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NeuroArchitecture and the Challenges of Hospital Architecture – Part I

By Andréa de Paiva 

What is the role of architecture in a hospital building? To create environments that stimulate the doctors’ productivity? To create environments that stimulate the recovery and wellbeing of patients? Or those that stimulate the making of profit for the hospitals, favoring the freeing of rooms and consumption in the cafes? Are all these objectives always aligned? The answer is: not always.

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The hospital is an environment in which potentially conflicting interests are at stake. That is why the architects’ mission is so relevant. Experience shows that a space conceived to stimulate attention in doctors may not favor the most immediate interest of patients, which is to rest and recover. On the other hand, the activities of housing, which are increasingly important in the hospitals, can be very different of the services actually related to health, and that generates demands which are also distinct in terms of architectural solutions. Therefore, the challenge for architects is to seek balance in this equation, taking into consideration a number of needs related to users and all the professionals who make, each of them, a very particular use of the built space [1].

Keeping in mind that,  the hospitals’ activities main objective is to offer the adequate treatment for the recovery of patients. This is why neuroscience is fundamental for a balanced hospital architecture. It’s not simply about creating aesthetically pleasing environments, but also functional ones, focused on improving wellbeing. Taking that into consideration, NeuroArchitecture can help fulfill the needs of the various stakeholders, generating a much more efficient building.

A classic case that illustrates the benefits of NeuroArchitecture in hospitals is neonatal Intensive Care Units. Until a few years ago, the architects designed UCIs that prioritized the work of nurses who took care of the infants. Because of that, among other elements, the lighting had to be very efficient, so that any alteration on the newborns could be quickly identified. The infants, on the other hand, had other needs. For example, receiving adequate stimuli so that the areas of the brain responsible for vision and hearing can be properly developed. That was a very relevant point of conflict. Until the beginning of adulthood, the development of the brain is marked by several windows associated with specific functions such as balance, speech and hearing, among others. The lack of adequate stimuli during these windows can compromise permanently the development of sensory and cognitive skills. In recent times, with the help of NeuroArchitecture, this potential conflict has been recognized and the design of ICUs has changed radically [2]. On account of that, the infants’ need for stimuli has been taken into consideration along with the functional demands of doctors and nurses.

The great challenge in the architecture of hospitals remains the enormous transit of people and their diversity. The universe of patients themselves is constituted by various subgroups, like newborns, the elderly, pregnant women, among many others. Even more, the interests of each of these groups can vary depending on the reason for the hospitalization and the treatment to be received: patients from oncology, Alzheimer’s patients, those with physical needs, contagious diseases, and so on. Just like that, the care and the conditions that each group will require is specific and the space dedicated to them is also characterized by different functionalities. That goes not only for the so called general hospitals, but also for specialized hospitals, although on a lesser degree. Likewise, the interest and needs of doctors and nurses varies greatly. During a surgery, the doctor needs to be able to concentrate and, at the same time, communicate with his assistants; in talking about diagnostics and treatments which patients and their families, the environment must favor the perception of privacy so that the patients feel confident to answer honestly to the doctor’s questions; during rest breaks, it is fundamental that doctors are able to rest and relax as much as possible to go back to work fully recovered.

In the middle of all this diversity and potential conflicts, the architect must also be aware of the common interests of the various groups, like generating an environment that all the professionals, patients and family members can circulate without getting disoriented. Specifically in the field of NeuroArchitecture, the importance of biophilia is known, that is, the positive influence that comes from the contact with elements of nature, which is is important not only for the performance of doctors and nurses but also for the recovery of patients, a subject that will be explorer more thoroughly in other articles in this website.

Keeping the wellbeing and quality of life of the users of a building as a principle, NeuroArchitecture offers answers to various of the most relevant questions in the conceptualization and use of hospital structures. In that way, in making use of applied Neuroscience, the Neuroarchitect must aim to reduce the potential conflicts between interests and needs of the stakeholders and strengthen the elements of convergence. In order for that to happen, however, neuroscientists, architects and doctors must join forces to conceive hospitals with spaces that tend not only to the operational and logistical aspects, but also to the humane and psychological needs of all those involved. The focus on the cure and recovery of patients takes on a new dimension, physical and psychological, with a strong interdisciplinary content. Along with the traditional assistants, such as nurses and anaesthetists, surgeons and clinicians will have great allies in architects when it comes to the treating of patients.

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[2] EBERHARD, J. (2008) Brain Landscape The Coexistence of Neuroscience and Architecture. Cary: Oxford University Press. ISBN: 9780195331721

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