HEALTH FACILIITIES
and the need for healthcare to be focused on health in a very broad way. This model can be an inspiration for other efforts around the world.
Health promotion strategies As the healthcare organisation becomes the change agent for a culture of community health, designers must respond with new civic architecture; that is, environments that are designed to bring people together for community health. Choice architecture encourages healthy behaviours; healthcare facility designers must be thinking about how to promote healthy behaviours and address social determinants in the spaces they create. At the highest level, this involves optimising geographical location and the physical size of a healthcare facility to meet the needs of the community it serves and allow for equal access to care. We will see a decentralisation of services to satellite sites, where resources can be appropriately allocated to the areas that need them most. According to Shannon Kraus and Kate Renner: “This distribution generates opportunities for connecting more at a community scale; for delivering healthcare in suitable settings; and for transforming practices for the efficient use of resources, supplies and even energy, resulting in improved population health”.9 Analysing local data using resources
such as community health needs assessments allows designers to better understand specific community needs. Designers may also elect to collect their own data by hosting conversations and engaging community members in the planning process. Then, this data must be translated into design elements that promote health. For example, factors that influence physical activity include function, safety, aesthetic and destination.10
Pathways should allow for
bicycles and stairwells should have access to natural light. In communities where social isolation is an influencing factor on health, specific space should be designated for socialising, such as a coffee/tea lounge. Where education on and access to healthy foods is needed, demonstration kitchens and farmers’ markets should be incorporated into the design. Designing quiet indoor and outdoor spaces of respite is also of particular importance in a high stress healthcare environment. Again, according to Shannon Kraus
and Kate Renner: “These relatively simple behaviour change interventions require little conscious engagement on the part of the individual to realise their intended effects. With time and repetition, others become part of the way an individual goes about day to day life. And, across a population, these actions will increase the general health of a group of people”.9 Behaviour change is at the core of
IFHE DIGEST 2018
Conclusion The world needs people who can work at the intersection of technology, biology, sociology, operations and building design. We will always need healthcare buildings designed to facilitate effective clinical treatments, but we will increasingly need to deliver health in a proactive, preventive way, ultimately keeping people out of hospital. This is a design challenge that is constantly evolving. Form follows function; that is, a building’s purpose should define
Healthy communities.
population health. Only 10 per cent of health outcomes result from the medical care system, while 50 to 60 per cent are due to health behaviours.11
This indicates
the need for collaborative, innovative approaches to population health that extend beyond the patient room. Designers of healthcare spaces and programmes should work together to develop the space and activities that will support healthy behaviours and embrace this empowering opportunity to drive the future health of our populations. Designers of healthcare buildings need
to see themselves as designers of systems because healthcare needs are much greater than buildings. There is an increasing focus on buildings that encourage or at least facilitate human wellness. Physical, mental and emotional human health should be a core concentration of healthcare design and operation. The WELL certification programme is a great expression of this notion, focusing on the main ways in which human health is influenced by the built environment and healthcare operations – by reducing stress, encouraging healthy behaviours and removing contaminants from air and water.
its look. The future value of healthcare will increasingly be in the function and not so much in the form. Architects and engineers should not only understand function, they should drive the way healthcare approaches function.
References 1 Centers for Disease Control and Prevention. (2017) Legionella (Legionnaires’ Disease and Pontiac Fever). [
www.cdc.gov/ legionella/
index.html].
2 The GBD 2015 Obesity Collaborators. Health effects of overweight and obesity in 195 countries over 25 Years. New Engl J Med 2017; 377 (1): 13-27.
3 Lindström B, Eriksson M. Salutogenesis. J Epidemiol Community Health 2005; 56 (6): 440-2.
4 Centers for Disease Control and Prevention. (2014) NCHHSTP Social Determinants of Health. [
www.cdc.gov/nchhstp/ socialdeterminants/
faq.html].
5 Heiman H, Artiga S. Beyond Health Care: The role of social determinants in promoting health and health equity. The Henry J Kaiser Family Foundation, 2016. [
www.kff.org].
6 Karash JA. Portland providers donate $21.5 million to housing initiative. Hospitals & Health Networks 2016. [
www.hhnmag.com/ articles/7691-portland-providers-donate- 215-million-to-housing-initiative].
7 O’Connor M. Looking upstream to tackle social health needs. Hospitals & Health Networks 2017. [
www.hhnmag.com/articles/ 8228-looking-upstream-to-tackle-social- health-needs].
8 Weiner LJ. Population health management. Health Leaders Media 2017. [
www.healthleadersmedia.com/physician- leaders/population-health-management].
9 Kraus S, Renner K. How architecture can help progress population health. Health Facil Manage 2016. [
www.hfmmagazine.com/ articles/2434-how-architecture-can-help- progress-population-health].
10 Pikora T, Giles-Corti B, Bull F, Jamrozik K, Donovan R. Developing a framework for assessment of environmental determinants of walking and cycling. Soc Sci Med 2003; 56 (8): 1693-703.
New civic architecture.
11 Hacker K, Walker D. Achieving population health in accountable care organizations. Am J Public Health 2013; 103 (7): 1163-7.
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