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This paper selectively reviews scientific research on the health benefits and influences of hospital gardens and indoor gardens and plants in hospitals and other healthcare settings.Article Reference: Green Plants for Green Buildings ArchiveBy: Roger S. Ulrich, Ph.D., Center for Health Systems and Design, Texas AM University
The discussion in this paper concentrates mainly on health benefits that patients realize by simply looking at indoor gardens and plants, or in other ways passively experiencing hospital gardens or other healthcare surroundings where plants are prominent.
The review also briefly addresses other advantages of gardens and plants in hospitals, such as lowering the costs of delivering healthcare and improving staff satisfaction.
It might be asked at the outset: why is worthwhile to focus exclusively on gardens or a landscape located in hospitals and other healthcare facilities? One important reason is linked to the fact that extraordinary amounts of money are spent internationally for construction of healthcare environments. This funding for hospitals potentially represents a major source of resources for gardens, plants, and related features such as atriums. Consider the example of only one large medical complex in the United States, the Texas Medical Center in Houston, which plans to spend about $1.8 billion on new construction during the next two years. In the State of California alone, new spending for hospital buildings will be upwards of $14 billion by 2010. Even individual buildings can be extremely costly -- Northwestern University’s recently opened main hospital in Chicago cost $687 million. Spending in the United States for new hospitals has averaged about $15 billion annually during the last decade. The United Kingdom plans to spend at least $4 billion on new hospital construction within the next three years or so. When substantial additional spending is considered for the many other types of healthcare environments -- for
example, nursing homes, primary care clinics, rehabilitation facilities -- it becomes even
clearer that healthcare design and construction directly accounts for vast amounts of
money. This reality implies great opportunities for funding and creating new indoor gardens to enrich and improve the lives of patients and the environments of hundreds, if not
thousands, of existing medical facilities.
Background: Gardens and Hospital Design
The belief that plants and gardens are beneficial for patients in healthcare
environments is more than one thousand years old, and appears prominently in Asian and
Western cultures (Ulrich and Parsons, 1992). During the Middle Ages in Europe, for
example, monasteries created elaborate gardens to bring pleasant, soothing distraction to
the ill (Gierlach-Spriggs et al., 1998). European and American hospitals in the 1800s
commonly contained gardens and plants as prominent features (Nightingale, 1860).
Gardens became less prevalent in hospitals during the early decades of the 1900s,
however, as major advances in medical science caused hospital administrators and
architects to concentrate on creating healthcare buildings that would reduce infection risk
and serve as functionally efficient settings for new medical technology. The strong
emphasis on infection reduction, together with the priority given to functional efficiency,
shaped the design of hundreds of major hospitals internationally -- that are now
considered starkly institutional, unacceptably stressful, and unsuited to the emotional
needs of patients, their families, and even healthcare staff (Ulrich, 1991; Horsburgh,
1995). Despite the intense stress often caused by illness, pain, and traumatic hospital
experiences, little attention was given to creating environments that would calm patients
or otherwise address emotional needs (Ulrich, 2001).
A growing awareness has developed in recent years in the healthcare community
of the need to create functionally efficient and hygienic environments that also have
pleasant, stress reducing characteristics. An important impetus for this awareness has
been the major progress achieved in mind-body medical science. A substantial body of
research has now demonstrated that stress and psychosocial factors can significantly
affect patient health outcomes. This knowledge strongly implies that the psychological or
emotional needs of patients be given high priority along with traditional concerns,
including infection risk exposure and functional efficiency, in governing the design of
hospitals (Ulrich, 2001). It also follows that conditions or experiences shown by medical
researchers to be stress reducing and healthful, such as pleasant soothing distractions and
social support, must become important considerations in creating new healthcare
facilities. The fact that there is limited but growing scientific evidence that viewing
gardens and garden decor can measurably reduce patient stress and improve health outcomes has been a key factor in the major resurgence in interest internationally in providing gardens in hospitals and other healthcare facilities.
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