HEALING ENVIRONMENT IN HEALTHCARE SPACES FOR CHILDREN

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International Journal of Architecture (IJA)
Volume 8, Issue 1, January-June 2022, pp. 1-12, Article ID: IJA_08_01_001
Available online at https://iaeme.com/Home/issue/IJA?Volume=8&Issue=1
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HEALING ENVIRONMENT IN HEALTHCARE
SPACES FOR CHILDREN
Fariel Khan1,
and Anamika Jiwane 2
1Department of Architecture and Interior Design, University of Bahrain, Kingdom of Bahrain
2 Department of Architecture and Interior Design, University of Bahrain, Kingdom of Bahrain
ABSTRACT
A new healthcare model speaks about healing and treatment to be incorporated
simultaneously in the healthcare institutions. In the absence of any them, the speedy
recovery and healing process of patients would be incomplete. Specially, when it is
about Paediatric hospitals- the multiple behavioral aspects of children like fear,
anxiety, curiosity, stress, constant mood fluctuations etc. must be considered to receive
better healing results. Based on the understanding of this important issue, the authors
have structured this paper. It views the literature reflected to healing environment,
healing design, interactive environment aspects along with the children psychology
during their hospital visit and stay. Four case studies were analyzed to highlight the
success of incorporating space planning through different design elements and smart
technology as important in enhancing the healing environment of paediatric hospitals.
Two experimental studies were conducted among students of Interior Design at
University of Bahrain to propose solutions for interactive spaces in children hospitals.
Some of these proposals are mentioned in this paper. Based on the discussion and
analysis of the studies, the authors conclude that, children being dynamic, need more
attention to make their hospital visit and stay more comfortable, engaging, painless and
highly effective towards healing. Therefore, multiple sensory space design ideas need
to be incorporated. Along with, if smart and interactive techniques are added, then their
healing experience can be tremendously uplifted.
Keywords: Healthcare spaces, healing environment, Pediatric hospitals, interactive
spaces, smart technology, physical and mental wellbeing, patient care
Cite this Article: Fariel Khanand Anamika Jiwane, Healing Environment in Healthcare
Spaces for Children, International Journal of Architecture (IJA), 8(1), 2022, pp. 1-12.
https://iaeme.com/Home/issue/IJA?Volume=8&Issue=1
1. INTRODUCTION
A new healthcare model includes the consideration of both the healing and the treatment [1].
From last three decades, the healing environment has been discussed as a crucial concept in
planning and designing the health care projects. Creating healing environment in Pediatric
hospital is a current trend [2]. Benefits of having such a physical environment on the physical
and psychological wellbeing resulting in speedy recovery, are well proven. Children are very
dynamic and exhibit multiple responses to their environment but unfortunately, they are

Healing Environment in Healthcare Spaces for Children
neglected in the field of space design [3]. It should be advised that, the designers consider the
perception of children towards the health care environment as important design data, then
design accordingly, and finally evaluate the impact of such design elements on their health.
Healing is directly associated with the psychological set up of human being. Hence healing
design in responsible for bifold changes-physical and psychological.
It has been universally accepted to integrate healing design as an important design approach
to hospitals. Various types of technology embedded interfaces, can make the spaces more
engaging and interactive. As a result of such spaces, children as patients can overcome their
pain and stress and empower their healing. Space design that will engage multi-senses and
provide participation and engagement through smart technologies can enhance the patient’s
care in pediatric hospitals. There are many benefits of creating healing environment as it helps
to reduce stress, anxiety, pain, improve immunity, help fast recovery, and thereby improve
health care quality. Health care institutions that emphasize in this, can see the results in the
formation of good bonds between the patient and the doctor. Patient care focuses on enhancing
patients wellbeing and interaction with other participants at healthcare institution to create
homely feeling that enhances their quick healing.
2. RESEARCH QUESTION
The research aims to answer the following question:
“How can space planning and design of health care spaces impact the healing process and
empower the physical and mental wellbeing of children in pediatric hospitals?”
3. LITERATURE REVIEW
3.1 Healing Environment for Healthcare Facilities
A healing environment can be defined as a holistic environment (physical and nonphysical) that
facilitates patient rehabilitation. [4]. Healing environment evokes and promotes therapeutic
effect on the patients. Through healing environment, patients’ anxiety and stress, feeling of pain
and agony can be reduced. This environment accelerates patient’s recovery process, reduces
use of medication and encourages the sense of well-being. The Healing environment not only
creates impact on the patient’s recovery process but also enhances the staff work satisfaction,
productivity and their retention [5]. Many researches showed that, the healing environment can
be created through incorporating different design elements in interior space planning. These
design elements are carefully chosen for children’s hospitals, which help to stimulate users’
multisensory experience. For example, healing environment can be created with right selection
of color [1], pleasant and therapeutic sound, natural light, visual appealing art work etc. [6].
Other studies included that, the use of interactive art [7], outdoor view [8], furnishing [9], and
atmosphere [10] can influence the creation of healing environment.
In addition, interactive spaces where children get engaged with other children as well as
with the surrounding spaces can create positive healing effects on them. Children love to play
in gardens, or interact with animals, or get happy with cheerful colors. Therefore, the enjoyment
derived from diverse visual and auditory aspects in hospital space design can distract the
children and alleviate their stress and pain. The National Association of Children's Hospitals
and Related Institutions (NACHRI) also assured that, active distraction strategies such as
providing opportunities for patients to engage in art and music can greatly help to reduce stress
and anxiety. They also mentioned that the natural sunlight can alleviate their depression [11].

