Biophilic
Hospital Room
Client
Hypothetical hospital open to complimentary healing
Location
Troy, NY
Year
2019
Services
Problem Definition,
Human Centered Design,
User Experience Design, Prototyping
For my senior design project, I chose to work on a passion project; the problem of the negative patient experience common at hospitals. I narrowed this problem down further to address the experience in the patient's room. The modern day hospital is cold in aesthetics, very specialized in pharmaceuticals, and not so patient friendly. Taking a human-centered design approach, I conducted interviews, prototyped solutions, held user testing, did lots of research, carried out surveys, and received feedback from my peers. All of this resulted in the design of a new inpatient room using the principles of biophilic design. This design is not only aesthetically pleasing for the patient, but the design inherently helps the patient to heal more quickly (based on a study done comparing the use of biophilic design verses without it).
Process
For this project, I used an iterative design process called the GADIE process. GADIE stands for goals, analysis, design, implementation, and evaluation. This process is very vague and flexible, allowing me to customize it how I see fit, while still acting as a guideline. Although this website is presented linearly, each milestone I talk about (i.e. choosing a project focus, user research, prototyping, etc.) fits into the GADIE process. As you'll notice, sometimes I follow the GADIE order, and sometimes I skip steps, or go back a couple steps.
g.a.d.i.e.
Goals
An in-class exercise to find a focus made me think about myself, my passions, skills I have or want to develop, and what I think the world needs right now. After writing all of this down I chose an topic I wanted to pursue; sustainability and the medical system. I thought about how the local community interacts with sustainability and the medical system. I came up with ideas for problems to explore on campus, in Troy (where I went to school), and on a global scale. I got a chance to talk to my class and professor about my ideas and in return I got feedback, connections, and resources to check out.
Choosing a focus
Analysis
Identifying Potential Stakeholders
The next step was to identify stakeholders in the community and larger systems related to the topic of sustainability and the medical system, Some stakeholders in the community I identified included doctors, nurses, and patients. I thought about other organizations that may have an interest in the intersection of sustainability and the medical field. I thought of the Living Building Challenge, Architects, a masters program offered through my college, called Built Ecologies, as well as insurance companies, and the medical system in the US.
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Ethnography
Throughout my four years as a design student, I drove home once a month to go to my local hospital for medical treatment. During my time in the hospital, I noticed that the only thing I liked about the hospital, was the people. A hospital is supposed to be a place you go to get better, however, not one person I spoke to liked going there. This made no sense to me; why would you not like going someplace that's purpose is to make you feel better? I realize this is a loaded question with many different answers, so I looked a little closer.
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Through observing the nurses every month, I noticed how they always tried to decorate and make the room feel more comfortable. They tended to complain about the color of the wall or the print on the curtains. Most of all they complained about how little room the caregivers of the patient had. Not only did that make a bad experience for the guests, but for the nurses, as well, since they had to squeeze into tight spaces to get near the patient. The lack of privacy also bothered them since this particular room was laid out so the patients faced one another.
background info
Online Research
After deciding to pursue a project I am passionate about, I went to the internet to see just how big this problem was. I found people all over the world were trying to come up with solutions. A handful of hospitals have been implementing different methods to improve the patient experience. Some methods included using technology to engage with patients, others included creating more privacy and comfort for the patient, and some focused on implementing complementary forms of medicine, like acupuncture.
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I also looked to other industries that are focused on user experience in a space, like hotels and spas. I honed in on aspects that would be beneficial to patients, like creating a relaxing atmosphere through various design techniques. A prominent technique that I saw over and over again throughout my research in the highest rated spas and hotels was biophilic design.
The video above shows the interactive media wall that researchers at UCONN created for Boston Children's Hospital with the goal of creating a more positive experience for patients and their families.
interactive tech
What is Biophilic Design?
Before we go any further it's important to know what biophilic design is. There are tons of studies on the health benefits of spending time in nature, however, now humans are spending most of their time indoors and are not getting these benefits. In fact, being indoors may even be negatively impacting people. Biophilic design aims to fix that.
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This design theory is based on the idea that humans have an innate love of nature because we have been intertwined with nature for most of our species' existence. It has served as our home and place of refuge for hundreds of thousands of years (for the modern human). Biophilic design uses patterns found in nature and brings them indoors to give humans some of the health benefits nature provides, including decreasing stress.​
amazon spheres
Scroll through the pictures to see the different ways Amazon implemented biophilic design to increase work productivity, efficiency, creativity and overall well-being of the workers in their Seattle HQ. All photographs are by Alex Garland.
hotels and spas
Scroll through the gallery above to see some hotels and spas that implement biophilic design. Click on the picture if you'd like to visit their website.
