Nerad Thesis Research : Fall 2017

NO APPOINTMENT NECESSARY instilling healthcare institutions with preventative wellness programming

Rebekah Nerad January 28, 2018

MI

ME

MOV

THREE ENE LANGHANA SAMA

IND

EAL

VEMENT

ERGETICS ANA BRAHMANA

CONTENTS

THESIS STATEMENT + QUESTIONS RESEARCH

stress in america

evidence-based design yoga levels of consciousness yoga energetics

surveys narratives

PRECEDENT ANALYSIS

park royal hotel alfred caldwell lily pool galter lifecenter swedish covenant hospital

IMPLEMENTATION

concept diagram key definitions movement sequence

study models

RESOURCES

THESIS STATEMENT + QUESTIONS

Current healthcare institutions, underlined by isolation and stress, primarily cater to illness and death. Strategically surrounding preventative and passive wellness programming around medical centers transforms the medical typology into holistic sanctuaries that promote daily health and well being.

By implementing phenomenological design strategies, new spaces will engage nutrition, meditation, and fitness.

Can small scale architecture help redefine the U.S. Healthcare industry?

Can hospitals be better integrated into their surrounding communities?

Can spatial design improve preventative healthcare?

RESEARCH

My research methodology is supported by literary reviews into current U.S. healthcare perceptions/efficacy, evidencebased design, and the yoga energetics/consciousness. The surveys and narratives were developed out of the base research. As I move forward, the research will also influence the context, site, and building analysis of my chosen prototype hospital - Swedish Covenant Hospital in Chicago, IL.

STRESS IN AMERICA surveys from 2007-2017, american psychological association

AVERAGE STRESS LEVEL (2017) Scale of 1 - 10, 1 is low stress and 10 is high stress

SOURCES OF STRESS (2017)

SYMPTOMS OF STRESS (2015)

6.2 6.0 5.6

5.5

5.4

5.3 5.4

5.4

5.2

5.1 5.1

5.0 4.8

2007

63%

2008

62%

2009

2010

2011

61%

57%

Household income less than $50K

2012

4.7

2013

Household income more than $50K

2014

51%

47%

46%

future of the nation

money

work

current political climate

violence + crime

health concerns

family responsibilities

37%

35%

34%

32%

32%

42%

33%

irritable/ angry

nervous/ anxious

lack of motivation

fatigued

depressed/ sad

lying awake

unhealthy eating

STRESS IN AMERICA surveys from 2007-2017, american psychological association

STRESS MANAGEMENT (2014) prevalence + effectiveness

HEALTHCARE PERCEPTION (2013) prevalence + effectiveness

48%

56%

listen to music

71%

62% 43%

exercise/ walk

19%

) describe their health care as good quality

42%

40%

29%

surf the internet

33%

watch tv (2+ hrs)

39%

70%

49%

read

07%

07%

get a massage

meditate/ yoga

12%

13%

09%

describe their health care as focused on education

describe their health care as focused on prevention

describe their health care as focused on mental health

“Fifty-three percent (53%) of adults say they feel good about themselves after exercising, thiry-five percent (35%) say it puts them in a good mood, and thirty percent (30%) say they feel less stressed.”

“Despite the connection between behavior and disease prevention, only ten percent (10%) describe their health care as focused on behavior or lifestyle issues that can impact their health.”

EVIDENCE-BASED DESIGN evidence-based environmental design for improving medical outcomes roger s. ulrich, phd

ENVIRONMENTAL PROPERTIES FOUND TO AFFECT OUTCOMES

HEALTHCARE ENVIRONMENT DESIGN WILL PROMOTE IMPROVED OUTCOMES IF ORIENTED TO FOSTER:

1. noise 2. music 3. windows 4. sunny rooms and view 5, single rooms vs multi-bed units 6. flooring material 7. furniture arrangement

1. sense of control and access to privacy 2. social support 3. access to nature and other positive distractions

7 LEVELS OF CONSCIOUSNESS

silence

vaishvaanara

deep sleep

unmani

dreaming

taijasa

waking

aladani

breath

prajna

senses + actions

turiya

ENGLISH

SANSKRIT

latent

active

conscious mind

body

unconscious mind

divine

THREE ENERGETICS

SAMANA

neutralizing

equalize inhalation + exhalation

twists + core

LANGHANA

reducing

lengthen exhalation

forward bends

BRAHMANA expanding

lengthen inhalation

backbends

------ to have a balancing effect on the human mind, body, and spirit

------ to have a calming effect on the human mind, body, and spirit

------ to have an energizing effect on the human mind, body, and spirit

SURVEYS a sample of the results gained in a survey meant to gather data on the intersections of the five human senses and the three energetics.

