Roger Ulrich, PhD, Professor at Texas A&M University and fellow at the Center for Health Systems and Design, conducted the first rigorous scientific study of evidence-based design.
By Lisa Zamosky
The first rigorous scientific study credited for setting evidence–based design on its course was conducted by Roger Ulrich, PhD, Fellow, Center for Health Systems and Design as well as professor in both the Department of Architecture and the Department of Landscape Architecture and Urban Planning at Texas A&M University. The study, “View Through a Window May Influence Recovery from Surgery,” was published in Science in 1984, to what Ulrich describes as an “overwhelming, but not large” response.
For the study, Ulrich observed two groups of patients that had undergone the same surgical procedure in a suburban Philadelphia hospital. With all other conditions the same, one group of patients recovered in a set of rooms that looked out onto another building. At the other end of the unit, patients looked out at a small grove of trees. The patients who recovered in the rooms that looked onto the natural setting had shorter lengths of stay, had better moods, developed fewer minor complications following surgery, and took less pain medication. “Clinical outcomes and recovery were improved simply by having this bedside visual companion of an attractive, soothing nature view,” Ulrich says.
This study was a milestone piece and the first of its kind with “a ring of scientific credibility,” Ulrich says. The American Medical Association (AMA) made it headline news of the week. “This highlighted, along with other evidence in the emerging field of mind-body medicine, the need to consider a broader picture, including physical environment, of factors that affect patient outcomes and the health of patients,” Ulrich says. Although the field didn’t noticeably begin to pay more attention to physical design right away, this study set Ulrich on a pioneering course toward the body of research known today as evidence- based design.
By the mid to late 1980s, Ulrich says, some architecture firms specializing in health care started to pick up on and put into practice his groundbreaking research. The Lucile Packard’s Children’s Hospital at Stanford, which is a celebrated design, was expressly influenced by Ulrich’s Science article. “That research evidence was used to justify the design to provide views of gardens and nature and access to the outdoors for patients, families, and staff. You could tie dollar benefits to aesthetic amenities that previously had been considered nice-to-have luxuries, and we began to sketch out the basic elements of evidence-based design.”
More than 20 years later, Ulrich and his colleagues have identified nearly 1,000 scientific studies pertinent to designing better hospitals that would help reduce long–term operations costs and improve clinical outcomes and safety. Many of these studies are coming directly from the medical community.
Ulrich continues to conduct research on the effects of healthcare facilities on a variety of hospital-related outcomes. He is also on the board of directors for the Center for Health Design and one of the organization's earliest members. Influenced heavily in his youth by sterile, emotionally unsuitable hospitals and healthcare settings, Ulrich has a passion for improving the environments in which people obtain and provide care. He is responsible for setting in motion the accumulation of a body of evidence that has contributed to radical improvements to healthcare facilities all over the world.