Preface. Social aspects and well‑being for improving healing processes’ effectiveness

The need to realize a monograph on "social aspects in healthcare facilities” becomes a key-point since the new trends in new hospitals’ planning and design or renovation of an existing health structure require that all the processes must rotate around the user and his needs. Hospital, since its origins, represents the social community and, in the socio-cultural context, the return to the values of interdependence and solidarity. Moreover, it embodies the permeability and the availability of entertainment and cultural activities in order to respond to the community’s demands. In fact, healthcare facilities should be oriented to the patient, providing system of diagnostic and therapeutic processes focused on the solution of health issues and able to meet the daily needs and rights of the patient: information, user-centered environments, safety, comfort, privacy, not excessive promiscuity with other users and the opportunity to meet his relatives should be ensured to each patient. “Social aspects” mean the possibility to guarantee the central role of the patient, taking into consideration also the workers and the high stress they undergo. In this way hospital’s spaces must be designed thinking to users and then considering the furniture, colours, quality of the materials, signage, sounds, temperature, humidity, ventilation, brightness, view, cleanliness and hygiene. All these parameters should communicate warmth and friendliness, thinking that health means the whole physical, mental and social wellness and not merely the absence of disease. In this context, it is obvious to highlight the innovative studies of R. Ulrich in the 80s about Evidence Based Design, focused on the principle that built environment produces psychological effects and influences the users’ behaviour through measurable clinical results. Nowadays, it is necessary a multidisciplinary approach for the design and managing healthcare structures in order to link different skills and needs. It is fundamental that several disciplines (medicine, architecture, engineering, technology, design, etc.) should be adapted to take into account the comfort, meant as the perception and quality of the spaces [6], for the user, who is recognized both in patient, visitor or worker. The research of factors, that define the health, shifts the attention from a sanitary model, focused on the individual, to a social model, where health is the result of socio-economic, cultural and environmental aspects or indirectly related to the specific characteristics of the urban settlement. Well-being is not anymore related only to the field of the health, but it is an important aim, strongly influenced by the context in which people live. The choice to deal with “social aspects” related to healthcare facilities through multidisciplinary research, aims to fill the contemporary lack of the State of the Art to propose works that take into consideration the improvement of the user’s experience inside the hospital and do not involve only the health care fields. The factors considered regards the perception of users, qualitative and quantitative studies and space’s analysis, ad hoc questionnaires for users and workers, etc. in order to underline and understand benefits that users and works can achieve. For this reason, the monograph is composed by several articles written by experts and research groups that are addressing the social-health issues in different forms and at different scales

Social health: the challenges for healthcare facilities’ design

The need to realize a monograph on "social aspects in healthcare facilities” becomes a key-point since the new trends in new hospitals’ planning and design or renovation of an existing health structure require that all the processes must rotate around the user and his needs. [1] Hospital, since its origins, represents the social community and, in the socio-cultural context, the return to the values of interdependence and solidarity. Moreover, it embodies the permeability and the availability of entertainment and cultural activities in order to respond to the community’s demands. In fact, healthcare facilities should be oriented to the patient, providing system of diagnostic and therapeutic processes focused on the solution of health issues and able to meet the daily needs and rights of the patient: information, user-centered environments, safety, comfort, privacy, not excessive promiscuity with other users and the opportunity to meet his relatives should be ensured to each patient. “Social aspects” mean the possibility to guarantee the central role of the patient, taking into consideration also the workers and the high stress they undergo. In this way hospital’s spaces must be designed thinking to users and then considering the furniture, colours, quality of the materials, signage, sounds, temperature, humidity, ventilation, brightness, view, cleanliness and hygiene. [2] All these parameters should communicate warmth and friendliness, thinking that health means the whole physical, mental and social wellness and not merely the absence of disease. [3,4] In this context, it is obvious to highlight the innovative studies of R. Ulrich in the 80s about Evidence Based Design, focused on the principle that built environment produces psychological effects and influences the users’ behaviour through measurable clinical results. [5] Nowadays, it is necessary a multidisciplinary approach for the design and managing healthcare structures in order to link different skills and needs. It is fundamental that several disciplines (medicine, architecture, engineering, technology, design, etc.) should be adapted to take into account the comfort, meant as the perception and quality of the spaces [6], for the user, who is recognized both in patient, visitor or worker. [7] The research of factors, that define the health, shifts the attention from a sanitary model, focused on the individual, to a social model, where health is the result of socio-economic, cultural and environmental aspects or indirectly related to the specific characteristics of the urban settlement. Well-being is not anymore related only to the field of the health, but it is an important aim, strongly influenced by the context in which people live. [8-9] The choice to deal with “social aspects” related to healthcare facilities through multidisciplinary research, aims to fill the contemporary lack of the State of the Art to propose works that take into consideration the improvement of the user’s experience inside the hospital and do not involve only the health care fields. The factors considered regards the perception of users, qualitative and quantitative studies and space’s analysis, ad hoc questionnaires for users and workers, etc. in order to underline and understand benefits that users and works can achieve. For this reason, the monograph is composed by several articles written by experts and research groups that are addressing the social-health issues in different forms and at different scales