SAMANA

balancing

LANGHANA

calming

BRAHMANA

energizing

SIGHT

SMELL

SOUND

TOUCH

TASTE

winding path through a garden with elevation change.

pile of leaves.

waves lapping on the shore.

thick bark on an old oak tree.

cured scotch.

dribbling water. birds nest. gnarled tree trunk.

crisp leave in the fall. reeds in the summer.

trees rustling. snow crunching.

sand between toes. grass under your feel.

hot tea. chocolate. red wine.

tall monument. steep angles.

air rolling off a white-cap lake.

large waves.

hot sidewalk.

coffee.

SURVEYS a sample of the results gained in a survey meant to gather data on the intersections of the five human senses and the three energetics.

SAMANA

balancing

LANGHANA

calming

BRAHMANA

energizing

SIGHT

SMELL

SOUND

TOUCH

TASTE

symmetry. natural light.

cedarwood. rosemary.

gong. wind.

linen. mix of materials: stone + wood, brick + metal.

salty mixed with sweet.

crisp lines. uncluttered. windows.

lavendar. vanilla.

running water. yoga music. fire crackling. rain.

cool surfaces. book.

bread.

bright colors. high ceilings.

lemon. orange.

metal. ice cracking.

hugs.

lime.

NARRATIVES a sample of the personal narratives gathering when discussing positive and negative attributes of current the U.S. healthcare industry.

THOMAS KONG architect

saic interior

architecture chair

PAUL ALT, AIA NCARB

healing environment architect

alt architecture +

research associates

ANGELA WEISHAUPT

retired hospital technician

“I go Northwestern Memorial Hospital because it’s cafeteria has a restaurant with the best Vietnamese food in the area.”

“You notice a lot when you are waiting in a hospital, especially as a designer. Noise level, privacy, how people move through the space, but what you notice the most are the obvious things that overlooked - like how the check-in desk was not designed for someone with a traumatic brain injury, in a unit that specializes in this type of injury.”

“It is important to address all the senses in a hospital. It always smelled like cleaning solutions, which was not pleasant for anyone, especially patients. A soft blanket, a room with a window to let the sun shine in, and music always made my patients feel better. I also found that artwork that had a pathway comforted people. It let them ponder their future, that they would not be in the hospital forever.”

PRECEDENT ANALYSIS

This precedent analysis focuses on two main areas of study movement sequences and implementation of the senses in the spatial design.

PARK ROYAL HOTEL 2013 - woha architects singapore

TYPICAL MOVEMENT SEQUENCE, HOSPITALITY

arrival

check-in

image source : https://inhabitat.com/park-royal-tower-wohas-stunning-vertical-urban-park-opens-in-singapore/

wayfinding

length of stay

check-out

exercise

nutrition

knowledge

relaxation/ meditation

departure

PARK ROYAL HOTEL 2013 - woha architects singapore

SENSE ANALYSIS

SIGHT

natural daylight plants vertical wood metal rails stone floor

SMELL

plants natural air wood surrounding smells

SOUND

wind footsteps talking

TOUCH

textured stone wood metal plants

TASTE

not evident

ALFRED CALDWELL LILY POOL 1936 - alfred caldwell (redesign) chicago, illinois

TYPICAL MOVEMENT SEQUENCE, OUTDOOR GARDENS + PAVILION

arrival

image source : https://www.gardenvisit.com/gardens/alfred_caldwell_lily_pool_lincoln_park

