This narrative review summarizes some of the evidence guiding current intensive care unit (ICU) design, focussing on environmental factors impacting on sleep, and compares available evidence and recommendations to current ICU designs and builds. The importance of sleep for recovery after illness is well known. However, hospitalized patients frequently experience poor and disrupted sleep. This is especially true for patients admitted to the ICU. There are many factors negatively impacting on ICU patients' ability to sleep. Some relate to their illness or pre-existing sleep problems; others relate to patient care activities. While the ICU bedspace may facilitate 24h care, there is growing awareness of the detrimental impact the bedspace environment (especially suboptimal lighting and excessive sound/noise) has on sleep quality, and important questions raised regarding how this may impact on recovery and health outcomes. Multiple guidelines and recommendations exist to guide ICU bedspace design. However, questions have been raised whether contemporary ICUs are evidence-based, and whether the available evidence is effectively translated into the built ICU. A comprehensive literature review was conducted, exploring the evidence supporting current ICU bedspace design and the impact of ICU design and environmental factors on patient sleep. This review summarizes the impact of the ICU bedspace environment on patient outcomes and describes features of the ICU bedspace design that may not adhere to best evidence and contribute to poor sleep. Suggestions on how ICU bedspaces can be improved to optimize sleep are provided.

This study proposes a user-centered methodology to quantify the design affordances of doffing spaces, focusing on the safety and efficiency of healthcare workers (HCWs).

The objective of an operating room (OR) ultra-clean ventilation system is to eliminate or reduce the quantity of dust particles and colony-forming units per cubic meter of air (CFU/m). To achieve this, ultra-clean goal high air change rates per hour are required to reduce the particle load and number of CFU/m. To determine the air quality in an ultra-clean OR during surgery, in terms of the number and type of microorganism and quantity of dust particles in order to establish a benchmark. Number of CFUs and the quantity of dust particles were measured. For measuring the CFUs, sterile extraction hoses were positioned at the incision, the furthest away positioned instrument table, and the periphery. At these locations, air was extracted to determine the quantity of dust particles. The number of CFU/m and particles was on average at wound level ≤1 CFU/m resp. 852.679 particles, at instrument table ≤1 CFU/m resp. 3.797 particles and in the periphery ≤8 CFU/m, resp. 4.355 particles. The number of CFUs in the ultra-clean area is below the defined ultra-clean level of ≤10 CFU/m for ultra-clean surgery. The quantity of dust particles measured during surgery was higher than the defined ISO 5.

To identify associations between inpatient hospital design features and empirical patient clinical outcomes as well as changes over time. A growing body of literature has emerged evaluating the association of hospital design features with measurable clinical outcomes during inpatient hospital admissions. However, there has been limited effort to evaluate the scope and quality of studies examining individual, inpatient hospital design features on empirical patient clinical outcomes. Primary research articles published in English between 1980 and 2021 evaluating inpatient clinical outcomes were included. Key terms for hospital designs and clinical outcomes were used. Ovid Medline, Embase, CINAHL, Web of Science, Scopus, Cochrane Library, Elsevier Embase, and Google Scholar were searched on May 28, 2021. Data were independently extracted by two authors, with arbitration from the third author. Forty-six research articles were included for analysis. Predominantly studied inpatient hospital design features included: single versus multibedded rooms/wards, windows, furnishings, installed lighting, ward size and spatial arrangement, noise level, air ventilation, and patient visibility. Although nearly half (43%) of the articles lack appropriate methods to account for residual confounding, a trend of improvement in the use of appropriate methods was identified with 68% of studies in the last decade having appropriate methods. Studies demonstrating positive associations were more likely to be cited than those with negative associations (average citation per article, 508 vs. 27). Our study demonstrates the use of empirical patient clinical outcomes as a feasible approach to evaluate hospital design features, and identified an incremental improvement in the methods being applied.

This study examined the augmented reality (AR) application in design evaluations through an immersive experience of medical task simulations in combination with a full-scale physical mock-up of a trauma room.

This review aims to assess the incorporation of patient and family input into intensive care unit (ICU) design processes. It aims to highlight the importance of prioritising patient and family perspectives in ICU design to improve patient experiences and clinical outcomes.

The aim of this systematic review was to identify which aspects of evidence-based design (EBD) and sustainable design principles overlap based on evidence in the peer reviewed academic literature. By doing so, the study enables hospital infrastructure design decisions that prioritize both sustainability outcomes (sustainable hospital infrastructure design) and therapeutic (EBD) outcomes. Healthcare facilities need to adapt to the future demands from a changing climate, demographic shifts, and economic restraints. Facilities need to be designed in ways that better support patients, staff, and the environment to ensure their long-term success. A systematic literature search was conducted through searches in SCOPUS and Web of Science. All studies in acute care settings were included in the review except those investigating EBD in the context of specific health conditions, which were excluded. Themes that overlap were identified to form a conceptual framework for sustainable EBD. Sixty-five articles were included in the final analysis. Identified sustainability features were related to: , and EBD thematic analyses were categorized into and . Key areas of synergy include and The development of the conceptual framework enables scholars and practitioners to identify design features that align both priorities and through future research, refine the framework.

