Lady Cilento Children's Hospital (Catapult Grant)

The healthcare industry is increasingly adopting integrated care systems in which building design plays a significant role in patient experiences, treatment and wellbeing. People-centred building design builds on several decades of research that demonstrate how certain environments stimulate behavioural, as well as physiological and neurological changes in people conducive to healing and general wellbeing. Importantly, these design considerations for health and wellbeing are typically well aligned with concurrent efforts to increase the sustainability of healthcare facilities. This paper explores the design of healing gardens in hospitals and how these environments can moderate stress and anxiety for patients and families during potentially traumatic periods. Whilst interest in, and the inclusion of, gardens in hospitals is increasing, there still remain few examples of rigorously researched and evaluated healing gardens that demonstrably contribute to patient experiences and well-being. In particular, there is a need for insight into landscape design that extends the aesthetics and functionality of contemporary hospital design, and attends to the contextualized experience of patients, families and staff. Within this emergent field, there is a need to bring together research and industry to develop evidence-based, integrated design solutions. The recently opened award winning Lady Cilento Children’s Hospital (LCCH) in Brisbane, Australia incorporates 11 healing gardens, the design of which drew extensively on emergent evidence-based research findings about the therapeutic and sustainability properties of integrated gardens. The LCCH building itself was also designed to maximise natural light, and to enable intuitive way-finding to the gardens and throughout the hospital, as complementary means of creating normalcy for patients and reducing stress and confusion. Preliminary evaluation of the LCCH healing gardens provides evidence of how these spaces create a critical sense of ‘being away’ from the hospital, and reduce stress and anxiety. Monitoring and evaluation of the environmental performance of the gardens additionally provides data on water capture and reuse for irrigation, and temperature regulation through micro- climatic conditions. Whilst further investigations will yield additional, valuable insights, these preliminary investigations provide much needed evidence of design considerations for healing gardens that contribute to both their ability to improve patient experiences and wellbeing, as well as the sustainability of these spaces. The findings of this paper have implications for practice and partnering with academia to inform healing gardens design within the healthcare industry.

Objectives: Research increasingly indicates that nature in the built environment (i.e. nature loving cities, or 'biophilic urbanism') impacts on health and wellbeing. This calls for a holistic approach to designing health care facilities that goes beyond immediate clinical care, and prioritises the practical importance of environmental design qualities that promote health and wellbeing. Currently, there is limited understanding of the effectiveness of green spaces in promoting positive health on the users of these space. This paper builds on the 2015 Design and Health World Congress presentation about the Lady Cilento Children's Hospital (LCCH) healing gardens, presenting a narrative of the industry-academia-hospital partnership working towards mainstreaming green spaces in healthcare facilities. Specifically, the paper aims to draw attention to the lessons learned from this partnership and implications for capturing knowledge about innovation in health infrastructure to revitalise health and tackle 21 st Century challenges. Methods used: Led by Conrad Gargett, a multi-faceted partnership spanning academia, industry and government (Conrad Gargett, Queensland Health, Queensland University of Technology and Griffith University) has emerged through a desire to better understand the role of green space in health care settings and to capture qualitative and quantitative data on the performance of these spaces. Over the last several years this partnership has progressed to comprise a number of projects related to the hospital and its subtropical context, including an evaluation of end-user experience (reflective journals), a review of the design journey (archival analysis and interviews) and evaluation of micro-climate and appreciation of green space (monitoring and surveys). Results: The design of the newly completed LCCH in Brisbane, Australia presents an excellent case study illustrating health and environmental benefits that can be achieved through 'green salutogenic' design. Addressing the gap between research innovation and applied design, this paper presents an evaluation of the emerging partnership, including lessons learned and implications for this hospital, other hospitals, the healthcare industry in Australia and around the world. Conclusions: The findings of this paper have the potential to influence practice and partnering with academia to mainstream biophilic urbanism within other healthcare settings including senior living facilities, palliative care and mental health centres.