wayfinding

length of stay

wayfinding

exercise

contemplation/ meditation

nutrition

social engagement

departure

ALFRED CALDWELL LILY POOL 1936 - alfred caldwell (redesign) chicago, illinois

SENSE ANALYSIS

SIGHT

natural daylight lily pond surrounding green rough-cut stone natural wood

SMELL

water lilies wood grasses trees

SOUND

water wind footsteps birds talking

TOUCH

rough-cut stone wood grass/plants water

TASTE

not evident

GALTER LIFECENTER swedish covenant hospital chicago, illinois

TYPICAL MOVEMENT SEQUENCE, HEALTH + WELLNESS CENTER

arrival

wayfinding

image source : https://www.google.com/maps/galterlifecenter

locker room/ waiting

length of stay

locker room

sauna/steam/ meditation

personal exercise

private class/ group class

nutrition

departure

GALTER LIFECENTER swedish covenant hospital chicago, illinois

SENSE ANALYSIS

SIGHT

classmates artificial light hard surfaces mirrors building systems

SMELL

classmates class tools cleaning solutions

SOUND

breathing movement quiet chattering instructor building systems

TOUCH

wood floor mirror glass gysum wall class tools

TASTE

not evident

SWEDISH COVENANT HOSPITAL 5145 n california ave chicago, illinois

TYPICAL MOVEMENT SEQUENCE, HOSPITAL

arrival

wayfinding

image source : https://www.google.com/maps/swedishcovenanthospital

check-in

waiting

appointment

diagnosis

treatment

departure

SWEDISH COVENANT HOSPITAL 5145 n california ave chicago, illinois

SENSE ANALYSIS

SIGHT

natural daylight plants fireplace aquarium

SMELL

plants fireplace cleaning solutions

SOUND

fireplace aquarium vocal chattering footsteps

TOUCH

stone wood textile terrazo glass

TASTE

not evident

IMPLEMENTATION

This section includes the preliminary stages of design work, based upon the research outlined in the previous sections.

CONCEPT DIAGRAM

movement

architecture of experiential wellness

three energetics + phenomenology

meal

health institution

mind

KEY DEFINITIONS

HEURISTIC APPROACH

------ enabling a person to discover or learn

something for themselves

( merriam-webster.com )

PHENOMENOLOGICAL DESIGN

------ implementation of sensory design to create

specific user experiences

( Holl, Pallasmaa, Pérez-Gómez )

EVIDENCE-BASED DESIGN

------

well-designed physical settings play an important role in making hospitals safer and more healing for patients, and better places for staff to work ( Roger S. Ulrich, PHD )

LOCAL COMMUNITY

------

not to live in isolation but in the company of others who share similar values and interests, and interact for mutual benefit ( merriam-webster.com )

PROPOSED MOVEMENT SEQUENCE

treatment

diagnosis

appointment

arrival

wayfinding

length of stay

wayfinding

exercise

contemplation/ meditation/ social support

nutrition

departure

SENSORIAL MODELS

STUDY MODEL ONE

STUDY MODEL ONE

STUDY MODEL ONE

RESOURCES

HEALTH, WELLNESS + YOGA PHILOSOPHIES

PHENOMENOLOGY + EVIDENCE-BASED DESIGN

PRECEDENTS

VA Healing Environment Design Guideline : Paul Alt

Ann Berger, MD : Chief of Pain and Palliative Care, NIH

Yoga in Practice : Edited by David Gordon White

Yoga - the poetry of the body : Rodney Yee

The Death and Life of Great American Cities : Jane Jacobs

The Geography of Bliss : Eric Weiner

Place and Placelessness : Edward Relph

Evidence Based Environmental Design for Improving Medical Outcomes : Roger S. Ulrich, PHD

Health Benefits of Gardens in Hospitals : Roger S. Ulrich, PHD

Healing Environment : A Review of the Impact of Physical Environment Factors on Users. Building and Environment Journal. E.R.C.M. Huisman, E. Morales, J. van Hoof, H.S.M. Kort

The History of the Senses : Diane Ackerman

Atmopheres : Peter Zumthor

Questions of Perceptions, Phenomenology of Architecture: Holl, Pallasmaa, PĂŠrez-GĂłmez

Swedish Covenant Hospital. https://swedishcovenant.org/

Galter LifeCenter. https://galterlifecenter.org/home

Stress in America Surveys 2007-2017. American Psychological Association.

A Review of the Research Literature on Evidence-Based Healthcare Design : Roger S. Ulrich, PHD

Park Royal Hotel. https://inhabitat.com/park-royal-tower-wohas-stunning-vertical-urban-park-opens-in-sin gapore/

Alfred Caldwell Lily Pool. https://www.gardenvisit.com/gardens/alfred_caldwell_lily_pool_lincoln_park