Humane design for hospital landscapes: a case study in landscape architecture of a healing garden for nurses.

OBJECTIVE The overall goal of this study was to design a beautiful garden to provide a spatial experience of renewal for hospital nursing staff and for their ecologically- and culturally-specific healing. The first objective of this study was to identify the physical, social, and spiritual attributes of an existing courtyard to determine which features encouraged or discouraged use. A site-specific design concept and user-specific survey instrument were developed to gather data directly from the nursing staff on campus. BACKGROUND There has been growing evidence that landscapes for renewal have measurable characteristics. Physical, social, and spiritual characteristics of the landscape interrelate to determine the appropriateness of a landscape for a particular health outcome. Increasingly, evidence demonstrates that contact with the living world around us is an important part of healing and recovery. This design project created a natural opportunity to research the effect of landscape improvements on renewal. METHODS The method combined standard landscape architecture ecological site design process with a qualitative empirical study of staff characteristics and landscape preferences. The transparency of the landscape design process provided the basis for a post-occupancy evaluation in the future. RESULTS Sixty-one nurses participated in the qualitative phase of the design process. Preferences for contact with nature and privacy were significant among the staff. The spatial structure of the concepts was revised to include private table-and-chair places for one or two people and features that would encourage a contemplative pedestrian walk along existing shortcuts. To encourage the benefits of the typical staff's very short exposure to the garden, archetypal landscape features-thresholds, contemplative paths, garden benches, a symbolic creek, and sacred springs-were arranged to shift the spiritual dimension of the place from that of an exposed, dry gulley ravine to a green, fertile oasis. CONCLUSIONS The courtyard was designed based on survey results. The final design was reviewed and found to satisfy the preferences of the nursing staff. Currently, the design is being detailed for construction, and a post-occupancy evaluation is being developed to ascertain the quality of the outcome for the nurses.