Evidence-based design draws ire
in some places, harmony in others


Kirk Hamilton, associate professor of architecture at Texas A&M, recently weighed in on a debate that erupted in Springfield, Oregon about the design of the new Sacred Heart Medical Center.

According to an Aug. 10 article published in the Eugene Register Guard, the hospital complex has a lodge-like lobby with art and a three-story river rock fireplace, sweeping views of the McKenzie River and Coburg Hills from patient rooms, and a stand of towering fir trees on the grounds.

A retired teacher told the newspaper the facility is an “opulent monument to medicine that could only have been built on huge profits and the promise of more … it’s like building a palace in the middle of suffering and poverty.”

Hamilton, associate director for the Center for Health Systems & Design at the Texas A&M College of Architecture, said the teacher’s view is a common misperception of the intent of evidence-based design at healthcare facilities.

“Whenever a hospital design is attractive it runs the risk of being criticized for excess or opulence because the presumption is that if it had been less expensive, more could have been spent in other ways, as in lowering the cost of healthcare,” said Hamilton.

“This is an erroneous assumption,” he continued, “because capital spending comes from other sources, may be funded by philanthropy, and quality of facilities are vital to recruiting and retaining the best staff.”

In fact, Hamilton said, capital and debt for facilities and equipment is usually only six percent of a hospital’s annual budget.

Almost a quarter-century ago, a landmark study by Roger Ulrich, professor of architecture at Texas A&M, showed that hospital patients whose rooms overlooked a nature scene, such as at the facility in Oregon, had better hospital stays and recovery rates than patients whose rooms looked out onto a concrete wall.

Since then, Ulrich and others have continued to show through research that evidence-based health facility design can benefit staff and patients by reducing medical error, improving staff performance and making patients healthier.

Despite these findings, patient- and staff-centered design at medical centers can be confused with extravagance, as is the case in Oregon.

On the other hand, health care buildings can reflect research by Ulrich and his contemporaries with nary a peep of protest.

"There is an abundance of research out there showing that art can go a long way to promoting a healing environment," Adonna Lowe, vice president and chief nursing officer of the new JPS Patient Care Pavilion in Fort Worth, Texas told the Dallas Morning News in an Aug. 18 article.

“A team of medical professionals worked with the building's designers and an art consultant to come up with 530 individual works, which adorn walls in the five-story hospital. The overarching goal in selecting the prints, photos and wall sculptures was to promote patient well-being,” the paper reported.

The Dallas Morning News story, which mentions Ulrich’s research, can be accessed online at the Dallas News website.

The Register-Guard story on the Oregon debate, in which Hamilton is quoted, is available online at the Register-Guard website.

- August 27, 2008 -

- the end -


A patient room in the Sacred Heart Medical Center overlooks a view of nature, but the center has been faulted for an “opulent” design.

Roger Ulrich

Kirk Hamilton

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