Volume 14 - Issue 2, 2014 - Cover Story: Paediatrics

Design for Paediatric Health


Prof. Alan Dilani


Research on the salutogenic direction highlights the impact of architecture that inspires the designer and planner toward designing for a healthy society and an environment that stimulates health and wellbeing and prevents the onset of diseases at all levels of society. The approach of salutogenic design for hospitals promotes health and wellbeing by creating a built environment that includes wellness factors, contributing to the sense of wellbeing for staff and strengthening the healing process.


The salutogenic approach to the design of children’s hospitals incorporates creativity and innovation through the interdisciplinary application of sciences such as architecture, medicine, public health, psychology, design and engineering with culture, art and music.


Salutogenic design stimulates and engages users in the environment, both mentally and socially, and supports an individual’s sense of coherence. The salutogenic approach to design begins with the quality of the space being able to capture people’s attention, and in many cases positive psychological attributes start to emerge. Anxiety experienced by the patients in hospital surroundings is vastly reduced, leading to positive feelings that can support recovery and improve wellbeing for the patients. A salutogenic approach focuses on positive factors that promote wellbeing as opposed to those that make people unwell by virtue of poor designs that lack inspiration. The main characteristics of great designs carry elements that stimulate the mind and senses in order to create pleasure, creativity, satisfaction and enjoyment.


The international Academy for Design & Health has performed extensive empirical research on salutogenic design for healthcare buildings, and studied hundreds of articles and other literature connected to the physical environment, health and behaviour to explain the benefits of promoting psychosocially supportive design and the power of properly designed spaces to influence wellbeing and health.


There are many inspirational ways in which design can contribute to better care and hospital planning, and this article looks at general principles as well as the example of the Royal Children’s Hospital, Melbourne, Australia, which has architectural design that promotes the sense of wellbeing through experiences and emotion.


Salutogenic Hospitals

The overall goal of salutogenic hospital design is to deliver the most appropriate medical services for patients in a very stimulating environment that supports the healing process for patients and is experienced by staff as an enjoyable and efficient workplace.


A salutogenic hospital furthermore provides services that actively prevent people getting sick by identifying risk factors in early stages through regular checkups. The salutogenic hospital serves its local community, its patient population and its own staff through the application of a holistic, knowledge based approach to the delivery of medical treatment and clinical services, provided in combination with preventative measures and public health information that promotes health, wellbeing and quality of life. The children’s hospital should be designed with consideration of all ages and sizes and should reflect interior design that creates welcoming and engaging spaces for all, particularly in common spaces where patients and their families come together.


The Royal Children’s Hospital, Melbourne

The Royal Children’s Hospital in Melbourne is surrounded by nature and parkland. The buildings blend into their surrounding through external façades that camouflage and unify the buildings with the landscape.


All sides of the building exploit the play of direct sunlight. Sunshades and window treatments have multiple purposes, protecting the buildings from the strong Australian sun, bringing views inside and creating an impressive, organic structure.


The Royal Children’s Hospital is an example of a large hospital experienced by visitors and children in manageable elements through a colourful and stimulating form with daylight creating stress-free navigation across the entire building.



Creating a small building unit landmark, the plaza has a different floor surface with a clear circulation system, which simplifies the horizontal and vertical navigation from the street. From the landmark entrance there is a zone to distinguish between the different parts of this level as well as different zones within the hospital. These design stimuli help visitors navigate easily within the hospital without wasting energy and reducing stress. The main entrance as a plaza or street acts as a prominent gateway to all departments identified by signage or unique floor number.


Each zone can be identified through a single letter to avoid confusion, similar to an airport terminal, using a colour system for direction and identification to support easy navigation through the hospital. To simplify orientation and easily remember different zones a combination of numbers and other information that relates to the function of each department can be used, e.g. “Family accommodation zone A level 2”.


Arrival/ Plaza/ Atrium/Street/ Main Entrance

The main entrance will be the first experience for most people, whether patient or relative/ friend, and it therefore needs to reflect the hospital’s image as a centre of health and be a welcoming environment.


The atrium as a landmark provides clear direction to information points and circulation routes. This is the initial point of navigation and it is essential that the visitor can directly recognise the main information points and that services are clearly visible for all. The use of both colour and signage are key elements within this space, and help create meeting places and points of reference.


The hospital includes remarkable elements such as the double height aquarium, which supports orientation and works as a landmark within the building, and also attracts all users’ views and engages patient and staff. It provides a joyful and stimulating experience.


The main outpatients reception and waiting area are focal points within the atrium space. Incorporating the double-height space aquarium as artwork provides patients and visitors with a comfortable and relaxing environment whilst waiting for their appointment.



Directional signage incorporated into floor and ceiling design supports way finding at the main ‘street’ and decision points with information centres. Clear signage and natural use of colour and shape provide assurance to patients and visitors when arriving in the hospital. Main circulation crossroads are highlighted in all floors and ceilings with natural daylight and art to make users aware of a potential direction. Different art and positive distraction elements here and in the main ‘street’ highlight entrances to different departments and rooms, and provide for people of all sizes and abilities easy navigation of the building.


Along the natural main ‘street’ as the hospital landmark, other areas are easily identified as gateways to further zones. These zones can comprise one or several departments. Each zone has its own unique shape and identity by design. The different floors are simply identified by the finishes used or through colour, art or graphics associated with the different floor identities to create interest and engage with patients and staff.


The main ‘street’ functions as a waiting area with play areas, a family lounge with café, gift shop, restaurant and services. There are different types of waiting areas provided for children and their families, for short-term and longer waiting periods with a variety of furniture types and attractions.


Patients’ Rooms

Children’s rooms are designed as a safe and pleasant environment with direct views of the park, and sky views inside the room designed to be experienced from the bed.

It is possible for parents / carers wishing to stay the night to use the visitor bed located in the room. Viewing nature through a window has more positive health outcomes for the patient.



Art both attracts and acts as a positive distraction during examination and treatment. The Royal Children’s Hospital has decorated rooms and walls with imagery that is both beautiful and educational, reflecting the nature of Australia. The intention is that the images will have a relevance to the themes developed in the hospital. In treatment rooms, using positive distraction is a way of giving the patient a sense of control and a stimulative environment. This makes them feel more relaxed and comfortable with the procedure.


Any patterns indicated in the therapies department flooring are for clarification and engagement purposes. The therapies department has specific exercises and activities designed for the treatment of patients, which are likely to involve particular flooring. The design ensures that the most suitable floor patterns are integrated into the overall flooring solution for the therapies department with different art supporting navigation.




Artwork brings creativity and life to children, fostering their imagination and creating a sense of fun whether being a patient or visiting a loved one. For staff as intellectual capital artwork provides positive stimuli. There is a children's zoo in the hospital and a cinema with movies to support healing, as well as digital interactive elements encouraging a sense of welcome and comfort. All elements are about reducing stress and strengthening the ability to better manage the level of stress associated with disease and hospitalisation.

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Author:Prof. Alan DilaniArchitect/Public HealthInternational Academy for Design & Health Stockholm, SwedenFor more information seewww.designandhea

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