There are fourteen patterns of biophilic design that act as guidelines for implementing biophilic design in the most effective way possible. They include:
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Visual Connection with Nature
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Non-Visual Connection with Nature
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Non-Rhythmic Sensory Stimuli
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Thermal & Airflow Variability
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Presence of Water
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Dynamic & Diffuse Light
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Connection with Natural Systems
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Biomorphic Forms & Patterns
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Material Connection with Nature
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Complexity & Order
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Prospect
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Refuge
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Mystery
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Risk/Peril. An identifiable threat coupled with a reliable safeguard
Analysis
Now that I had determined my problem space, it was time to do some state of the art research to see what was currently being implemented. I started by looking further into biophilic design and found that there were studies on using biophilic design to help patients recover more quickly. Not only were there studies on biophilic design, but I found hospitals starting to implement it.
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I noticed that the hospitals I found in the United States that were using this design method, only implemented a pattern or two each. One hospital in Iowa used essential oils to help patients relax and reduce feelings of nausea/vomiting. At the Boston Children's Hospital, they've created a rooftop garden to give their patients a place to get some fresh air and enjoy a little piece of nature. Mount Sinai is also looking into biophilic design in the realm of lighting. Specifically, they are trying to help patients sleep better by using light to support their circadian rhythms, much in the way sunlight regulates our sleep patterns.
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State of the Art Research
biophilia in hospitals
US Hospitals have incorporated biophilic patterns sporadically. Above you can see how Boston's Children's Hospital is incorporating a rooftop healing garden. Rendering by Mikyoung Kim Design.
KTPH
Above are pictures of KTPH. You can see their commitment to give as many people as possible a view of nature, come to life.
Overseas, I've noticed a more holistic approach, rather than one-off ideas. A hospital in Singapore, called Khoo Teck Paut Hospital (KTPH), is a great example of biophilic design in the medical field. Studying this hospital gave me some ideas on how to improve patient experience while also benefitting the hospital.
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KTPH is like a man-made rainforest with plants cascading over its façade. Many hospitals are concerned about an increase in maintenance when it comes to biophilic design, however, KTPH has come up with some solutions. KTPH uses neem oil on their plants, a non-toxic naturally occurring pest deterrent. They also use louvres to ventilate the public areas by channeling the wind while allowing natural light.
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Some features I would like to add to my design that have come from my research include: circadian lighting, plants, water features, aromatherapy, natural ventilation, and views of nature.
Goals
Problem Definition
Determining a problem definition for this project was a much different approach than past projects. Because I was so close to the problem, I wanted to change basically everything about a hospital. However, I only had one semester to develop a solution so I had to do some convergent thinking and narrow my scope.
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To help me determine the root of the problem, I used a tool called the 5 Why's. You start with an initial problem and ask "Why?". The answer to that question is your new problem. You ask why that is problem and continue at least 5 times. Breaking down the problem in this way really helps you understand the true problem puts you in a better position to solve it. While a problem definition is developed to guide my research and solution, I used surveys, research, interviews, and many iterations to land on my final problem definition.
Analysis
Interviews
Throughout the course of this project, I interviewed stakeholders to better my understanding of the problem and solution space. I spoke with Dr. Chuck Ventresca, Doctor of Chiropractic and Acupuncturist, Jodi Smitts Anderson, Director of Sustainability Programs at the Dormitory Authority of the State of New York (DASNY), and a group of infusion suite nurses at Cohen Children's Medical Hospital. I spoke with them about the medical world, wellness, and biophilic design. Below is a synopsis of what I learned from each of them.
Dr. Chuck Ventresca
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Was already aware of biophilic design and uses it in his office: pictures of nature, plants, and a sound system that plays nature sounds
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Recommends also using full spectrum lighting, blackout shades, and aromatherapy to assist in patient wellness
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Aesthetically he recommends softening the room with curtains made with silver (antimicrobial), wood floors, plants, and art
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Also spoke about getting more nutritious food options in the hospital
Chiropractor, Accupuncture
Infusion Suite Nurses at Cohen's Childrens Hospital
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What they would change about a hospital room: the color, curtains, adding outdoor space
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Mentioned nurses are never consulted about room design
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Two TV's instead of one (for the caregiver), couch instead of recliner chairs for overnight guests
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Lack of hospitality; there should be greeters, complimentary coffee, and overall zen feeling
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Informed me biophilic design would help the hospital with quicker patient turnover and better surgical outcomes
Jodi Smitts Anderson
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Anderson was excited about the use of biophilic design and was already familiar with the concept
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She recommended adjustable lighting that works with circadian rhythm
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Give patient control of their environment- can benefit their experience, too much control can be overwhelming- my solution is a health concierge ​
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Recommended using intake process to customize their room, i.e. music preference
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Suggested suite style rooms, but that would increase time for nurses to get to patients
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She also recommended an outdoor area for patients and caregivers
Director of Sustainability Programs, Dormitory Authority of the State of NY
Surveys
After narrowing my scope through refining my problem definition, I started my second phase of research; interacting and listening to people. I created an online survey about hospital design and sent it out to my family, friends, and medical professional friends who forwarded it to their colleagues.
