Architectural Evaluation of Healthcare Facilities

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This entry is adapted from the peer-reviewed paper 10.3390/buildings13122926

The architectural design of healthcare institutions impacts patient experience and health outcomes. As the architectural landscape evolves, healthcare institutions face multifaceted challenges, ranging from demographic shifts to rapid technological advancements. Addressing these challenges necessitates innovative architectural solutions that cater to immediate healthcare needs while aligning with broader objectives of creating sustainable, efficient, and user-centric built environments.

architectural design healthcare facilities building evaluation

1. Introduction

The European Union recognizes architecture as a vital cultural and life component, particularly in healthcare, where it transcends mere aesthetics to foster environments conducive to healing and well-being ^[1]. In this realm, the role of architecture extends beyond visual appeal, playing a pivotal role in enhancing quality of life and contributing significantly to national wealth through thoughtful design and construction practices ^[2]. However, the challenge lies in ensuring these architectural principles are consistently applied across all healthcare settings, particularly in under-resourced areas.

In healthcare systems, architectural design is instrumental in creating environments that cater to the unique needs of patients. These environments, sensitive to the needs of health-impaired individuals, prioritize comfort, safety, and therapeutic value, significantly impacting patient recovery and staff efficiency ^[3]. Critically, there is a need for more empirical research to quantify the impact of architectural design on patient outcomes and staff productivity. Historically, the focus of healthcare architecture was predominantly on functionality. However, recent advancements in architectural practices have shifted the emphasis towards patient-centered design, sustainability, and adaptability. This modern approach integrates natural lighting, efficient ventilation, noise control, and energy efficiency, all contributing to improved patient outcomes and enhancing the working conditions of healthcare staff ^[4]^[5]. This shift represents a positive trend, but the challenge remains in balancing aesthetic appeal with practical functionality. Despite these advancements, the field of healthcare architecture faces ongoing challenges. The rapid evolution of medical technologies, shifting patient demographics, and an increasing focus on sustainable practices present a complex landscape for architects. These challenges, however, also offer opportunities to innovate and integrate evidence-based design principles, creating healthcare facilities that are more attuned to the needs of patients, staff, and the broader environment ^[6]. The critical message here is the need for continuous adaptation and innovation in architectural design to meet evolving healthcare demands.

In Slovenia, the architectural landscape is marked by challenges such as widespread suburbanization, the erosion of cultural heritage, and environmental pollution. These issues lead to architectural and urban solutions that often need a long-term, strategic vision ^[2]. Addressing these challenges through a strategic and integrated approach to urban planning and architectural design is imperative. Addressing these challenges is crucial and requires a commitment to inclusive architecture. This commitment involves planning diverse, accessible housing and public spaces, ensuring equal access to services, and developing new building typologies to accommodate the needs of an aging population. Inclusive architecture is not just about building design; it is a tool for democratic development, fostering active public life, social interactions, and cultural presentation and regulation ^[2].

The architectural design of healthcare institutions, while crucial in realizing care concepts, has received limited attention in research. Studies like those by Steenwinkel et al. have emphasized the importance of freedom, particularly freedom of movement, and the balance between experiencing freedom and its connection with a social and physical framework. These studies highlight architectural features such as the number of residents per housing unit, spatial generosity, and physical accessibility, all of which play a significant role in patient care and staff well-being ^[7]. This underscores the need for more focused research on the specific architectural elements contributing to effective healthcare environments. A comprehensive approach to planning high-quality living environments is essential. This approach must consider various environmental, sociological, functional, and cultural perspectives and view the environment as interconnected. The role of open space and green areas in enhancing the quality of life is particularly noteworthy, as confirmed by research findings ^[8]. Therefore, comprehensive and holistic planning is critical in creating sustainable and livable healthcare environments.

The therapeutic benefits of nature in healthcare settings have been well-established. Prof. Roger Ulrich’s seminal work in 1984 on hospital design, which emphasized the healing power of natural views, has had a lasting impact on hospital architecture ^[9]^[10]. However, the increasing complexity of healthcare treatments and the aging of current infrastructure necessitates systematic investment in new, efficient infrastructures. This need is particularly acute in Slovenia, where there is a lack of comprehensive research in the health and social care infrastructure field and an absence of strategic planning documents ^[2]. This highlights a critical gap in research and strategic planning in Slovenia’s healthcare infrastructure. As Ulrich and others advocate, evidence-based design improves treatment outcomes and hospital efficiency ^[9]^[11]. This approach requires a holistic, multidisciplinary perspective, integrating various fields such as architecture, medicine, health sciences, and gerontology. It emphasizes the importance of considering the entire ecosystem of healthcare facilities, from the layout of individual rooms to the organization of whole buildings ^[11]^[12]. The essential insight is the significance of evidence-based design in fostering healthcare settings that are both productive and efficient.

