Engaging Nature - the eco ward.
The Recent Health Care Architecture in Japan symposium held at the RIBA and Cube in Manchester in September was a most important event on the Japan 2001 calendar. The occasion brought together many practitioners in hospital design from both Japan and the UK and established official links between the Japan Institute of Healthcare Architecture and Architects for Health. During a recent debrief visit to Japan it was a privilege to be invited to present a lecture to the Department of Architecture at the Tokyo University. The subject was Engaging Nature - A proposal to bring natural phenomena nearer to the inpatients experience.
In Britain as a result of extensive advocacy the health service in Britain in the last decade more artists than any other sector have been commissioned, considerably raising awareness of the aesthetic agenda. In both countries healthcare arts are used as a vehicle to promote a positive image and to enhance the corporate profile so much of the art dimension remains concentrated in the public domain of the facilities. The typical hospital arts programme however remains largely independent of the building fabric and the spatial context of the patient with its specific demands and requirements. The theme for this occasion was how to introduce the delights of nature to the hospital users and in particular the inpatient? In the UK there have been a limited number of landscape successes amongst which the gardens and courtyards at St George's Tooting and the West Dorset Hospital can be included. Similarly in Japan the roof gardens at St Luke's Tokyo and the Gamagori Hospital are exceptional. The quality of light and tree planting in the main entrance concourse and the outpatients mini lightwells at Gamagori are particularly well regarded..
The quality of the environment clearly impacts on the patients perception, their well-being, and ultimately their recovery rates. The Tokyo lecture was focused predominately on the delicate subject of the inpatients personal comfort, their space and the immediate surroundings. As a benchmark some of the best ward accommodation in Japan were presented for illustrations. The single room only wards at the exclusive St Luke's and the semi circular Keiyu Hospital suites in Yokohama with superb sea views over Tokyo Bay were selected from the new larger hospitals. It is however the smaller scale clinics were the humanitarian criteria and nature have the most chance of meeting and merging. The Dohtai Clinic in Kamakura by Norihiko Dan and the Seaward Stress Care Centre by Itsuko Hasegawa promised new possibilities in planning new forms of ward space. The listening architect Hasegawa is primarily concerned with how well the building performs its duties beyond the construction phase.. Locating the Stress Care unit next to the harbour estuary overlooking the Shiranui sea means the inpatients are able to benefit from a wash of reflected light off the tidal river. In this diaphanous building patients become subliminally orientated to the natural rhythms of the special location which have resulted in reduced length of stays. It is said looking up to the clouds on a sunny day is perhaps the most beautiful visual experience and the patient's can observe and enjoy such views floating by the roof lights in the ceiling directly above their bed headboards.
Hasegawa san was able to radically relocate the new stress care unit next to the tidal river but of course this is an exceptional case. However designers can learn at great deal from the Shiranui Hospital about how to improve the patients experience and realign the ward space to interact with the natural elements. The interface between inside and out needs attention, how do we connect the floor to the ground and the ceiling to the sky!. The immediate surroundings is the critical mediation space and requires careful landscape attention. The adjoining garden can be animated for instance by pools and running water, rocks and shrubs. The water will reflect sunlight into the space and onto the ceilings. In larger ward areas introduce roof lights or even more desirable mini light well gardens. The patient must however be empowered to control and to orientate themselves to enjoy their environment, and be also able to interact with the new social common activity spaces described earlier (see HD Mar02)
Generally the inpatient experience is highly restricted, isolated in artificial and controlled conditions hermetically sealed protected against the outside elements, their access, contact and interaction with nature denied.. Todays ward accommodation suffers from institutional conformity, is repetitive, shabbily utilitarian and cluttered with ugly & non functional furnishings.. Although clinical functionality doesn't raise spirits, such service priorities would appear to prevail. There is a growing need to re-address the situation in favour of the comfort, perception and interaction of the inpatient . The physical surroundings of the bed space are important to the spiritual well-being of the patients and engaging natural phenomenon offers a solution. Maybe the 21st century will see a move away from the clinical white cube clone to the eco-ward, a patient focused space which connects to the local culture, topography and natural habitation. The eco ward suggests a fundamental reappraisal of the bed space offering a fresh challenge for hospital design of the future
Note should readers know of outstanding examples of ward spaces which invite in the natural elements and surrounding landscape the author would be pleased to hear from you.
Above published in Landscape & Art Network Journal No35