Eco-effective design and evidence-based design: perceived synergy and conflict

Influence of the Acoustic Environment in Hospital Wards on Patient Physiological and Psychological Indices

Patients in general wards are often exposed to excessive levels of noise and activity, and high levels of noise have been associated with depression and anxiety. Previous studies have found that an appropriate acoustic environment is beneficial to the patient's therapeutic and treatment process; however, the soundscape is rarely intentionally designed or operated to improve patient recovery, especially for psychological rehabilitation. To gain the most accurate, and least variable, estimate of acoustic environmental stimuli/properties, virtual reality (VR) technology should be used to ensure that other environmental factors are stable and uniform in order to reduce the stimulation of other environmental factors. Therefore, this study aims to discuss the influence of the acoustic environment on patient physiological/psychological indicators and the mechanism of the effect on recovery using VR technology. A digital three-dimensional (3D) model of a hospital room was constructed, and experimental subjects wore VR glasses to visualize a real ward scene. Four typical sound categories were selected to analyze the effect of the acoustic environment on recovery; physiological indicators were monitored, and psychological factors were subjectively evaluated. The results show that music plays an important role in reducing stress as it can aid in a patient's physiological (skin conduction levels) and psychological stress recovery. Furthermore, mechanical and anthropogenic sounds exert negative effects on a patient's stress recovery. However, the effect is only limited to psychological stress indicators. The interaction effects of demographic characteristics and the acoustic environment are not significant, and future studies could consider the social-economic characteristics of patients. Based on these findings, we provide evidence that indicates that a hospital's acoustic environment is an important influencing factor on the stress recovery of patients and can serve as a reference for healthcare architects and policy makers.

Evidence-based design and transformative service research for the healthcare in hospitals

Purpose

The purpose of this study is to combine the two fields of transformative service research (TSR) and evidence-based design (EBD) to improve the healthcare service provided in hospitals. TSR and EBD are two separate research fields that aim to improve the well-being of consumers within the service sector. Research propositions for making changes in the hospital physical environment to improve the patient well-being are developed to link the two fields.

Design/methodology/approach

This work takes a theoretical approach to develop research propositions based on the literature. The research propositions guide the development of the framework developed for future studies under TSR and EBD.

Findings

The research propositions should be tested empirically in future studies to develop a methodology for transforming a hospital physical environment. The implementation of these propositions would allow hospitals to reach a new and more sustainable competitive advantage.

Originality/value

The relationship between the domains of TSR and EBD has not been explored before in the literature. This study presents an unprecedented work that is needed to improve patient well-being. It contributes to TSR and EBD by providing a research agenda for healthcare practitioners and researchers to pave the way for achieving improved healthcare services focusing on patient well-being and sustainability.

Sustainable healthcare design

Purpose

Healthcare projects face multiple obstacles in achieving sustainability. This paper aims to provide information regarding the energy consumption of healthcare facilities, to identify barriers to sustainability and to suggest methods to improve the effectiveness of these buildings.

Design/methodology/approach

This study investigates sustainability in healthcare buildings by examining national databases about energy use and energy savings. The authors then initiate a dialogue on this topic by interviewing experts in healthcare planning and design regarding the implications of this data, challenges to sustainability and potential solutions to these challenges.

Findings

An analysis of data from the Energy Information Administration revealed that healthcare facilities rank second among building types in the USA in energy use per square foot and rank fourth in total energy use. Data from the US Green Building Council showed that only 1 per cent of healthcare buildings are registered with the Leadership in Energy and Environmental Design rating system, and 0.4 per cent have achieved certification, which is low compared with other building types.

Research limitations/implications

Research and discussion must continue engaging all stakeholders to interpret the data and identify transformative solutions to facilitate sustainable healthcare design construction and operation.

Practical implications

It is important to approach sustainability in healthcare from social, economic, environmental and health-related perspectives. The authors identify five major barriers to sustainable healthcare design and construction and discuss 12 practical solutions.

Originality/value

Given the energy demands of healthcare buildings, facilitating their sustainability has the potential to make a significant difference in national energy use. Empirical research and evidence-based design can potentially help to accelerate sustainability by clarifying impacts and documenting the economic and operational returns on investment.

Analysis on energy efficiency in healthcare buildings

The aim of this paper is to analyze and quantify the average healthcare centres' energy behavior and estimate the possibilities of savings through the use of concrete measures to reduce their energy demand in Extremadura, Spain. It provides the average energy consumption of 55 healthcare centres sized between 500 and 3,500 m². The analysis evaluated data of electricity and fossil fuel energy consumption as well as water use and other energy-consuming devices. The energy solutions proposed to improve the efficiency are quantified and listed. The average annual energy consumption of a healthcare centre is 86.01 kWh/m², with a standard deviation of 16.8 kWh/m². The results show that an annual savings of €4.77/m² is possible. The potential to reduce the energy consumption of a healthcare centre of size 1,000 m² is 10,801 kWh by making an average investment of €11,601, thus saving €2,961/year with an average payback of 3.92 years.