How Does Sustainable Design Help Create Better Healthcare Facilities?

Connecting patients with the natural world through design.
Robert Fryer, MA, Director of the MS in Sustainable Design Program in Jefferson’s College of Architecture & the Built Environment. ©Thomas Jefferson University Photography Services.

There is evidence that the design of a space can measurably improve patient outcomes, staff morale and visitor experience. Research from The Center for Health Design points to 12 factors that should be considered in healthcare design based on best practice research, such as access to nature, single patient rooms and furniture arrangements. Studies have shown that patient rooms looking out on sunshine, rather than cloudy or drab conditions, foster more favorable outcomes. Research has also linked the absence of windows in critical or intensive care with high rates of anxiety, depression, and delirium relative to rates for similar units with windows.

To add another layer, Robert Fryer, MA sees wellness and sustainability as inextricably linked. As director of the MS in Sustainable Design Program in Jefferson’s College of Architecture & the Built Environment, Fryer’s research centers around the potential of design to support the wellbeing of both patients and caregivers across a range of healthcare facilities, through the lens of eco-friendly practices in design. Researchers like Fryer are interested in developing approaches and tools to create spaces that are both energy efficient and socially equitable. Find out more about the questions he is trying to answer.

Q: Tell us a bit about your field or area of research.

A: I currently have two areas of research focus. The first is how to teach sustainability of the built environment more effectively. The predominant method of thinking about and teaching sustainable design ignores the fact that what we design must improve multiple factors, such as social equity, integration of buildings with ecological systems at the urban and regional scale, and eliminate carbon emissions. All of these need to be achieved simultaneously, yet students’ skills aren’t developed to think from multiple perspectives, across scales and time, and they aren’t provided with the tools to do this. My research focuses on how to develop these skills using innovative tools, and how to do this in both face to face and online courses.

The research builds on Donella Meadows’s approach to systems thinking, who, with other researchers, published groundbreaking work called The Limits to Growth in 1972. This study used system dynamics to demonstrate that environmental and economic collapse would result from a “business as usual” approach. (These predictions have so far been correct). My research looks at how this tool, which was developed for economics, can be applied to the built environment as a design tool.

The second area of research explores how to improve health and wellbeing using these approaches and tools to design spaces for seniors, such as adult daycare centers.

Q: What’s one question you’re exploring currently?

A: I’m currently exploring the potential of design to support the wellbeing of both patients and caregivers across a range of healthcare facilities. This includes the hypothesis of biophilia, which states that our physiology and psychology responds positively to being in nature. This hypothesis is supported by years of studies that demonstrate cognitive improvements when patients are immersed in nature, provided views to nature, or even their facsimiles, during a hospital stay. Designing spaces that connect people with nature are good for us. I’ve also started to look at ways to improve energy efficiency in healthcare facilities to reduce carbon emissions.

Research and understand the bigger picture first and follow the process to identify the most appropriate design. – Rob Fryer

Q: What do you enjoy most about your job?

A: Seeing students accomplish more than they thought possible. Among the classes I teach is the thesis sequence. Students are often anxious at the beginning, worried their ideas aren’t good enough or achievable. However, by the end of the two courses students surpass their initial worry and expectations and are proud of their projects, as they should be. The MSSD thesis helps students secure jobs after graduation, to be accepted to prestigious PhD programs, and has led to over 10 new businesses and a pending patent. I am always impressed with the students and what they can achieve.

Q: What’s a unique fact, surprising statistic, or a myth about your study subject?

A: Sustainable architecture cannot be achieved through energy efficiency alone. Authentic sustainability is multidimensional. The built environment is comprised of cultural needs and expressions, impacts people through subjective individual experiences and is interactive with other natural and built systems. When all of these are integrated across scales from the individual person to a building, to a site, to a city and beyond it becomes truly sustainable.

Q: What are the biggest challenges to teaching this concept to your students?

Expanding their minds to think beyond the building form, which is the focus of conventional architectural education. Instead, getting students to put that aside for a moment to research and understand the bigger picture first and follow the process to identify the most appropriate design is difficult for those who are product-focused. Process versus product is an approach that can be unfamiliar to students.

Q: Is there a piece of advice that stuck with you or that you try to pass on to young researchers?

A: Linear, reductive reasoning is a powerful tool, but has limited applications. The built environment is a complex system that is integrated with several other complex systems such as social interactions, government policies, ecosystems and climate. Linear thinking doesn’t help much in such conditions. It’s essential to be humble when trying to understand such systems and their interactions because the full extent of cause and effect are not just hard to understand, but are unknowable. And it’s because of this that resilience and adaptability are essential to sustain socio-environmental systems, such as cities, ecosystems and human wellbeing.

Q: What led you to Jefferson?

A: I was first hired at the University to research sustainability and help local businesses innovate to improve their ability to adapt and become sustainable. This spirit of innovation led to the creation of the MS in Sustainable Design Program, of which I am a cofounder. It was the opportunity to explore big questions, engage important topics and local leaders and find innovative solutions that first attracted me to the University.

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