What do most architects think of when they hear the term healing environment? Is it innovative technology, buildings, and facilities planning? Or is it water features, artwork, and views of lush landscaping? The answer should be both, according to Portland, Oregon-based landscape architecture firm Macdonald Environmental Planning (MEP) when challenged with broadening the definition of a healing environment and communicating this expanded view with the Samaritan Health Services system. The plan encompassed five hospitals and two senior care facilities in the Willamette Valley and along the Oregon coast.

 

Typically, healthcare administrators and facilities managers involve landscape architects late in the decision-making process – often after major planning decisions have been made. The result? Missed opportunities: Views of parking and maintenance areas from patient rooms, entrances made up of asphalt, areas of un-mowed and un-irrigated grass, and a lack of uniform signage. By themselves, these can be minor issues that don’t hold much weight. Taken collectively, these can add up to environments that can actually be detrimental to the well-being of patients, staff members, and visitors. In essence, the environment can harm instead of heal.

 

“We proposed taking a holistic approach to healing environments based on an overall master plan. The plan identified many potential projects and elements throughout the system that could be implemented as time and budget allowed,” explains MEP principal Laurel Macdonald, ASLA. “This master plan effort provided a workable, multi-year tool for Samaritan. It also created institutional support for healing environment options throughout the system.”

 

Research and site visits showed that there was no simple solution to building or planning for healing environments due to the different needs of each facility. A number of the facilities involved in the master planning process were recently combined under the Samaritan umbrella. The history of diverse ownership, coupled with regional variations, made each facility a unique situation. For example, Good Samaritan Regional Medical Center in Corvallis serves a three-county area of 250,000 people with 1,500 employees. In comparison, Samaritan Pacific Communities in Newport has 380 employees and is situated on the Oregon coast, a radically different social and physical environment. While they are now all members of the Samaritan system, they remain independent of each other in many ways. The goal wasn’t to give each facility a general aesthetic; it was important to maintain each facility’s unique regional character. This is where the healing environments philosophy came into play.

 

“We interact with many medical facilities, but mostly on a project-specific basis,” Macdonald adds. “It dawned on us that something in the way the campuses were coming together was missing. There are some great prototypes of healing gardens, but if you just create one garden without addressing the entire campus, you limit the potential to provide multiple opportunities and experiences for a variety of users. It was clear that we needed to be broader in how we implement areas for healing.”

 

The reality is that everyone in a healthcare system – administrators, staff, and patients – has a different idea about how an environment can contribute to healing. The specifics of facilities, priorities, and budgets all fall into place when the system administration and staff buy into and proceed with a shared vision.

 

Providing participation at all levels at all seven facilities was accomplished through a combination of communications tools including videoconferencing, web/e-mail lists, and face-to-face meetings. Visuals such as graphics, photos, and drawings helped participants explore and understand the possibilities that healing environments offer. Surveys yielded answers to questions about favorite and least favorite areas at each facility, site navigation, specific types of activities that may take place outdoors, and opportunities for privacy and respite for patients, visitors, and staff.

 

“By starting out with a discussion about how we treat one another as part of a healing environment as co-workers, visitors, and patients it became clear that not everything has to cost money,” explains Julie Manning, VP of Development and Community Relations, Samaritan Health Services. “Ultimately, MEP contributed a philosophy about how we want people to feel in our facilities. Healthcare is a people intensive, hands-on business. These projects should enhance what people are about.”

 

Upfront planning is a relatively small investment that will have a huge payoff on morale, productivity, and overall environmental quality. The planning will help in the pursuit of alternate funding sources. Progressive hospital leaders, always looking for ways to increase quality while maintaining budgets, understand this and will support funding for construction and maintenance when they see the innate value. The system-wide healing environments master plan identifies a wide range of cost benefits to make this case including:

 

·                    Less staff turnover and training due to reduction of stress

·                    Ability to recruit more qualified staff due to healthy environment

·                    Reduction of inpatient stays and recovery time increases the bottom line due to lower patient care costs and less patient transfers

·                    Ability to compete with other hospitals and systems + increased amenities = increased marketability

·                    Simple items like irrigation control systems, appropriate plants, and low-maintenance materials have an initial cost, but can save money in the long run by reducing maintenance

·                    A beautiful, well-maintained site gains more support from the community, potential donors, and funders.

 

 

 

Macdonald Environmental Planning, p.c. was established in 1982. MEP is a design-oriented firm involved in a wide variety of landscape architecture and master planning projects. The firm specializes in medical facility design and planning, housing, and sustainable design.

 

Jack Rubinger specializes in marketing for the design/architecture/construction industry; contact: 503-469-9209.