The text on the cornerstone of Pennsylvania Hospital, the nation's first hospital, can still be viewed under its plexiglass cover. "This building," Benjamin Franklin wrote in the inscription, "was piously founded for the relief of the sick and miserable."
The hospital was created in 1751 by progressives, and yet many of its design elements would seem primitive to us now. On the ground floor "were the cells for lunatics," with a long hallway "for such patients as could be trusted to walk about," an 1897 history of the Philadelphia landmark noted. The state-of-the-art building also included open fireplaces and "ventilators to carry off the foul air."
But while some of the building's most forward-thinking features seem backwards today, American hospitals of the future may take at least one important cue from their earliest predecessor, which was seen not just as a place for the sick but as a crown jewel of a quickly growing city.
Pennsylvania Hospital's opening ceremonies were such a big event that the city's schools were dismissed so that children could be in attendance for the historic occasion. While it's difficult to imagine a hospital opening today creating enough excitement for a citywide holiday, we may again be moving beyond thinking of such critical institutions only when we fall ill — or at least hospital architects see some hopeful signs.In Sickness And In Health
In the future, "hospitals can and should become more of a centerpiece of the community," said Charles Griffin, president of AIA's Academy of Architecture for Health, in an interview. "They're transitioning from a place for sickness to a place where you can learn about health."
This focus on wellness and preventative care is a driving principle of the Affordable Care Act and a healthcare trend in general, so it's no surprise that it's being reflected in the designs of hospitals themselves. While no amount of preventative care will remove the need for emergency rooms, trauma centers, and intensive care, the hope is that hospitals might expand their services that help keep people out of their sickest wards.
A growing body of research has suggested that better-designed hospitals — with private rooms, plenty of windows, natural light, and noise control — are actually associated with shorter stays and better outcomes for patients. And beginning in the 1990s, hospitals began going even further, adding demonstration kitchens, for example, to teach patients how to cook healthy meals when they leave.
Griffin pointed to Florida Hospital Celebration Health as a living example of what hospitals in the future could look like.Doctor Disney
The resort-like hospital, built in 1997, is in the somewhat Stepfordian community of Celebration, the planned village that was designed by and is adjacent to Walt Disney World. "It was built specifically to be in Mickey Mouse land," said Griffin. "They went way out of their way to focus on health and not illness."
To that end, it was conceived as a hospital that felt more like a community center — somewhere you might want to stick around. "The hospital's strategy is to offer a wide range of health services under one roof, as if combining a doctor's office with a health club and a restaurant," The Orlando Sentinel reported when the project was enjoined. "That way, patients can get a physical or a lab test and finish up the visit with a swim or a class in nutrition at an activities center."
Fancy hospitals are not good for our ballooning healthcare costs, and don't necessarily translate into better care. Luxury healthcare, in any case, is not equally available to everyone.
But there is a boom in hospital construction, and taking a look at the almost surreal world of Celebration Health might provide a glimpse of the future — or at least the possibility — of tomorrow's hospitals.Celebration's Mediterranean-style architecture is meant to evoke a resort: Here is the front entrance. It was designed to feel more like a hotel than a hospital: The hospital says the grounds are "landscaped to create a superior environment for recovery." Here's a view of one of the "healing gardens": The patient rooms are designed with smart technology to give patients more control, and large windows let in an abundance of natural light: The exterior areas of the fitness center look more like Disney World than a typical hospital:
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