The death of modern hospitals: Towards a comprehensive approach for restorative healthcare environmental design

Abstract

This study criticises the design strategies of today’s so-called sustainable hospitals which mainly focus on reducing the hospitals’ adverse impact on the environment and energy consumption rates. Based on a review of the historical literature, the study offers an alternative approach to treating a true sustainable hospital, a restorative environment that connects human health with nature by combining salutogenic and biophilic design principles with restorative environmental design strategies. The positive impacts of biophilia, the inherent human affinity to affiliate with nature, on both humans and nature have been demonstrated through rigorous and empirical studies over the past 40 years. In 2008, Restorative Environmental Design (RED) was introduced by Stephen Kellert to integrate biophilia and environmental design principles to have a more beneficial impact on both building users and the surrounding environment. Still, implementing this approach in design practice is a challenging mission. Green building and evidence-based design principles are the main guidelines used by architects and planners to design hospitals, but little attention is given to improving the relationship between building users and nature. Further research is therefore required to facilitate implementing the RED approach in healthcare design. RED is based on Stephen Kellert’s biophilic design attributes which need to be tailored to fit the complex needs of healthcare architecture and to consider restorative environment design principles. This study addresses common ground between biophilic design and salutogenic design by taking a comparative approach, exploring two case studies of recently constructed hospitals in Australia and Singapore to generate a comprehensive design framework. The targeted Restorative Healthcare Environmental Design (RHED) should be tested as a suggested model in introducing biophilic design to the healthcare design and planning community in a realistic and practical way. However, a more comprehensive assessment of the proposed framework is needed.