and beautiful landscaping. For interior applications, different color patterns, textures, and shapes can be used to enhance the environment along with a variety of other interior design concepts.

According to the Whole Building Design Guide, healthcare facilities are designed not only to support and facilitate state-of-the-art medicine and technology, patient safety, and quality patient care, but to also embrace the patient, family, and caregivers in a psycho-socially supportive therapeutic environment. The characteristics of the physical environment in which a patient receives care affects patient outcomes, patient satisfaction, patient safety, staff efficiency, staff satisfaction, and organizational outcomes. The effects can be positive or negative. No environment is neutral.

A healthcare environment is therapeutic when it does all of the following:

• Supports clinical excellence in the treatment of the physical body
• Supports the psycho-social and spiritual needs of the patient, family, and staff
• Produces measurable positive effects on patients’ clinical outcomes and staff effectiveness

The Theory of Therapeutic Design:

Therapeutic Environment theory stems from the fields of environmental psychology (the psycho-social effects of environment), psychoneuroimmunology (the effects of environment on the immune system), and neuroscience (how the brain perceives architecture). Patients in a healthcare facility are often fearful and uncertain about their health, their safety, and their isolation from normal social relationships. The large, complex environment of a typical hospital further contributes to the stressful situation. Stress can cause a person’s immune system to be suppressed, and can dampen a person’s emotional and spiritual resources, impeding recovery and healing.

Healthcare architects, interior designers, and researchers have identified four key factors which, if applied in the design of a healthcare environment, can measurably improve patient outcomes:

• Reduce or eliminate environmental stressors
• Provide positive distractions
• Enable social support
• Give a sense of control

Research on completed projects by organizations including the Center for Health Design, Texas A&M University’s Center for Health Systems Design, the Academy of Neuroscience for Architecture, and by a growing number of architectural firms and their clients shows measurable benefits to patient outcomes, safety, and quality of care, from such factors.

The application of these factors has been focused on the patient and patient’s family. However, there are also recognized potential benefits for staff and caregivers in terms of satisfaction, effectiveness, and staff retention, from environmental factors such as:

• Noise reduction
• Same-handed patient rooms
• Access to daylight
• Appropriate lighting
• Providing ‘off-stage’ areas for respite
• Proximity to other staff
• Appropriate use of technology
• Decentralized observation, supplies, and charting

The benefits staff receive from these environmental factors may impact the quality of care patients experience. (For more information on design of effective workplaces, see WBDG Productive Branch.)

In general, Therapeutic Environments have been proven to be cost-effective by improving patient outcomes, reducing length of stay, and by enhancing staff satisfaction, recruitment, and retention of staff.

Ideas to Incorporate Therapeutic Design:

• Artwork and aesthetics can enhance the soothing and calming qualities of a space
• Adequate space should be provided in public areas and waiting rooms to avoid crowding
• Visual and noise privacy
• Wayfinding; the built environment should provide clear visual cues to orient patients and families, and guide them to their destination and return. Landscaping, building elements, daylight, color, texture, and pattern should all give cues, as well as artwork and signage
• Reduce or eliminate sources of noise; other patients, public address systems, equipment ‘clatter’, loud conversations at nurse stations
• Acoustical treatment of corridors adjacent to patient rooms; carpet tiles, rubber flooring
• Acoustical separation of staff work areas from patient rooms; “even low noise levels (40-58 dB) combined with poor acoustics can reduce sleep quality and negatively affect other outcomes” (Roger Ulrich, Ph.D., Healing Environments Virtual Seminar, AIA, 2003)
• Appropriate lighting systems; “lighting can be a stressor that alters mood, increases stress, disrupts daily rhythms, and modulates hormone production” (J. Roberts, Ph.D.)
• Provide lighting that supports natural circadian rhythm; “Provide natural daylighting where possible, or bright white lights (400-600nm) in the daytime. Ensure absolute darkness in the evening; for nighttime movement only red lights (650-700nm) should be present in the rooms.” (J. Roberts, Ph.D.)
• Maintain good indoor air quality; 100% outside air where climatic conditions allow
• Color, while subjective, can be a design factor in reducing environmental stress when understood and used in the context of the color preferences of a project-specific population.

How VISTAMATIC Privacy Glass is Inspired by Therapeutic Design

Due to the customizable nature of the VISTAMATIC Privacy Glass Vision Panel, all privacy glass vision panels incorporate the ability to showcase art. Any licensed or royalty-free artwork can be applied to virtually any panel. Used with a transparent sand-blasted vinyl, the artwork is visible from both sides.

In addition to the benefits of using artwork, the privacy glass vision panel’s core functionality is privacy, therefore, you can still open and close the panel for privacy or observation. In the closed position, the artwork is complete and in the open position you can see through the alternating, clear lines into the room or space.

To create a therapeutic environment, all members of the design team—medical planner, architect, engineer, interior designer, site and landscape designer,—are responsible for using the power of design to find solutions that will affect the patients and staff in positive ways, throughout the facility; from the parking lot, approach, and entry, to the public spaces, clinical spaces, and ultimately the patient room.