Fariel Khan and Anamika Jiwane
3.2 Interactive Environment in Healthcare Facilities
Interactive technology and solutions are making a revolution in health care facilities. These
technologies are evolving unprecedented engagement of patients with the spaces in hospitals,
clinics and many other health care facilities over the world.
Hi-tech companies are producing different interactive technologies like multi-touch
interactivity, with tremendous flexibility and adoptability to install to any surfaces of any
spaces around the healthcare facilities. The users including patients can control and engage
with these products to resize, reshape, rotate and zoom in and out etc. The ground breaking
3D depth-tracking software allows the users to control onscreen interaction with simple hand
motions and gestures from a distance. In short, these are highly engaging and entertaining
for hours together for patients and visitors of all age group and with all physical abilities.
This creates a dynamic environment or sense of healing ambience. It has been a proven fact
that, all these efforts of engaging and entertaining the patients, especially the children, can
reduce their anxiety and pain, and increase their will power and motivation to recover during
the treatment.
Besides entertaining the patients, the interactive and smart technologies include point-
and-control systems, dynamic and interactive multi-touch displays etc. to search and navigate
information useful for staff members, patients and visitors [12]. The advanced technologies of
multi-sensory systems have enabled the engagement of the patients with severely limited
mobility. The users can create amazing virtual reality environments, just by waving hand, or
by the blink of an eye or the sweep of a foot and without having any direct physical touch or
contact. All these immersive virtual reality displays & equipment create huge impact and
substantial positive difference in the lives of people with disabilities. Through these
approaches, the patients from all age groups and with all types of physical situations can
build their self-esteem while having fun during their treatment [12]. Children would specially
enjoy such surrounding and environment as they are so tech-savvy in the present time.
3.3 Children and their Psychology during Hospital Visit and Stay
Some of the common changes in behavior during the hospital visit or stay in hospital may
include increased demand for attention, throwing temper-tantrums, greater fear and distress
etc. These changes can happen with children even with short hours duration in hospital as
patients. Thus, they are looking for a diversity of readily available, accessible and appropriate
leisure and entertainment facilities integrated in the hospital environment. Children like to
have social connection and technology can aid this and this can enhance their psychological
wellbeing [13]. Hospitalized children are commonly confused, frightened and need to be
treated just not as physical bodies but as human with emotions, pain, sickness, concerns,
dilemmas etc. [14].
Coping is when children try to regulate their body movements, emotions and behavior in
the stressful environment of hospitals. This can be done by using problem- solving skills,
avoidance, distractions etc. Playing can increase problem solving abilities of children. Various
studies show that, visual and auditory environment can really help the healing of kids.
Psychologist have clearly mentioned that the indoor and outdoor hospital environment can
have an impact on their healing process. Designers can take care of colors, furniture,
furnishing, light, sound, safety, artwork and moreover, the interactive spaces and surfaces to
engage the kids and distract their attention from pain and distress.
It is suggested that, hospital health care professionals must keep in mind the psychological
and emotional health of children. Their target should not be only to provide medical aid but
to create an environment in which this aid can effectively heal the children. It is well said

that, ‘immerse the kids into emotion, feelings and sensation of relaxation to escape from the
real things in hospital’.
4. CASE STUDY
Designers are taking utmost care and efforts in space planning and designing for healthcare
centers. They are adding different design elements and ideas to uplift the healing environment
of those spaces. Following are some analyzed cases, where designers have b e e n successful
in achieving healing environment in hospitals for children.
Case Study 01: The Royal Children’s Hospital, Melbourne, Australia.
Type of hospital: Providing full range of clinical services, tertiary care and health promotion
and prevention program for children.
Age group: 0-12 years old.
Concept: This case study mainly emphasizes on infusion of ‘nature’ as the main design element
to comfort the health condition of the patients.
Design elements: Layout of the building, physiography and topography of the site, nature in
interior and exterior, view to outdoor parks and indoor courtyards etc.
Figure 1 Image of Cabin reflecting homely calm and comforting environment connecting with the nature
Impact on users: Kids receive calm, comfortable and cozy environment in their cabins to live
and feel at home with their families. The layout if the building taking the benefit of its
physiography and topography of the site allows the true benefits of nature on the exterior as
well as interior.
Figure 2 layout of the hospital and the inpatient department- start shape wings of building spreading
to the nature