We explored the literature on the use of design in dementia care and the relationships with inclusion, accessibility, and equity in the past decade. A body of research indicates the importance of studies that focus on a person-centered approach, with a direct potential to impact the quality of life of people with dementia through inclusion, accessibility, and equity. Although there is a growing presence of the literature on design approaches in dementia care settings, there is a need to integrate these findings for a better understanding of the progress in this field. We conducted a scoping review of the literature in seven databases, covering a period of ten years in May 2023. Twenty-nine papers were included and analyzed with a focus on person-centered design and its relationship with inclusion, accessibility, and equity. Based on the identification and analysis of these studies, we discuss the significance of person-centered design, emphasizing its impacts on inclusion, accessibility, and equity. We present a summary of findings and offer recommendations for future research. By exploring and presenting existing practices, resources, and tools tailored to specific needs in dementia care, this research provides information for researchers, designers, and policymakers in developing interventions that prioritize the well-being and dignity of those affected by this condition.

Despite a lot of studies that have been conducted on the effects of the built environment on the health of the elderly and environmental salutogenic factors, a limited number of studies have investigated the architectural physical factors clearly. This paper investigated the architectural elements in the non-therapeutic built environment that can achieve salutogenic goals for the elderly. It also aimed to provide an answer to the question of how architectural design might be used to physically bring salutogenic theory to life. In this review study, data were collected systematically using the PRISMA checklist. The three lists of keywords used for the initial search were "built environment" or "architecture," "elderly," and "health," and were supplemented with synonyms for a second search in four databases: Scopus, Science Direct, Web of Science, and PubMed, in the period from 2000 to 2024. By applying inclusion and exclusion criteria, 26 articles were selected for review and data extraction. The data were then qualitatively analyzed, and two reviewers independently verified the analysis. This study found that architectural elements can be salutogenic by supporting the comprehensibility, manageability, and meaningfulness. Porches, Stoop, above-grade entrances, and balconies are key elements in the home that support the sense of coherence. In assisted living facilities, walls were recognized as the only physical factor supporting the sense of coherence due to the creation of a personal, distinct, meaningful, comprehensible, and manageable space.

Navigating unfamiliar environments poses significant challenges, especially for individuals with cognitive impairments. These individuals often struggle with maintaining orientation, recalling routines, and traveling through new environments due to their limited cognitive capacity. The current state of research on visual environmental attributes of wayfinding reveals a gap, particularly regarding individuals with mild cognitive impairment (MCI), compared to healthy older adults. Few studies have objectively identified the visual cues and environmental factors that influence wayfinding in those with cognitive impairments. This study addresses this research gap by objectively identifying the visual environmental attributes influencing wayfinding among MCI subjects in a memory care facility compared to healthy older adults. Using eye-tracking technology, we investigated which visual environmental attributes attract eye fixation during wayfinding in care facilities. Forty-eight subjects, categorized into MCI and non-MCI groups, navigated through unfamiliar indoor environments while their eye movements were tracked. The results, in agreement with previous research, showed that MCI group exhibit significant reduced success rates and longer navigation times compared to non-MCI group. Findings of the eye-fixation rank-order analysis showed that MCI subjects prioritized directional signs and architectural features, while non-MCI subjects focused on identifying signs and informative elements. These findings emphasize the importance of tailored design practices for care facilities, highlighting specific visual cues crucial for guiding navigation in individuals with MCI. The study provides insight to guide architects and healthcare professionals in creating inclusive environments that support independence and well-being for older adults with cognitive impairments, advocating for interventions to enhance wayfinding in care facilities.

The objective of this was to explore how the physical environment in a hospital contributes to care partner inclusion practices.

This study aims to explore the relationship between the perspectives of both family members and healthcare staff regarding the design of hospital inpatient rooms. It investigates the impact of family presence on the healing environment and examines the influence of specific design elements within inpatient rooms on the extent of family presence. The positive impact of family presence in healthcare settings is rooted in the notion that patients and their families are significant stakeholders in the care process. However, little is known about the influence of inpatient room design elements on family presence in healthcare settings in the Middle East. A questionnaire survey was conducted among 359 participants, encompassing patients, family visitors, and healthcare professionals from three hospitals in Saudi Arabia. The questionnaire items sought insights into the influence of design elements within inpatient rooms on family presence and the overall healing environment. The results indicate a strong preference for single-patient rooms (74.5%), natural light (77.6%), comfortable seating (85.8%), and a family zone positioned by the window for unobstructed views of nature (50.5%). Furthermore, the study reveals that family presence is perceived to have positive effects on the healing environment (84.0%), patient safety (81.3%), and satisfaction with the care process (88.0%). This study proposes a design model for inpatient rooms that can effectively cater to the needs of patients and their families, thereby contributing to the overall improvement of healthcare building design.