SOCIAL HEALTH: THE CHALLENGES FOR HEALTHCARE FACILITIES' DESIGN. Edited by Stefano Capolongo. Preface: Social aspects and well‑being for improving healing processes’ effectiveness

Abstrac

IL RUOLO DELLE SCELTE LOCALIZZATIVE NELLA PROMOZIONE DELLA SALUTE: UNO STRUMENTO DI VALUTAZIONE MULTICRITERIALE IN AMBIENTE GIS

IL RUOLO DELLE SCELTE LOCALIZZATIVE NELLA PROMOZIONE DELLA SALUTE: UNO STRUMENTO DI VALUTAZIONE MULTICRITERIALE IN AMBIENTE GI

How Can Design Features and other Factors Affect the Indoor Air Quality in Inpatient Rooms? Check-Lists for the Design Phase, Daily Procedures and Maintenance Activities for Reducing the Air Concentrations of Chemical Pollution

Indoor Air Quality (IAQ) is one of main topics of Public Health on which international institutions and countries are taking action. With regards to healing architectures, several studies have reported data analysis and case studies to improve users’ health (patients, and medical and administrative staffs), but there are not enough regarding volatile organic compounds (VOCs). Regarding chemical pollution of indoor air, the Scientific Community has highlighted that there are several factors that affect the IAQ, in particular the design and management, and energetic efficiency, of inpatient wards. Several stakeholders, from the designers to the managers, are responsible for the indoor air in healing environments. Supported by analysis of the State of the Art and the main factors that influence the heterogeneous scenario of inpatient wards, the paper presents three check-lists, designed for supporting the stakeholders during the design phase, or for the daily procedures and maintenance activities, for pre-assessment of factors that affect chemical pollution, and for the definition of strategies to be applied. In fact, in such environments IAQ assumes a particular meaning and importance, both for the vulnerability of the patients and for the long time spent by the sanitary staff. The multidisciplinary approach emphasizes the continuous need for interdisciplinary knowledge and skills aimed at finding solutions able to protect users’ health status (including patients, workers and visitors), especially in the field of the indoor air issue

Water use and water saving in Italian hospitals. A preliminary investigation

Aim. The aim of this work is to investigate about water use, wastage, saving and reuse in hospitals. Methods. An anonymous ad hoc questionnaire was tested in a sample of 36 public hospitals of Lombardy Region (21% of total public hospitals). Daily water consumption reported is on average equal to 481 m3, ranging from 30 to 2280 m3. There is a strong correlation between water consumption and number of hospital beds (p < 0.005). In 33 hospitals (92%) water consumption is measured and, among them, in about 48% more than one flow meter is installed; 86% consider “important” the reduction of water consumption and about 55% recognize that wastewater could be minimized within the structures. Discussion. There is consensus about the need to train health personnel and to implement technical measures to improve the water resources management, but initiatives to raise knowledge and awareness of health personnel have been promoted only in 10% of hospitals. Results. Results show not only a lack of awareness regarding water use and saving among the personnel in general, but also among heads of the hospitas’ technical office and energy managers as well. For this reason, it will be of interest to carry out this investigation at national level and also to develop recommendations to support and promote a safe reuse of water in all the hospitals

Addressing decisions about new hospitals’ siting: a multidimensional evaluation approach

Background. Site selection for urban facilities is a crucial topic in planning decision processes for the several side effects they produce and the multiple criteria involved, especially for healthcare facilities. Nevertheless, the location problem has been ignored by most of the existing evaluation systems. Methods. Starting from a deep literature review and the analysis of hospitals in 10 European cities, the paper proposes an evaluation system divided into four macro-areas (Functional quality, Location quality, Environmental quality, Economical aspects), each in turn composed by criteria and sub-criteria. Results. The evaluation system has been applied for the site selection of “La Città della alute” in Milan, Italy. Furthermore, the ShOS (Selection hospitals’ Site) Evaluation Tool has been defined, with the aim of assessing the land suitability for new healthcare structures. Conclusion. The ShOS evaluation tool improves the transparency and robustness of the decision-making process and it could be broadly applied

Healthy and Sustainable Hospital Evaluation—A Review of POE Tools for Hospital Assessment in an Evidence-Based Design Framework

Hospitals are complex, high-performance systems that demand continuous quality improvement. Several instruments evaluate the organizational or clinical qualities but very few focus on the built environment. The purpose of this paper is to compare and review the recent tools able to assess the hospital built environment and test how they measure health, sustainability, or both through Post Occupancy Evaluation (POE). A literature review has been conducted in the field of hospital quality assessment and 13 POE instruments have been included and analyzed through Ulrich’s Evidence-Based Design (EBD) framework. The percentage and the content of health or sustainability-related criteria have been compared and further discussed. Health related criteria the most recent tools are used three times more than in the tools developed in the nineties. The most used EBD criteria are safety enhancement (n = 131; 14%) and visual environment (n = 119; 13%). Although sustainability remains a relevant issue, today, growing attention is dedicated to the impact of built environment on occupant’s health. Further investigation is needed to understand the effectiveness of those instruments in practice