Case Study 02: SJD (Sant Joan de Déu) Barcelona Children's Hospital,
Barcelona, Spain.
Type of hospital: Hospital specialized in Pediatric Oncology treatment.
Age group: Infants till 21 years old.
Concept: Designers aim to create interactive spaces related to human body.
Design elements: Interactive spaces, simple signs, pictograms, installations, smart vehicle with
emotion-detecting technology etc.
Impact on users: In SJD, a new hall has been designed with five interactive and playful
installations based on interactive environmental concept related to human body. These
installations are extremely attractive for the kids that, they instantly get engaged and start
playing with them. With the help of simple signs, pictograms and with the active
participation and engagement of the kids, the installations can scan and record very important
data for the doctors in informal and friendly way. This approach helps the kids to engage with
the interactive installation, thus overcoming the fear of hospital.
Figure 3 Images of smart & interactive installations inside the SJD hospital
In addition to fixed interactive installation, they also have a mobile object (car) design
by the Hyundai motor group. This smart and innovative technology of the car can scan
facial expression, heart rate, respiratory rate etc. while the kids are playing with light, music,
rhymes and bubbles. All these attempts reduce emotional stress and anxiety of the kids and
helps in their treatment process. [15]

Figure 4 Mobile interactive installations scanning patient’s health condition
The designer needs to be careful while assigning spaces for such mobile objects so that,
they do not interfere with the circulation of users and functionality of space.
Case Study 3: Golisano Children's Hospital of Southwest Florida, USA. [16] [17]
Type of hospital: Providing facilities for behavioral health, surgery, intensive care, orthopedics,
cancer treatment, cardiology etc.
Users: Children of all ages.
Concept: The designers aim to make ease of the young patients with the help of smart
installation of interactive walls, floors, cartoon characters etc.
Design elements: Smart and interactive technology, colourful and engaging interiors etc.
Impact on Users: The children find the hospital spaces interesting, relaxing and healing.
Figure 5 Images of colorful and smart interactive installation inside Golisano Children's Hospital,
Florida
Case Study 4: Golisano Children’s Hospital, Upstate New York, USA. [18].
Type of hospital: Lifesaving care for children
Users: children of all age.

Concept: The interior of the hospital is designed to illustrate the amazing landscape of upstate
New York.
Design elements: Art and architectural features of landscape representing upstate New York,
interactive objects and spaces, smart technology etc.
Users Impact: By including the above design elements, the interior has achieved an active,
eye catching and engaging spaces where kids can feel happy and energetic.
Figure 6 Interactive and eye-catching installation of Golisano Children's Hospital in upstate New
York
Above mentioned all case studies indicate the benefits of adding interactive spaces and
design tools that can keep the children engaged and motivated in the hospital spaces during their
treatment.
5. EXPERIMENTAL STUDY
Two experimental studies were done in two consecutive years with the students of Department
of Architecture and Interior Design Program, University of Bahrain. In both the studies,
students were asked to introduce various design ideas and elements in the space planning of
hospitals which can uplift the healing process of the kids and provide enhanced health
care to them.
• Experimental study 01: Design V-Health care centers for children, as their design
project (Academic year 2020-21)
• Experimental study 02: Graduation Project-Specialized hospital for children
(Academic year 2021-22)

5.1 Experimental Study-I (Design Project-01)
Type of health care center: Kids Dental Clinic
Figure 7 Images of interactive and engaging spaces from Experimental Study-I (Design Project-01)
User Study:
• Age: Kids up to 10 years accompanied by parents/relatives
• Health conditions: kids suffering from dental pain and illness.
• Mood condition: fear, anxiety and confusion.
Expectations from hospital space: To overcome the fear in interesting and playful way.
Designer’s Concept: Conquering adversity through growth, changes and adaptation.
Designer’s approach: To create an active and joyful interior where design elements can
make the kids feel at ease and comfort.
Design Elements: Appropriate colour scheme, soft materials, curvy shapes, interactive
displays and smart technology.
Interactive Ideas:
• Display gallery: Enabling interaction with displays and learn more about dental issues.
• Kid’s zone: Providing interaction with given interior through natural elements-to keep
away from fear.
• CT scan room: Creation of galaxy space which attracts the children and release their
stress.
• Healing Library: Provision of informal sitting spaces with specially designed furniture,
appropriate colours and materials that help to heal the mind and body of the children.
• Café: Creation of welcoming, relaxing and interacting environment through the use of
hanging elements that attract children’s attention.
Impact on users: Children move throughout the hospital spaces with ease, comfort and no
fear, no pain which is intended by the designer.
5.2 Experimental Study-I (Design Project-02)
Type of health care center: Kids Nutrition Health Care Centre
User Study:
• Age: Kids up to 14 years accompanied by parents/relatives
• Health conditions: Children suffering from nutritional issues, weakness, obesity etc.
• Mood condition: frustration, depression etc.
Expectations from hospital spaces: To achieve a healthy life style and win over the obese
condition through playful way.