Today, healthcare architecture places the patient at the center, focusing on individuality and humanization. Health and social care infrastructure design is evolving to create spaces that positively influence the patients’ mood and self-image, aiding in faster recovery ^[13]. The challenge for architects is to design hospitals that support modern healthcare needs while minimizing patient harm ^[11]. The key conclusion imperative for patient-centered architectural design in healthcare is that which enhances patient experiences and outcomes. The University Medical Centre Ljubljana (UMCL) exemplifies the balance between preserving cultural heritage and adapting to technological advancements ^[3]. The goal is to create healthcare environments that are not only efficient and accessible but also adaptable to future needs, ensuring long-term sustainability and improved quality of life for patients and residents ^[13]. This example highlights the importance of balancing heritage preservation with modern healthcare needs in architectural design.

To provide a concise overview of the key themes discussed in this introduction, Table 1 summarizes the principal aspects of healthcare architecture.

Table 1. Critical aspects of healthcare architecture.

Research Themes	Key Points	References
The Role of Architecture in European Healthcare	- The EU recognizes architecture as a cultural cornerstone, especially in healthcare. - Emphasis on healing, well-being, and efficiency in architectural design.	^[1]^[3]
Evolving Healthcare Architecture	- Shift from functionality to patient-centered design. - Modern architecture focuses on natural lighting, ventilation, and energy efficiency.	^[4]^[5]
Challenges and Opportunities in Healthcare Architecture	- Challenges include evolving medical technologies and changing demographics. - Opportunities in integrating evidence-based design and sustainability.	^[6]
The Slovenian Context	- Issues with scattered construction, suburbanization, and cultural heritage erosion. - Need for inclusive architecture in Slovenia.	^[2]
Importance of Comprehensive Approach	- Emphasizes a multi-perspective approach in planning living environments. - Role of open spaces and green areas in enhancing quality of life.	^[8]
Therapeutic Benefits of Nature in Healthcare	- Nature’s role in healthcare settings for better recovery outcomes. - Importance of integrating natural elements in design.	^[9]^[10]
Need for Systematic Research and Innovation	- Lack of comprehensive research in Slovenia’s health and social care infrastructure. - Importance of effective construction in hospitals for treatment outcomes.	^[9]^[11]
Patient-Centric Design in Healthcare	- Focus on patient-centric design for improved patient experiences. - Role of architecture in mood and recovery enhancement.	^[13]
Case Study: University Medical Centre Ljubljana	- UMCL is an example of balancing heritage preservation with modernization.	^[3]

2. Addressing Demographic Shifts and Healthcare Challenges through Architectural Innovation

Recent demographic shifts and technological advancements in Slovenia have brought new challenges to healthcare architecture, underscoring the need for innovative design solutions that are sustainable, patient-centric, and adaptable. The aging population is a significant factor, with the proportion of those over 65 increasing from 9.9% in 1971 to 19.4% in 2018. This demographic change and extended life expectancies have profound implications for healthcare infrastructure and architectural design ^[14]^[15].

The objective of this study, originating from the “Targeted Research Program «CRP-2019»”, is to critically analyze the architecture of healthcare institutions. This analysis aims to develop and improve conditions for managing demographic changes and ensuring quality care. The foundation of this research lies in addressing the gap between current architectural practices and the evolving needs of healthcare systems, particularly in the context of an aging society.

In addition to demographic challenges, the evolving nature of healthcare treatments and the integration of new technologies have significantly influenced the design and functionality of healthcare environments. The project seeks to review and analyze architectural solutions in healthcare care institutions, examining how spatial and environmental factors impact patient and staff safety and well-being. This comprehensive approach is essential for proposing future architectural directions that are technically sound for and empathetic to the users’ needs.

This study aims to bridge the gap between architectural design and healthcare delivery, ensuring that the built environment effectively supports the evolving needs of the healthcare system. By focusing on sustainable, patient-centric, and adaptable design solutions, the study aims to contribute to the broader discourse on healthcare architecture and its role in enhancing the quality of life for patients and healthcare professionals alike.

