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The Architecture of Recovery: Can Design Affect Your Health?

April 17, 2014
Amber Bauer, ASCO staff
Maggie’s Centre, Dundee, Scotland

No one would ever say it's possible for a building to eliminate cancer—that’s the health care team’s domain. However, in recent years there has been emerging research about something called “evidence-based design." Like it's cousin, evidence-based medicine, evidence-based design relies on research and data to create physical spaces that will help achieve the best possible outcomes. In the context of cancer care, this means designing environments that are not only places where people can receive the highest quality medical care, but also places for them to heal.

According to Dr. Ellen Fisher, Vice President of Academic Affairs and Dean of the New York School of Interior Design, “An environment designed using the principles of evidence-based design can improve the patient experience and enable patients to heal faster, and better. Design elements such as a comfortable place for the family in the patient’s room, a sink in the room, control over lighting, temperature, and air flow, all assist in healing...The design of the physical environment also has a substantial impact on the caregivers through creating more efficient and productive work areas, better support in the patient rooms, and the proper design of settings to mitigate medical error.”

This positive effect on caregivers and staff is probably one of the biggest strengths of using evidence-based design in hospitals. As architecture critic and landscape architect Charles Jencks said in a 2013 interview: “Architecture creates the ambiance and frame of mind for the carers, who then pass it on to the patients. And in that sense, architecture is key.”

This is something Jencks has had firsthand experience with, as his wife Maggie was diagnosed with breast cancer in 1993. Maggie, who was a writer and landscape architect herself, observed in her essay A View from the Front Line:

“At the moment most hospital environments say to the patient, in effect: ‘How you feel is unimportant. You are not of value. Fit in with us, not us with you’. With very little effort and money this could be changed to something like: ‘Welcome! And don’t worry. We are here to reassure you, and your treatment will be good and helpful to you’. Why shouldn’t the patient look forward to a day at the hospital?”

Making a hospital more like home

Maggie spent much of the last two years of her life creating the blueprint for her vision of the ideal cancer treatment environment—a warm, inviting place where people could learn to cope with their diagnosis and meet with friends and family members, as well as health care professionals. Maggie envisioned a “homey oasis” where people would not only become informed participants in their medical care, but also could relax, do yoga, make a cup of tea, and have a chat.

In 1996, approximately a year after her death, Maggie’s vision became a reality with the opening of the first Maggie’s Centre on the grounds of Western General Hospital in Edinburgh, Scotland, the hospital where she had received treatment. Now there are 17 centers and more planned in the United Kingdom and beyond.

“Maggie's blueprint is essentially about creating a warm, welcoming, home-like setting in contrast to the impersonal and institutional environment found in large hospitals,” said Dr. Fisher.

But you don’t have to travel to Europe to find this. Many hospitals and cancer centers around the United States and around the world are also focused on creating patient- and family-centered environments and a restorative atmosphere.

DIY tips

Another option is to create a calm, healing environment in your personal space. To do this, Dr. Fisher suggests:

  • Establishing a connection with nature. “A view to the outdoors and of nature is very important to healing,” Dr. Fisher said. “However, if one does not have a garden, or even a view of nature, then bringing plants, artwork or photographs depicting nature, and natural materials into the home would be effective.”
  • Incorporate both art and music.
  • Increase the amount of daylight as much as possible by removing heavy drapes. Then you can control the natural light with blinds or shades.
  • Reduce noise, which is a major source of stress. For people living in a busy city, installing soundproof windows could be an option, as is installing cushioned carpet.
  • Think about creating a space for meditation or quietness using a soft color palette and materials.


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