November 1, 2005
Cure for the Common Hospital
Equal doses of nature and art produce a healthier dialysis pavilion in Pistoia, Italy.
Because the greatest considerations in health-care design have traditionally been functional—hygiene, efficiency, and flexibility for changing technology—hospitals have evolved to become dehumanizing ghettos. Emphasis on shorter inpatient stays coupled with economic constraints has only exacerbated this tendency. However, the goal for a new 26-bed dialysis pavilion in Pistoia, Italy, was to make a more livable place since it is practically a second home for the chronically ill patients who undergo several hours of therapy there three times per week.
Architect Giannantonio Vannetti considered it an advantage that this was his first health-care project: his research into the latest trends inspired a design based on the holistic principle that medical treatment cannot be separated from psychological considerations. “Whenever I visit a hospital, it makes me feel sick,” Vannetti says. “You have laws regarding sanitation, seismic and fire risks, handicapped access, and even prohibiting slippery floors. If you follow the regulations, you obtain the classic hospital. We started with the human being at the center, so I had to mediate all those requirements.”
The result is an airy ellipse that incorporates nature and daylight, color and art, and domestic comforts. Floor-to-ceiling windows look onto three interior Zen gardens—one with a circular rock formation and another with a boat-shaped tree planter signaling rescue—created by Japanese artist Hidetoshi Nagasawa. Although gardens have been used for healing since ancient times, they were eclipsed by advances in medical technology. But a growing body of research is giving credibility to the widely held belief that exposure to nature can improve health. Studies conducted by Roger Ulrich, director of the Center for Health Systems and Design at Texas A & M University, found that surgical patients with views of nature recovered more quickly with less pain medication; other research shows that depression patients required shorter stays when given sunnier rooms. “If a researcher had seriously proposed two decades ago that gardens could improve medical outcomes in health-care facilities, the position would have met with skepticism by most behavioral scientists and probably with derision by many physicians,” he has noted. But such principles are finally being incorporated into contemporary hospital designs like the dialysis clinic in Pistoia.
Chronically ill patients tend to feel isolated, so art was integrated to provide both physical links between places on site and a cultural connection to the outside world. A new green in front of the pavilion lures passersby with a gazebo by Israeli Dani Karavan and a bench of two concrete lunar slivers by local artist Gianni Ruffi. American sculptor Robert Morris made a wisteria-entwined arch under which visitors pass; a vibrant wall mural by Sol LeWitt greets them in the entryway. The central hallway floor is covered with a whimsical mosaic by Claudio Parmiggiani depicting constellations. And in patient rooms privacy is enhanced by French artist Daniel Buren’s colorful screens; hues for the walls were chosen according to chromotherapy guidelines—blue for its calming quality and yellow to soothe pain.
Pistoia has a legacy of hospital art: the portico of the local Ceppo hospital features a Renaissance masterpiece by the della Robbia workshop. Even so, health officials initially opposed the pavilion’s design, but the reason is a testament to its extraordinary form—they were afraid people would compare it too favorably with the main hospital. However, head nurse Silvana Giardi reports a more important outcome: “It is immediately apparent that patients feel more comfortable.”