WELCOME!WELCOME!

Inaugural SessionInaugural SessionAdvisory Council MeetingAdvisory Council Meeting

June 17-18, 2008June 17-18, 2008

Roslyn Lindeim, Roslyn Lindeim, Architect and Social Architect and Social

ScientistScientist

Angelica ThieriotAngelica ThieriotVictoria FayVictoria Fay

How it All Began…How it All Began…

Planetree design theory is a synthesis of social-Planetree design theory is a synthesis of social-science research findings and original research science research findings and original research with patient focus groupswith patient focus groups

How it All Began…How it All Began…

Member of The Institute of Medicine of the Member of The Institute of Medicine of the National Academy of ScienceNational Academy of Science

Tenured Professor at the University of Tenured Professor at the University of California, BerkeleyCalifornia, Berkeley"Environmental Design, Stress and Disease" "Environmental Design, Stress and Disease"

Interdisciplinary class at UC BerkeleyInterdisciplinary class at UC Berkeley

Children's Hospital at Stanford. Children's Hospital at Stanford.

Montefiore Hospital, Bronx, New YorkMontefiore Hospital, Bronx, New York

Roslyn LindheimRoslyn Lindheim

Publications Publications (prior to Planetree)(prior to Planetree)::Uncoupling and regrouping the hospital system (CSU Center for Uncoupling and regrouping the hospital system (CSU Center for Planning and Development Research. 1967 Planning and Development Research. 1967 

Uncoupling the radiology system (Health services monograph Uncoupling the radiology system (Health services monograph series) 1971 series) 1971

Changing Hospital Environments for Children (CommonwealthChanging Hospital Environments for Children (Commonwealth Fund Publications) Fund Publications) 1972 1972

Changing Hospital Environments for Children 1972 Changing Hospital Environments for Children 1972 

Neighborhood health center project 1975Neighborhood health center project 1975

Birthing centers and hospices: Reclaiming birth and death 1981Birthing centers and hospices: Reclaiming birth and death 1981  

Roslyn LindheimRoslyn Lindheim

ENVIRONMENTS, PEOPLE, AND HEALTHENVIRONMENTS, PEOPLE, AND HEALTHAnnual Review of Public Health 1983Annual Review of Public Health 1983• Collaboration with Leonard Syme, Epidemiologist • Focus in this paper is on those factors that affect host resistance

rather than on disease agents.• All of the findings have as a common element the importance to

health of being "connected": with others with one’s biological heritage. with one’s cultural heritage

Planetree Beginnings:Planetree Beginnings:

Findings: basis of PlanetreeFindings: basis of PlanetreeThe Importance of:The Importance of:– Social Relationships

Hierarchial Status: Living and Working Conditions, Stigmatization, Participation and Control

Connection to Biological HeritageBiological Rhythms, Artificial Light,

Findings: basis of PlanetreeFindings: basis of PlanetreeConnection to Biological Heritage (cont’d)

Connection to Nature, Connections to the Life Cycle

Connection to Cultural Heritage Connections to Place

NEW DESIGN PARAMETERS FOR NEW DESIGN PARAMETERS FOR HEALTHY PLACESHEALTHY PLACESPlaces, Vol 2, No. 4 1985Places, Vol 2, No. 4 1985

• Published after first Planetree Model Hospital completed.

• Explores implications for environmental design based on new findings of importance of social factors.