Modern architectural practices prioritize the creation of environments that elevate the quality of life for their inhabitants, as Allam et al. ^[16] clarify that integrating innovative technologies, such as artificial intelligence, big data, and the internet of things (IoT), can redefine urban planning and service provisioning, leading to enhanced urban efficiencies and improved quality of life. The architectural design of healthcare facilities, influenced by sustainable and evidence-based design principles, can redefine patient experiences, leading to enhanced well-being and improved quality of care ^[5]. The historical context and cultural significance of healthcare facilities, as seen in Ottoman healthcare structures, emphasize the importance of preserving and adapting these spaces to contemporary needs ^[4]. Thus, the intersection of architecture and healthcare becomes a pivotal domain, contributing significantly to the broader vision of sustainable, efficient, and human-centric built environments.

References

EU. Council Resolution of 12 February 2001 on Architectural Quality in Urban and Rural Environments; European Union: Brussels, Belgium, 2001.
Žižič, B. Arhitektura za Ljudi: Arhitekturna Politika Slovenije; Ministrstvo za Kulturo Republike Slovenije: Ljubljana, Slovenia, 2018; ISBN 978-961-6370-25-7.
Čeferin, P. Stanko Kristl: Z Odprtjem Kliničnega Centra Smo Bili Katapultirani v 20. Stoletje. Available online: https://old.delo.si/sobotna/stanko-kristl-z-odprtjem-klinicnega-centra-smo-bili-katapultirani-v-20-stoletje.html (accessed on 20 September 2019).
Aydin, D.; Yardimli, S.; Mihlayanlar, E. The Effects of Physical Environment in Ottoman Healthcare Facilities: 2nd Beyazid Complex in Edirne. GRID 2023, 6, 254–284.
Sun, C.; Chrysikou, E.; Savvopoulou, E.; Hernandez-Garcia, E.; Fatah gen. Schieck, A. Healthcare Built Environment and Telemedicine Practice for Social and Environmental Sustainability. Sustainability 2023, 15, 2697.
Ismaeil, E.M.H.; Sobaih, A.E.E. Enhancing Healing Environment and Sustainable Finishing Materials in Healthcare Buildings. Buildings 2022, 12, 1676.
Van Steenwinkel, I.; Dierckx de Casterlé, B.; Heylighen, A. How Architectural Design Affords Experiences of Freedom in Residential Care for Older People. J. Aging Stud. 2017, 41, 84–92.
Skalicky, V. Sodobna Skandinavska Načela in Kriteriji za Urbanistično Načrtovanje Bivanjsko Visokokakovostnih Stanovanjskih Okolij = Contemporary Scandinavian Urban Planning Principles and Criteria for High-Quality Living in Residential Environments. Ph.D. Thesis, V. Skalicky, Ljubljana, Slovenia, 2017.
Ulrich, R.S. View through a Window May Influence Recovery from Surgery. Science 1984, 224, 420–421.
Yamaguchi, Y. Better Healing from Better Hospital Design. Available online: https://hbr.org/2015/10/better-healing-from-better-hospital-design (accessed on 14 September 2019).
Hamilton, D.K.; Berry, L.L. How to Build a Better, Safer, More Welcoming Hospital. Available online: http://theconversation.com/how-to-build-a-better-safer-more-welcoming-hospital-98532 (accessed on 1 October 2020).
Demirkan, H. Housing for the Aging Population. Eur. Rev. Aging Phys. Act. 2007, 4, 33–38.
Mezquita, J.A. How Can Hospital Architecture Impact the Lives of Patients? Available online: https://blog.ferrovial.com/en/2019/01/hospital-architecture-impact-lives-patients/ (accessed on 4 October 2023).
SICRIS. Analiza Arhitekturnih Rešitev Slovenskih Zdravstvenih in Socialno Varstvenih Zavodov. Available online: https://www.sicris.si/public/jqm/prj.aspx?lang=slv&opdescr=search&opt=2&subopt=405&code1=cmn&code2=auto&psize=1&hits=1&page=1&count=&id=17961&slng=&search_term=FAculty+of+Criminal+Justice&order_by= (accessed on 16 November 2023).
Vujović, A.; Ramovš, A. Poročilo SZO o Staranju in Zdravju Za Leto 2015. Kakov. Starost 2016, 19, 52–55.
Allam, Z.; Sharifi, A.; Bibri, S.E.; Jones, D.S.; Krogstie, J. The Metaverse as a Virtual Form of Smart Cities: Opportunities and Challenges for Environmental, Economic, and Social Sustainability in Urban Futures. Smart Cities 2022, 5, 771–801.

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Marko Jaušovec

Branko Gabrovec

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1. Introduction

2. Addressing Demographic Shifts and Healthcare Challenges through Architectural Innovation

References