Samenvatting

Purpose In recent years, the effects of the physical environment
on the healing process and well-being has proved to be increasingly relevant for the patient,
family, carers (PFC), and staff. Moreover, it is a growing concern among health care providers,
environmental psychologist, consultants, qualified installers of technologies, and architects.
These concerns are about the traditional, institutionally designed health care facilities (HCF) in
relation to the well-being of patients. Different studies have found that an improved design of the
built environment can enhance the safety and quality, satisfaction of this so-called healing environments.
This is an overview of the evidence presented in the literature on healing environments.
The scientific research on evidence-based design is ordered and structured. Method
The Cochrane Methodology1 was used to search data. Pubmed [Medline], Jstor, and Scopus
were searched for relevant articles. A total of 54 keywords were used and structured in four
groups, patient, staff, environmental factors, and relevant authors. After eliminating duplicate
articles, the remaining articles were examined for further selection. At the final stage, articles
were selected based on title and abstract that referred to the physical environment of healthcare
facilities in the title and the abstract. To order and structure the evidence regarding healing environments,
the framework of integrated building design by Rutten2 and Ulrich3,4 was used and
adapted. The studies included in the review were subdivided into two groups, PFC-outcomes
and staff outcomes by using methodology according to the pyramid of evidence5
. Results & Discussion
Results illustrate the effects of different aspects and dimensions that deal with the physical
environmental factors of HFC on PFC and staff. A total of 798 papers were found to fit the
inclusion criteria. Of these, 68 articles were selected for the review: less than 50% were classified
with a high level of evidence, and 87% were included in the group of PFC-outcomes. The
study demonstrates that evidence of staff outcomes is scarce or insufficiently substantiated. With
the development of a more customer-oriented management approach to HCF, these results are
important for the design and construction of HCF. Some design features to be addressed are:
identical rooms, single-patient rooms; and lighting. For future research, the main challenge is to
investigate and specify staff needs and integrate these needs into the built environment of HCF.