Timely light exposure is a vital aspect to achieve better sleep and well-being. As there are risks with a disturbed circadian rhythm and benefits with light settings that stimulate the rhythm, the circadian effective light, circadian stimulus (CS), for radiographers was examined. The aim of the study was to compare radiographers' light environment on the workstations, at a university hospital in Southern Sweden in the form of CS and relate that to recommendations published by the Swedish Environmental Protection Agency. A cross-sectional method has been applied. The measurements for CS were collected in all labs in the radiology department in the middle of January. A total of 804 measures were evenly collected resulting in a median for the 19 labs, where the observed median for all labs was 0.091 CS which is significantly lower than the recommended value of 0.3 CS ( < .001). Comparing work light settings with maximum light levels in the brightest and darkest labs showed a significant difference ( < .001). The CS values in the labs, at the radiology department at a university hospital in Southern Sweden, do not reach the recommended values of circadian stimulus published by the Swedish Environmental Protection Agency when the radiographers themselves set the light. There is a potential for improvement as a significant difference could be seen between the chosen level of light and the maximum possible level of light.

The current study performed a post-occupancy evaluation on a new cancer infusion center with pod-like layout and compared results to a pre-occupancy evaluation to investigate the impact of different cancer infusion center designs on staff efficiency and patient and staff satisfaction.

With a prevalence of mental disorders affecting 18 out of every 100 Iranians and a rising urban population, it is crucial to examine the impact of built environments on people's well-being.

Chinese classical gardens, designated as a vital world cultural heritage, embody a lasting legacy transcending generation. Despite the cultural importance of these gardens, a notable research gap exists in deciphering the nuanced emotional and physiological responses triggered by individual elements within classical garden landscapes. Our research question aims to uncover the specific emotional and physiological impacts of key garden elements-plants, architecture, waterscape, and rockery-on visitors, with a particular focus on the Humble Administrator's Garden. These elements serve as the primary subjects for video capture at four sites. A within-subject design experiment was used. Videos were recorded at these sites, encompassing visual, auditory, and tactile elements. Ninety-five participants watched these videos in an indoor setting. While viewing, we measured participants' physiological responses, including heart rate variability, skin conductance, and skin temperature, will be monitored alongside subjective assessments obtained through self-reported questionnaires such as the Emotional Perception Scale and State-Trait Anxiety Scale. Findings suggest that while all landscape types evoke positive emotions, natural elements exert a more profound influence. Additionally, the Large Rockery emerges as a focal point, indicating enhanced emotional relaxation through auditory and tactile stimuli, particularly among younger individuals. This research contributes to the broader understanding of how classical gardens impact human emotions and well-being, offering insights that can inform future landscape design and promote mental health in diverse cultural contexts.

The purpose of this study is to investigate if there is a physiological stress response to the visual and auditory characteristics of waterscapes. Biophilic research suggests that the presence of water can reduce stress, reduce blood pressure, and increase circulation. However, water has largely been omitted from healthcare design due to concerns of cost, maintenance, waterborne pathogens, and contamination. Existing research has not yet provided a design methodology to incorporate the healing effects of water potential diseases, contamination, and maintenance issues associated with physical water. Given the current technological capabilities, the isolation of the auditory and visual sensory stimuli has potential to re-introduce the healing benefits of water into healthcare design. Participants were either exposed to a slow-moving or fast-moving waterscape for 20 minutes. Pre- and post-anxiety were measured using the State Trait Anxiety Scale in an online Qualtrics survey (118 participants) and through a salivary cortisol biomarker (in which 26 participants also partook). The overall results demonstrate that the utilization of digital blue space was effective in reducing stress. There was no significant difference between the lake or waterfall environment in both salivary cortisol and state-trait anxiety measures. However, it is suggested that the slow and fast-moving waterscapes may be beneficial in different settings. Design recommendations are made regarding potential biophilic design in healthcare facilities. The utilization of sensory waterscapes can also provide a cost affordable, non-pharmacological, alternative for anxiety mitigation for patients and staff undergoing high-stress situations.

To explore how evidence-based design is transforming healthcare environments into transforming spaces that improve patient outcomes and staff experiences.

This qualitative study aimed to explore needs and wishes of older adults concerning their perceived need for contact with outdoor environments at residential care facilities (RCFs) and what implications it has for theory and practice. There is increased awareness of the importance of health-promoting everyday environments for persons with special needs. Therefore, it is important to include the experiences of older adults at RCFs in research. Twelve older adults from three Swedish RCFs participated in semistructured walking interviews. Two categories were identified concerning the needs and wishes of older adults for contact with outdoor environments. The first category, , describes aspects of normality linked to outdoor stays at RCFs. The second category, , describes supportive and hindering aspects of outdoor stays, as well as accessibility regarding different body positions and access to personal support. It was found in this study that the needs and wishes of older adults are important to consider to increase their opportunities for outdoor stays. Their needs and wishes could also be included in briefs and programs for the design and planning of new construction or refurbishment of RCFs. The results of the study can serve as the basis for further discussions concerning older adults' outdoor stays and the accessibility of outdoor environments. Further, the results are intended to facilitate practical knowledge that is useful for care workers and managers at RCFs and to support decision makers, property developers, architects, and planners.