Health Benefits of Hospital Gardens, Indoor Gardens and Plants in Hospitals

INTRODUCTION

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.