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The survey I sent out, called The Hospital Design Survey, was very open-ended and had some questions that may, at first, appear irrelevant to my project. My findings confirmed a lot of what I had learned about biophilic design and the benefits it provides. I found people favored colors common in nature like blue and green. I found the people surveyed like to get outside or get some form of movement in their day when they feel stressed or sick. When asked where they felt relaxed, most people answered with some sort of place in nature. The affirmations kept coming when most people answered that their favorite place is outdoors with the second being with family.
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surveys
Above are some screenshots of responses to a handful of the questions asked on the survey. The survey was made in Google Forms.
surveys
Chart showing most people prefer to be somewhere in nature.
The participants of the survey were sure to note that they feel hospitals are currently cold, unwelcoming, and industrial. The only positives mentioned about a hospital were the nurses and the welcome desk.
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The last time most participants felt relaxed tended to be in their favorite place, which a majority answered as somewhere in nature.
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The reasons nature made people feel relaxed varied. Many said the fresh air, and that nature is calm and soothing. I took this feedback and tried to incorporate it into my final design.
Design
Mood Board
I started making a mood board to communicate the direction of my designs. I used it as a tool to get feedback quickly before moving forward with a room design. On the mood board, I incorporated a color palette inspired by nature: the dark green inspired by plants and mosses, the blue from the sky and water, the tan from wood and dirt, and finally, the gray inspired by rocks. The mood board also includes possibilities for the floor in a variety of wood stains. The decision to include wood rather than tile on the mood board was to try and incorporate natural elements wherever possible.
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mood board
The center of the board includes the word wellness to communicate the goal of the room; to promote wellness through a better patient experience. You can also see pictures on the board of hotels and spas that have utilized nature to make a luxurious and relaxing experience.
At this point in time, I was planning on redesigning the whole hospital and got some feedback from my classmates that I may want to limit my scope to have enough time to work on it. I took this advice and moved forward towards designing an inpatient hospital room.
Prototype 1
Keeping in mind my progress thus far, I moved on to create a prototype of my ideas using a free app I found online called Planner 5D. I found a lot of restrictions with this software since it did not have any medical furniture or machines that I could incorporate into my design. However, it was a good starting point for getting my ideas out there and getting feedback.
After looking back at this iteration of the design, I realized I had only made small changes compared to the hospital rooms I had been in. From the research I have done, I knew I could do better and incorporate more biophilic design to improve the patient experience. While creating this iteration I was also creating a room on another free software that has an app for users to see their creation in virtual reality. I thought VR would be a great way to test out my design and really immerse people in it. This software was also very limiting due to the lack of medical equipment and plants I wanted to incorporate.
prototype 1
Online designs using Planner 5D. The design features outdoor access, a television, plants, and a couch for visitors.
Prototype 2
The feedback on these prototypes were similar to my own assessment; the designs looked like bedrooms. I took to paper and pencil to be able to better communicate my designs without the limits of the accessories software has to offer. Two views of my sketched-out designs are shown to the left and below. Yes I know I'm not an artist, but I use sketching as a tool to communicate my ideas and in that aspect, this sketch was successful.
Hand-drawn room hospital room designs featuring a wood wall, plant wall, water wall, window seat with a view of nature, comfortable recliners for visitors.
prototype 2
This view shows a projector screen for the patient to watch movies and tv shows with their guests. This room also features an arched doorway in line with the pattern "Biomorphic Forms & Patterns."​
Evaluation
User Testing
User testing happened iteratively throughout my design process. I would give users an open-ended question about how to improve hospitals and then share with them my thinking and progress I had made on designs. With their feedback I would then iterate my designs like I did when I got feedback from classmates, nurses, doctors, and others.
I also used my in-class presentations as a way to get some user feedback. During the presentation, I played nature sounds and diffused lavender essential oils. I also dimmed the lights so they were not so harsh. I feared this would make my classmates sleepy but the feedback contradicted this. Many classmates said it made them more focused on my presentation and they were disturbed when the sounds were shut off. They hadn’t realized how soothing it was until it was shut off. I took this as a good sign that everyone preferred the sounds, lighting, and aromatherapy, and did not want them to end.
