Can the Design of Hospitals Help Patients Recover Faster

Can the way hospitals are designed improve the experiences of staff and visitors, and even the recovery of patients? Lucy Maddox finds out.

"If one room can alter how we feel, if our happiness can hang on the colour of the walls or the shape of a door, what will happen to us in most of the places we are forced to look at and inhabit? What will we experience in a house with prison-like windows, stained carpet tiles and plastic curtains?" — Alain de Botton

This summer, Laura gave birth to twins. Five weeks early.

Laura's girls were looked after in the Dyson Centre for Neonatal Care at the Royal United Hospital in Bath, England. Laura arrived there after a caesarean section, having lost more blood than expected and with a dangerously low temperature. Despite her condition, she remembers being wheeled through the double doors of the Centre for the first time: "It's kind of a blur," she says. "But I do remember the light just really hitting me."

To reach the Dyson Centre you have to walk, or be wheeled, through the old corridors of the main hospital. It feels hot, that particularly uncomfortable hospital warmth that amplifies the medical smell. Your shoes click on the lino floors and the sound echoes off the plain walls.

As soon as you go through the doors to the Centre, things change. It is light, airy and spacious. Natural wood and soothing greens make it feel more like a Scandinavian spa than part of a hospital. You're greeted by a wooden reception desk, and to the left, French windows open onto a Zen-like pebbled garden. It smells slightly of chlorine, like a posh swimming pool.

The Dyson Centre, finished in 2011 and funded in part by Sir James Dyson, of vacuum cleaner fame, is an example of a new and different type of healthcare design. Deliberately distancing itself from the traditional hospital look, feel and smell, this and other places like it are drawing on a growing body of research that shows that buildings themselves can speed the recovery of patients, as well as boosting the health and happiness of the staff who work in them.

The Dyson Centre is eight decibels quieter than the old Neonatal Intensive Care Unit that it replaced, and has both more natural and more controllable light. A central corridor loops round in a horseshoe shape with smaller rooms coming off it. The ceiling of the corridor is high, with skylights running its whole length, bright blue sky visible throughout. The upper walls are painted moss green. The floor below is a sandstone colour and the walls and the ceiling beams are whitewashed wood, not unlike a sauna.

The babies who need most care are in the high-dependency room. It's dark as you enter, but the room still feels spacious, and the size of the tiny babies makes it seem even bigger. Born before they were quite ready, the babies are a disconcertingly dark red colour and lie in futuristic white cots with plastic bubbles protecting them. Further round the corridor the rooms progressively become lighter, with fewer machines, and bigger, healthier-looking babies.

The ward was designed to give parents a sense of progress as their newborns move from the high-dependency room to regular neonatal rooms. Laura, mum of the twin girls, noticed this sense of flow: "It's like a horseshoe really. You have to make your way around."

Looking at the original sketches for the Centre, one of them stands out. The architect has drawn the building like a hug, its arms enveloping a baby. "The whole point… was to provide a secure base," says clinical psychologist Dr Mike Osborn, who was part of the team consulted about the design. "Secure base" is a term from attachment theory. It explains how as infants we attach to our primary caregivers, using them as a secure base from which to explore the world, and returning to them when we are afraid, ill or in need of care and reassurance. "Essentially we want the building to be a great big nurse. A really good nurse," he says.

The design principles in typical healthcare environments inadvertently make patients and staff more stressed, Osborn says. "Ceilings are low, the lights are glaring, the floors are noisy, the privacy is non-existent," he says. "It all accumulates to push us towards hyperarousal… it's not soothing at all."

For a building to be therapeutic, it should have spaces that flex to allow both sociability and privacy. Social spaces with comfortable, movable furniture encourage people to speak to other patients. Places that encourage family and friends to visit, like single-bed rooms or private areas which can be screened off, increase visiting, reduce patient stress and speed up recovery.

The Centre has been designed to allow families to get a balance between socialising with other patients and privacy. For example, relatives are free to rearrange the chairs, which are different heights: tall ones for looking in the incubators and lower, more comfortable ones for holding the babies.

"It's very different," says Debbie Grant, nurse specialist at the Centre. "I can honestly say I fell in love with this building."

James Dyson, who enjoys living in the Wiltshire countryside, believes that good hospital design can make people get better more quickly. "Well-considered design and the inventive use of technology at the Dyson Centre for Neonatal Care is improving the health of premature babies," he says. "New research, comparing the old and the new building, has proved that the building is a treatment in itself."