Concept: Designer integrated the concept of ‘Biophilia’ which is love for nature in the interior
built environment of the nutritional clinic along with the motivational and emotional
therapies to improve their healing process.
Figure 8 Images of interactive and engaging spaces from Experimental Study-I (Design Project-02)
Design Elements: Playful colors, spaces that promote playful activities, creation of social
spaces to share common interest, including nature, green spaces, daylight etc.
Interactive Ideas:
• Reception: Addition of plants to give refreshment to the eyes and allow fresh air for
good health.
• Sensory gym: Involvement of children during exercises using different senses.
• Atrium: Addition of sustainable elements of nature, plants, daylight etc. to enhance the
space experiences.
• Kids’ hub: Engagement of kids in different activities.
• Nutritionist therapy rooms: Allowing the kids to interact and be close to the doctors.
Impact on users: kids find their visit interesting and can be educated about their health and
nutrition through easy and playful means.
5.3 Experimental Study-II (Graduation Design Project-01)
Type of Hospital: Asthma Hospital for Children
User Study:
• Age: 0-12 years.
• Health Issues: Children suffering from Asthma and related issues.
• Expectations from the spaces: To enjoy a relaxed treatment and healing in the hospital.
Design Concepts:
Providing health care for children with asthma and meeting their social and edutainment needs,
by designing interactive and playful spaces that evoke their emotions and feelings.
Design Elements:
Earthy Colors, texture, sustainable, eco-friendly & hygienic materials, safe and playful shapes,
creating thematic environment of sea, land & sky.
Impact on Users:
Kids remain busy throughout their visit and stay in hospital. They get motivated and empowered
to forget their pain.

Figure 9 Interactive wall and floor inside the inpatient wards from Exp Study-II
(Graduation Project-01)
Figure 10 Interactive & thematic play area beside the outpatient dept from Exp Study-II
5.4 Experimental Study-II (Design Project-02)
Type of Hospital: Diabetic Children Hospital
User Study:
• Age: 0-12 yrs.
• Health Issues: Children suffering from diabetes and related illness.
• Expectations from spaces: To experience a healthy and welcoming environment that
supports their health issues
Design Concepts:
Providing a therapeutic & healthy welcoming environment that embraces and satisfies the needs
of the diabetic children while connecting with the nature.
Design Elements:
Colors, texture, materials, shapes, symbols, thematic characters, man-made and natural
greeneries etc.
Impact on Users:
Kids become playful and dynamic and get distracted form their painful health issues.

Figure 11 Interactive & thematic play area & corridor, inpatients ward from Exp Study-II
Above experimental studies help to identify the role of designers through space planning
and designing in creating the healing environment in pediatric hospitals.
6. CONCLUSION
The research concludes that, smart technology embedded in the spaces by the creative minds
of the designers can achieve an interactive environment in health care spaces. This can keep the
kids engaged and happy by creating a deep impact on their behavioral pattern and psychology.
The interactive environment helps to distract their attention from their painful health issues and
thus indirectly help them to improve their health condition.
The discussion on experimental studies performed during the research, highlight the needs
for the pediatric hospitals to shift their narrow focus of ‘medical treatment’ to the broader
spectrum of ‘healing environment’. Children as we know are suffering through both, the
physical as well as psychological trauma, no matter for short time or long time, during their
visit to the health care spaces. Hence, the health care professionals should encourage
appropriate environment for their quick healing. Here, the role of designers of the health care
spaces is very significant. They should incorporate suitable design tools to model the space to
be interactive, engaging, participating and thus empowering the healing process. Space
planning and design that establishes a communication between the kids and the health care
space- is the mile stone towards their healing journey.
Designers need to focus on the spaces that involve the kids through multisensory organs
and keep them active and dynamic. Since mental and physical wellbeing are primarily
connected: both clinical and persona recovery become essential to lead a better life. Designers
are responsible to achieve the wellbeing for children through the design of appropriate healing
environment.
ACKNOWLEDGEMENT
The authors would like to thank all the students of Design-V and Graduation Design for
participating in the experimental study.
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