Final Prototype
For my final prototype I designed a one-bed hospital room using biophilic design to make a better patient experience and to promote healing. I used SketchUp which allowed me to design this quickly before my deadline due to their library of pre-modeled features. Below lists the features of the room with detailed images below.
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Room Features:
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private room
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pull-out couch for visitors
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recliner with cupholders
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2 televisions (for guest and patient)
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tray table
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night stand
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dresser
Biophilic Features:​
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living wall (plants)
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water wall feature
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wooden wall to bring in natural materials
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essential oil diffuser
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sound system with nature sounds (or music)
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circadian lighting
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views of nature or nature photography/art
Services:
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health concierge for any questions
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room service for food
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option for mini-fridge and microwave for food from guests
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access to gym and Physical Therapist
On the left is a view of the newly designed hospital room from the doorway entering the room. On the right is a living wall and water wall. On the back wall is a dresser and coat rack for the patient’s clothes. A patient bed is against the wooden wall which features a piece of nature art. A large recliner is to the left of the patient bed for caregivers. A nightstand is to the right of that but is hidden in this image. In the center of the room are two ceiling mounted TVs. Curtains that can block out the light dress the windows and finally there is a pull out sectional for caregivers and visitors spending the night.
Many plants, a living wall, a wood wall and a water wall are all included in this design to increase the patient’s exposure to nature to help the patient be more relaxed. This also helps them to reap the benefits that nature has to offer such as a quicker recovery time. Additionally, the plants help to filter the hospital air and meet the tenth biophilic design requirement. The water wall also doubles as a relaxing sound feature. The aesthetics meet the requirements of the first principle of biophilic design; visual connection with nature. The water wall also allows the second and fifth principle of biophilic design to be met; non-visual connection with nature and presence of water, respectively. The wood wall fulfills the ninth requirement; material connection to nature.
There are three large windows that allow for a view of nature. Curtains sporting a biophilic design pattern surround the patient’s bed and windows and can be easily drawn for privacy. The pattern on the curtains is part of Designtex’s biophilic line, meaning the patterns and textures were inspired by nature. A close-up of the curtain I chose is shown in the lower-right corner of the image.
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The room’s color palette aligns with my initial research of biophilia. In other words, the colors are inspired by nature, specifically moss, trees, grass, plants, water, the sky, rocks, wood, dirt, and sand. These serve as subtle reminders of nature.
After speaking with Dr. Ventresca and Jodi, it became clear that circadian lighting should be included in the design of the room. Changing the tone of the light to mimic the color temperature of the sun can help patients’ sleep patterns. When a person is exposed to the light from sunrise to sunset, their circadian rhythm is set to 24 hours. These rhythms are biological rhythms that repeat every 24 hours. If these rhythms are disrupted, a person will have an increased risk for “breast cancer, diabetes, obesity, heart disease, sleep disorders, and other ailments." To minimize these risks and promote better sleep quality, the light in the morning will be bright and cool in temperature (more blue), while the lighting in the evening will dim, become less intense, and warmer in temperature (more red), like the sunset.
View of room featuring windows with a view of nature and curtains with a biophilic design. These are blackout curtains that block the light so patients may nap during the day. This window will also be able to open, allowing for fresh air to circulate throughout the room.
All of the materials used in the design are also inspired by nature. There are wood floors and a wood wall, bringing natural elements inside. This incorporates biomorphic forms & patterns, and material connection with nature. The fabrics are also inspired by nature. As mentioned above, the curtains are made from Designtex’s biophilic patterns. The couch’s color and the linens are also inspired by stones. Based on feedback from a survey, patients will also be provided with a fleece blanket to make them more comfortable [Hospital Design Survey].
Speakers will be incorporated into the room and the patient will be able to control the sounds, music, and volume with a universal touch screen remote, similar to a tablet. This remote will also control the other features I have mentioned like light, aromatherapy, and thermal controls, as well as the TV. Nature sounds, “spa” music, as well as all other types of music, will be available for the patients to choose from. Providing access to nature sounds fulfills some of the biophilic design patterns.
Patients will also gain control of an essential oil diffuser with recommendations on which oils can ease their symptoms. The patient can also pick a scent that is pleasing to them regardless of their symptoms. The essential oil diffuser is placed on the nightstand next to the patient.
Results
The final hospital room takes elements I have learned about through research and speaking with stakeholders, as well as user feedback, to create a room that allows for a better patient experience. The room is designed for adult use and the principles used in its design can be applied to hospitals and rehab centers throughout the country. I have designed this room using biophilia and human-centered design. Had I had enough time to do more user testing, I would compare my design to a standard hospital room through immersing users in both experiences.