Planetree beginnings:Planetree beginnings:

Significance to health of:Significance to health of:– Social ConnectednessSocial Connectedness– Hierarchy, Self-Esteem, and MeaningHierarchy, Self-Esteem, and Meaning– Participation and ControlParticipation and Control– Connection to the Natural OrderConnection to the Natural Order– Contact with NatureContact with Nature– Connection to the Life CycleConnection to the Life Cycle– Connection to PlaceConnection to Place

Findings: basis of PlanetreeFindings: basis of Planetree

Initial Planetree DesignInitial Planetree Design

Initial Planetree DesignInitial Planetree Design

• Human InteractionHuman Interaction• Family, Friends, & Social SupportFamily, Friends, & Social Support• Information & Education Information & Education • Nutritional & Nurturing Aspects of Food Nutritional & Nurturing Aspects of Food • Architectural & Interior Design Architectural & Interior Design • Arts & Entertainment Arts & Entertainment • SpiritualitySpirituality• Human Touch Human Touch • Complementary Therapies Complementary Therapies • Healthy CommunitiesHealthy Communities

Planetree Model ComponentsPlanetree Model Components

• TouchTouch• SpiritSpirit• PersonalPersonal

• EmotionalEmotional• Caring Caring • HumaneHumane

Planetree Hospital ModelPlanetree Hospital Model

First Planetree ModelFirst Planetree Model

““At Pacific Medical At Pacific Medical Center in San Francisco Center in San Francisco

an important new an important new experiment is taking experiment is taking

place influenced by the place influenced by the experience of Norman experience of Norman Cousins. Planetree, an Cousins. Planetree, an

organization dedicated to organization dedicated to humanize health care, humanize health care,

is restructuring a hospital is restructuring a hospital nursing unit physically, nursing unit physically,

socially, and socially, and organizationally to organizationally to increase the control increase the control

patients have over their patients have over their own health and to reduce own health and to reduce

the traditional the traditional hierarchical attitudes of hierarchical attitudes of

staff.”staff.”

First Planetree ModelFirst Planetree Model

““To reinforce these changes the To reinforce these changes the physical form of the nursing physical form of the nursing

station was altered. The nurses station was altered. The nurses are no longer separated from are no longer separated from

patients and families by a high patients and families by a high counter.counter.

Instead the workspace is opened Instead the workspace is opened up, making charts available to up, making charts available to

patients and families as well as to patients and families as well as to physicians and nurses. To physicians and nurses. To

motivate patients to greatermotivate patients to greater

mobility and personal control, a mobility and personal control, a lounge has been located directly lounge has been located directly

adjacent to patients' beds.”adjacent to patients' beds.”

Families will be encouraged to Families will be encouraged to participate in patient care. There participate in patient care. There

is a place for them to stay is a place for them to stay overnight, and even a small overnight, and even a small

kitchen has been constructed so kitchen has been constructed so that patients can have their own that patients can have their own

favorite foods on their own favorite foods on their own schedules.”schedules.”

First Planetree ModelFirst Planetree Model

First Planetree ModelFirst Planetree Model

To personalize and To personalize and deinstitutionalize the deinstitutionalize the

environment and create environment and create a more familiar and a more familiar and relaxed atmosphere, relaxed atmosphere, careful attention has careful attention has

been given to the been given to the quality of light, the use quality of light, the use of natural woods, and of natural woods, and

the selection of the selection of paintings, plants, and paintings, plants, and

fabrics.fabrics.

Design MattersDesign Matters• Environment is significantly related to recovery ratesEnvironment is significantly related to recovery rates• Patients behave better in well designed rooms.Patients behave better in well designed rooms.• Design of a hospital makes a difference to staff morale.Design of a hospital makes a difference to staff morale.

– 2003 CABE/ICM Survey (Great Britain)2003 CABE/ICM Survey (Great Britain)

• Physical improvements may improve patient’s perceptions of care.Physical improvements may improve patient’s perceptions of care.– Swan JE, Richardson LD, Hutton JDSwan JE, Richardson LD, Hutton JD Health Care Manage RevHealth Care Manage Rev. 2003. 2003

• Physical improvements may shorten length of patient stay and reduce need for analgesicsPhysical improvements may shorten length of patient stay and reduce need for analgesics– Lawson B, Phiri M.Lawson B, Phiri M. Health Serv Journal. Health Serv Journal. 2000 2000

Can Design be a Complementary Can Design be a Complementary Therapy?Therapy?