While the healthcare system in America is in a state of crisis, the hospitals, care centers and research facilities that make up the industry -- in the States and abroad -- have never looked better.
Gone are the days of sterile spaces, shared rooms and buildings that could be confused for corporate offices. Instead, we've seen a new class of hospitals that are more like hotels, with private rooms, gardens and art installations.
But competition is driving people away from private facilities and into county hospitals that are adopting a new, more patient-centric approach, according to Pat Bosch, design director at the Miami office of architecture firm Perkins + Will.
"We're seeing a lot of intersections with corporate America, retail, hospitality and civic [architecture]," she says. "It's about: How do you attract and retain your community and your patients? How do you attract and retain doctors and nurses?"
The 'same principles as medicine itself'
To answer these questions, today's healthcare design follows the same principles as medicine itself — extensive research, data-driven decisions and constant reassessment.
This research-heavy approach, known as evidence-based design, forces design firms to take the tiniest details into consideration, from minimizing the distance between the nurse's station and patients' rooms, to perfecting the acoustics for quieter wards and choosing hardware that limits infection.
The challenge that many designers face is convincing clients to approach these considerations in new and inventive ways.
"As a designer who approaches things from a humanistic and contextual perspective, the challenge I always encounter comes from a facilities perspective -- the old-school mentality of 'I've done this before [and] I want to do it again the same way.'"
A balancing act?
Design firms must also balance the technical needs of doctors and staff with the comfort of patients.
This is where innovative solutions come into play. At the Jacobs Medical Center in La Jolla, California, the design director of CannonDesign's Yazdani Studio, Mehrdad Yazdani, created sculptural walls behind patients' beds to house medical equipment that is usually left out in the open.
"You see [headwalls] in most hospitals. But while they're very needed, they're not necessarily aesthetically pleasing and are, if anything, intimidating to patients and their families." he says. "[My design] has panels that are removable, so they don't only conceal a lot of that technology, making it less intimidating, but they also give the hospital flexibility as technology changes and the needs are different."
Maggie's Centres, a collection of cancer support facilities on hospital campuses in the United Kingdom, Hong Kong and Japan, are known for their creative designs by 'starchitects' such as Zaha Hadid, Frank Gehry and Sir Norman Foster.
Since Maggie's Centers are not treatment facilities requiring complex technological considerations, architects who might not normally take on healthcare projects are able to create spaces that are inspiring and healing.
"There's just no question that when someone walks into [a Maggie's Centre], there's something about the architecture that you can see people's body language," says Laura Lee, the chief executive of Maggie's Centres.
"They quickly change from being tense and anxious. Their shoulders relax. There's something about the materiality of the building that says it's a nice place to be."
On June 9, Maggie's opened its latest center in Oldham, a town northeast of Manchester. Designed by London-based firm dRMM, the simple timber building hovers over a landscaped garden, offering serene views of the horizon and the nearby Pennines mountain range.
Architecture as an oasis
One of dRMM's co-founders, Alex de Rijke, calls it an "oasis" and a "manifesto for healthy architecture."
"We tried to make a building that offered a three-dimensional statement about what healthcare architecture could be," he says.
"That's important to me, as is the idea that we're bringing some pleasure -- simple pleasures -- to people who are having a really hard time."
Throughout the design process, de Rijke and his team researched cancer treatment and healthcare architecture extensively. As well as consulting Maggie's, they spoke with cancer patients and their loved ones to figure out how to make the new center as comfortable as possible.
Their findings present themselves subtly throughout the 2,800 square-foot center. Wooden handles replace sterile metal ones, which can aggravate the neuropathic hands of patients undergoing chemotherapy.
Carefully placed eaves protect photosensitive patients from UV rays, while allowing in enough natural light to enliven the space. The neutral color palette offsets post-treatment pallor.
De Rijke says: "It's not like you sit in this chair and receive radiotherapy or chemotherapy, and the chair has to be this big and in this position relative to the window. That's the land of hospital design. This is much more about the relationship between psychology and design."
Design beyond function
Creating a calming environment is a top priority in hospitals and treatment centers, given that reduced stress has been shown to shorten patient stays. Firms have worked to bring nature into the patient experience with indoor and outdoor gardens, glazed exteriors that provide views and light, and the use of natural materials such as wood and stone.
For the Kaiser Permanente Radiation Oncology Center in Anaheim, California, Yazdani used his design to connect the facility with the landscape, something that was previously unthinkable, given the need to contain radiation. His team installed zen gardens and living walls that face the treatment rooms.
Even after these projects open, they continue to be studied by researchers -- and design firms themselves. "We want to go back after a few years to look at the length of [patients'] stays to see if this building is helping speedy recovery because of the comfort and experience that we created through its planning and design," Yazdani says of Jacobs Medical Center.
This constant research allows design firms to keep testing and refining innovative solutions that can improve the patient experience and add beauty to their communities.
After all, as Yazdani notes: "These medical facilities and hospitals can be beautiful and powerful pieces of architecture beyond just being functional buildings."