The Building, Growth and Applications of a Model for Holistic Healing Environments

Providence, June 2013

Fiona de Vos Ph.D.Knowledgeable Design by Studio

dVOwww.studiodvo.com

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Studio dVO

Research and consultancyin Environmental Psychology since 1995

Specialized in: Healing Environments

Mission: Enhancing the ‘fit’ between a building and its users

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Agenda

1. Definition HE2. Building of the model3. Growth & applications

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What is a Healing Environment?1

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Reduce unnecessary stress for patients

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Unnecessary stress

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Create an efficient work environment …

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Create a welcoming environment for visitors

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Building the model2

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Rationale original study (2002-2005)

Fragmented literature

A more holistic approach to Healing

Environments

Need for more integrated approach

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Research question

How can a hospital environment approximate the normalcy of daily life?

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Multi-phased research design

I. Develop Charts & Model Literature Analysis Formative Research

II. Apply Model in Case Study Pre- and Post comparison

III. Revise Charts & Model of Healing Environments Implications for Design

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Creating the dimensions

Dimensions of Healing

Related Concepts Design Healing Relationships Further

Reading

Patients 0 to 18 years

Sleep

Getting adequate sleep and restFeeling and being rested. Helps recovery of child. Prerequisite for psychological wellbeing. Create facilities for parents, comfort and quietness, private rooms.

Olds et al., 1987

Basic Physiological Needs

Food

Getting adequate foodMeeting appetite. Helps recovery prerequisite for psychological wellbeing. Increase choice of food and ability to make your own in nearby pantry.

F. de Vos, 2004

Pain

Getting adequate pain reliefAvoid needless suffering. Self-administering of pain medication. Alternatives for pain relief such as place for praying, relaxation, meditation, etc.

F. de Vos, 2004

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Seven dimensions

Patient & Parent(s)

Safety &Security

SocialSupport

Normalized Behavior

Normalized Environment

Distraction & Engagement

Basic Physiological Needs

Agency & Control

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Pre- post comparison

WestchesterMedical Center

Maria FareriChildren’s Hospital

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Methods used

Literature Analysis

Participant Observations (700 hours)

Interviews (N=142)

Behavioral Mapping (40 days x 5 times)

Questionnaires (N=510)

Photography (3,000 photos)

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Basic physiological needs

“Food should be provided for parents as well as the children, so that we as parents don’t have to leave our child’s bedside to eat.”

--A mother

Most parents do not want to leave their child alone even for a few minutes

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Normalized behavior

“Patients are often too sick to get out of bed.”

Not if we create reasons for them to get out of bed

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What about Staff?

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The eightth dimension

Patient & Parent(s)

Safety &Security

SocialSupport

Normalized Behavior

Normalized Environment

Distraction & Engagement

Basic Physiological Needs

Agency & Control

What about Staff?

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Balancing the needs of all users

Balancing needs

Patients & Family Staff

Functionality Efficiency Comfortable

Environment Manageable

Environment

Patient &Parent(s)

Basic Physiological Needs

Safety & Security

SocialSupport

Normalized Behavior

Normalized Environment

Distraction & Engagement Agency &

Control

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Balancing needs

Ease boundaries between families and staff Empowering parents and patients Confidentiality issues staff

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Holistic Healing Environments

Patients

Normalized Behavior

Distraction & Engagement

Social Support

Normalized Environment

Basic Physiological Needs

Agency & Control

Safety & Security

Supportive & Effective Parents

Supportive & Effective Staff

Control

Functionality & Efficiency

Distraction

Convenient & Restorative

Facilities

Family Centered

Care

© F.

de

Vos,

200

5

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Growth and application3

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Growth & adaptation

From children’s hospital

(US)

to

General hospital (NL)

Senior housing

Rehab center

Acute psychiatry

General real estate

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Holistic Healing Environments

Patients

Normalized Behavior

Distraction & Engagement

Social Support

Normalized Environment

Basic Physiological Needs

Agency & Control

Safety & Security

Supportive & Effective Parents

Supportive & Effective Staff

Control

Functionality & Efficiency

Distraction

Convenient & Restorative

Facilities

Family Centered

Care

© F.

de

Vos,

200

5

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ModelHolistic Healing

Environments

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Checklist Patients and Visitors

A Orientation / AccessibilityIn a stressful situation we perceive our environment differently. It is therefore important to create an inviting and easy to find and access location.

Location

A1Does the location suit the client? Safe, green, quiet, shops in the vicinity etc.?

- + A

A2Is the environment safe, also in the evening? Does it feel safe?

- + A

A3Is the building on the ground floor? Is it a low rise building?

- + A

A4 Can one easily find the building, also at night? - + A

A5 Are the signs easy to read, also at night? - + A

A6Can one reach the location by public transportation?

- + A

A7Can one easily locate and find the main entrance to the building?

- + A

Evaluation patients & visitors

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Evaluation Patients & Visitors

A Orientation / Accessibility

Location

A1Does the location suit the client? Safe, green, quiet, shops in the vicinity etc.?

- + A

A2Is the environment safe, also in the evening? Does it feel safe?

- + A

A3Is the building on the ground floor? Is it a low rise building?

- + A

A4 Can one easily find the building, also at night? - + A

A5 Are the signs easy to read, also at night? - + A

A6 Can one reach the location by public transportation? - + A

A7Can one easily locate and find the main entrance to the building?

- + A

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Evaluation Patients & Visitors

Orientation

Food

Patient Room

Environmental Aspects

Bathroom

Treatment RoomsIsolation

Family Support

Distraction

Building Overall

Hotel Services

0

50

100

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Evaluation Staff

Building Overall

Efficiency

Environmental Aspects

Support

CommunicationPatient Room

Facilities

Patient Focused

Facilities Residents

0

50

100

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How to use the building to support strategic goals Market share Less medical errors Less aggression,

incidents, medication Infection control Philanthropic support Volunteer involvement Patient/family

satisfaction Staff satisfaction Staff turnover rates Staff recruitment Community pride ….....

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Knowledgeable Design