1. The Building, Growth and
Applications of a Model for Holistic
Healing Environments
Providence, June 2013
Fiona de Vos Ph.D.
Knowledgeable Design by Studio dVO
www.studiodvo.com

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Studio dVO
Research and consultancy
in Environmental Psychology
since 1995
Specialized in:
Healing Environments
Mission:
Enhancing the ‘fit’ between a
building and its users

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Agenda
1. Definition HE
2. Building of the model
3. Growth & applications

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What is a
Healing Environment?1

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Reduce unnecessary
stress for patients

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Unnecessary stress

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Create an efficient work environment …

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Create a welcoming environment for visitors

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Building the model2

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Rationale original study (2002-2005)
 Fragmented literature
 A more holistic approach to Healing Environments
 Need for more integrated approach

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Research question
 How can a hospital environment approximate the
normalcy of daily life?

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Multi-phased research design
I. Develop Charts & Model
 Literature Analysis
 Formative Research
II. Apply Model in Case Study
 Pre- and Post comparison
III. Revise Charts & Model of Healing Environments
 Implications for Design

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Creating the dimensions
Dimensions
of Healing
Related
Concepts
Design Healing Relationships
Further
Reading
Patients 0 to 18 years
Sleep
Getting adequate sleep and rest
Feeling and being rested. Helps recovery of
child. Prerequisite for psychological wellbeing.
Create facilities for parents, comfort and
quietness, private rooms.
Olds et al.,
1987
Basic
Physiological
Needs
Food
Getting adequate food
Meeting appetite. Helps recovery prerequisite
for psychological wellbeing. Increase choice of
food and ability to make your own in nearby
pantry.
F. de Vos,
2004
Pain
Getting adequate pain relief
Avoid needless suffering. Self-administering of
pain medication. Alternatives for pain relief such
as place for praying, relaxation, meditation, etc.
F. de Vos,
2004

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Seven dimensions
Patient
& Parent(s)
Safety &
Security
Social
Support
Normalized
Behavior
Normalized
Environment
Distraction&
Engagement
Basic
Physiological
Needs
Agency& Control

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Pre- post comparison
Westchester
Medical Center
Maria Fareri
Children’sHospital

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Methods used
 Literature Analysis
 Participant Observations (700 hours)
 Interviews (N=142)
 Behavioral Mapping (40 days x 5 times)
 Questionnaires (N=510)
 Photography (3,000 photos)

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Basic physiological needs
“Food should be
provided for parents
as well as the
children, so that we as
parents don’t have to
leave our child’s
bedside to eat.”
--A mother
Most parents do not want to leave their child alone
even for a few minutes

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Normalized behavior
“Patients are often too sick to get out of bed.”
Not if we create reasons for them to get out of bed

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What about Staff?

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The eightth dimension
Patient
& Parent(s)
Safety &
Security
Social
Support
Normalized
Behavior
Normalized
Environment
Distraction &
Engagement
Basic
Physiological
Needs
Agency & Control
What about
Staff?

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Balancing the needs of all users
Balancing needs
Patients & Family Staff
 Functionality
 Efficiency
 Comfortable
Environment
 Manageable
Environment
Patient &
Parent(s)
Basic
Physiological
Needs
Safety &
Security
Social
Support
Normalized
Behavior
Normalized
Environment
Distraction &
Engagement Agency &
Control

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Balancing needs
Ease boundaries between families and staff
 Empowering parents and patients
 Confidentiality issues staff

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Holistic Healing Environments
Patients
Normalized
Behavior
Distraction &
Engagement
Social
Support
Normalized
Environment
Basic Physiological
Needs
Agency & Control
Safety & Security
Supportive & Effective
Parents
Supportive & Effective
Staff
Control
Functionality &
Efficiency
Distraction
Convenient &
Restorative
Facilities
Family
Centered
Care
©F.deVos,2005

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Growth and application3

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Growth & adaptation
 From children’s hospital (US)
to
 General hospital (NL)
 Senior housing
 Rehab center
 Acute psychiatry
 General real estate

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Holistic Healing Environments
Patients
Normalized
Behavior
Distraction &
Engagement
Social
Support
Normalized
Environment
Basic Physiological
Needs
Agency & Control
Safety & Security
Supportive & Effective
Parents
Supportive & Effective
Staff
Control
Functionality &
Efficiency
Distraction
Convenient &
Restorative
Facilities
Family
Centered
Care
©F.deVos,2005

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Model
Holistic Healing Environments

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Checklist Patients and Visitors
A Orientation / Accessibility
In a stressful situation we perceive our environment differently. It is therefore
important to create an inviting and easy to find and access location.
Location
A1
Does the location suit the client? Safe, green, quiet, shops in
the vicinity etc.?
- + A
A2 Is the environmentsafe, also in the evening? Does it feel safe? - + A
A3 Is the building on the ground floor? Is it a low rise building? - + A
A4 Can one easily find the building, also at night? - + A
A5 Arethe signs easy to read, also at night? - + A
A6 Can one reach the location by public transportation? - + A
A7
Can one easily locate and find the main entrance to the
building?
- + A
Evaluation patients & visitors

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Evaluation Patients & Visitors
A Orientation/ Accessibility
Location
A1
Does the location suit the client? Safe, green, quiet, shops in the
vicinity etc.?
- + A
A2 Is the environment safe, also in the evening? Does it feel safe? - + A
A3 Is the building on the ground floor? Is it a low rise building? - + A
A4 Can one easily find the building, also at night? - + A
A5 Arethe signs easy to read, also at night? - + A
A6 Can one reach the location by public transportation? - + A
A7 Can one easily locate and find the main entranceto the building? - + A

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Evaluation Patients & Visitors
0
50
100
Orientation
Food
Patient Room
Environmental
Aspects
Bathroom
Treatment RoomsIsolation
Family Support
Distraction
Building Overall
Hotel Services

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Evaluation Staff
0
50
100
Building Overall
Efficiency
Environmental
Aspects
Support
CommunicationPatient Room
Facilities
Patient Focused
Facilities
Residents

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How to use the building to
support strategic goals
 Market share
 Less medical errors
 Less aggression,
incidents, medication
 Infection control
 Philanthropic support
 Volunteer involvement
 Patient/family satisfaction
 Staff satisfaction
 Staff turnover rates
 Staff recruitment
 Community pride
 ….....

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Knowledgeable Design