Meeting human needs in the spaces we design and the health care we deliver is paramount, according to cutting edge experts in these fields. When form follows function and function includes visceral and emotional needs, people flourish.
At a recent University of Texas at Austin conference, The Psychology of Architecture, Dr. Cristina Banks, Director of the Interdisciplinary Center for Healthy Workplaces at University of California, Berkeley, was emphatic about the power of design to conjure well-being. She said that if the built environment meets eight human needs — physical vitality, equity, connection, safety, flexibility, predictability, comfort and privacy — people are productive, happy and healthy. Spaces that stimulate conversation with others but also facilitate solitude bring out the best. Banks explained that whatever one’s role in the office, when all players have access to private space, wellness is preserved.
Another feature of a well-designed building is proximity to nature. Buildings with ample windows, raw wood, greenery, films of waving wheat, rolling waves and fluttering leaves in enclosed stairwells keep people peppy and primed to engage. In “sick” or “toxic” buildings, sick days, slack-off and miseries mount. When people are seated in windowless boxes for the duration of the day it takes a toll. Exposure to nature, autonomy and agility breed positive results in work and preserve wellness.
Another speaker, UT Austin School of Architecture Dean Elizabeth Danze, described commonalities between the psychoanalytic process and architecture. A successful building and a successful psychoanalysis free the inner person. A good building, like a good treatment, awakens daydreams, deep wishes, imagination, tranquility and creativity. Danze pointed out that we have visceral responses to our spaces — they have a huge impact on emotion.
Dell Med is also designing health care to meet human needs. Through a deeper understanding of the people we treat and the circumstances they face, we can create health-enhancing spaces. Stacy Chang, Executive Director of the Design Institute for Health, writes, “The patient is an equal partner in care, and the healthcare profession’s responsibilities include capturing the patient’s narrative and co-designing a personal health plan.” Reductions in hospital stays, pain prescriptions and costs ensue when we take the time to understand the inner workings of people.
One might say that medicine has always focused on treating human needs. After all, that’s what we do: diagnose, deliver and restore as much as we can. This is tricky because (spoken from the view of a psychoanalytically trained psychiatrist) the true need is not always expressed. Maybe the patient has not had enough time or information to reflect upon what he or she truly wants. Perhaps “yes” or “no” questions from a checklist do not allow the deeper need or true problem to fully emerge. In other words, sometimes the communicated chief complaint is not the actual chief complaint. For example, physical pain can be an expression of emotional distress. Some people grow up in a world where the processing of emotion is neither taught, nor encouraged.
Deep listening on the part of clinicians leads to conversations that can elucidate true needs. My colleague, Dr. David Ring, Associate Dean of Comprehensive Care, and I are trying to design questions that connect to patients on a deeper level, helping them feel cared for and engaged. While time for a longer dialogue helps, even a five-minute empathic exchange during a physical exam can change a mood, a mind or a course of treatment. Meaningful dialogue in an overall therapeutic milieu can have an impact. A culture of care can be powerful. From the way the first screening questionnaire is presented, to the voice on the phone, to the painting behind the desk, to the view out the window — little things add up. Being connected to a place that conveys beauty, possibility and openness can motivate people to protect and maintain their health.
As Beto Lopez, Managing Director of the Design Institute for Health, said in a South by Southwest interview, “The biggest thing we have learned is to start with the needs people have and create what we can with that information.” As it is in architecture, so should it be in health care.