The incorporation of natural elements and sustainable design into healthcare facilities, including skilled nursing facilities, promotes the health and recovery of patients, benefits staff and visitors, and ultimately increases a facility’s return on investment. 

Did you know that design and architecture can have a measurable impact on a resident’s experience during their time at your facility? There is evidence that design can improve patient outcomes, staff morale, and visitor experience.

From hospitals to long-term care facilities, the design of a space can be a significant help or hindrance to the health and recovery of patients and residents. Given recent interest in sustainability, the positive effects of eco-friendly design choices on occupants’ well-being are beginning to come to light. Research from The Center for Health Design contributed to 12 factors that should be considered in healthcare design based on best practice research. The following strategies can help facilities of all sizes embrace evidence-based design for improved patient experience, environmental sustainability and profitability. 


The incorporation of sustainable and natural materials is beneficial to the well-being and recovery of patients in healthcare facilities.  Within the design itself, focusing on materiality is a direct way to enhance the healthy qualities of the environment. Some materials and products release harmful chemicals (Volatile Organic Compounds, or VOCs) into the air, which can cause health problems, especially for sensitive patients. This is a reason to consider sustainable materials and look for products marked as “low or no VOC.”

Healthy and sustainable material options are more available now than ever before. The life cycle of each material is what most strongly contributes to its sustainable character. Everything — from how the materials are sourced, processed, shipped, installed, and, ultimately, recycled — impacts the full sustainability of the materials. With the number of options available today, a diverse variety of aesthetic choices come into consideration. Materials that counteract the clinical feel of institutionally-designed facilities help promote a sense of comfort and relaxation, which is so vital to the healing process. 

There are several resources available for those working on construction projects to incorporate sustainable materials, whether building from the ground up or renovating existing facilities. Consult with an architect or designer familiar with sustainability strategies and who can research materials that fit your design and budget. The Healthy Materials Lab at Parsons School of Design, for example, offers professionals a number of resources to find materials and construction techniques with proven health outcomes.

In the mid-Atlantic region, Pittsburgh’s Living Product Hub offers a guide designed to direct people towards healthy and sustainable materials. Declare, a “nutrition label” for products, is a novel system that seeks to promote transparency in material sourcing. These resources can help guide your architect or designer towards materials that are beneficial to your patients and have a minimal environmental impact.

Access to nature

Resident access to nature has been shown to reduce stress and depression, increase pain tolerance, and improve quality of life, all important measures of well-being.  The incorporation of gardens and plants is the most direct way to include nature. There are a multitude of options, from an indoor garden in a lobby to incorporating plants as partitions aside a nurse’s station in a corridor. Urban facilities and internal rooms and spaces can even benefit from this by mimicking nature through wall coverings and lighting. This direct incorporation creates a more relaxing and welcoming environment, as well as potential benefits for air quality within the facility. Surrounding green spaces provide places for patients to heal and enjoy nature within accessible distance. 

Windows + light

Views towards green spaces and natural light are both important natural elements and are made possible through the deliberate placement of windows. Allowing residents to have views of nature from their rooms is visually interesting and provides the emotional healing impacts of proximity to nature. Windows are also vital in the incorporation of natural light into the space. A significant portion of the negative institutional feel of healthcare facilities is bolstered by the fluorescent direct overhead lighting. Alternative lighting solutions — especially natural light – can help create a warmer, more peaceful environment. Artificial lighting that mimics nature and circadian rhythms can also be incorporated if windows are unobtainable.

Building Layout

Floor plans that increase efficiency benefit staff, some of the most important users of a healthcare facility. Having both centralized and decentralized nursing stations aids both patients and staff. The reduced travel time to and from patient rooms limits the number of injuries, as well as the amount of time staff spends on their feet. Borrowing natural light from the perimeter of the building and bringing it into the internal spaces where staff typically spends most of their time is a good strategy for staff to stay connected to nature and circadian rhythms. Building orientation and room layout can also play significant roles in both evidence-based design outcomes as well as sustainability. Space planning between front of house and back of house operations will also help limit the amount of noise that detracts from a restful, relaxing environment.

Air quality

Air quality is an invisible, yet critical, facet of a healthy environment. With poor indoor air quality being linked to a variety of health conditions, from allergies to asthma, improving it can not only help those suffering said conditions, but also help to prevent the development of further conditions in patients. Improving air quality is also an easier way to save money. In one study conducted in the state of California, researchers found that by improving their air quality, hospitals in the state could have saved $193,100,184 over a two-year period. Air filters are a common solution; however, research has shown that they do not reduce levels of all pollutants, and some may even aggravate health issues. In keeping with increasing access to nature, indoor plants are a green way to help improve indoor air quality without the negative side effects. 

The multiplicity of positive impacts resulting from sustainable, wellness-minded design in healthcare environments is evident.  It not only achieves architectural sustainability in an age of climate change, but creates staff happiness, improved patient outcomes and fast-tracks patient recovery. By prioritizing the users of the space, evidence-based and patient-centered design help construct healthcare facilities that are healthfully beneficial and aesthetically engaging places to be. While the full cost and wellness advantages of sustainable construction are still being researched, the ethos of sustainable architecture has already shown its invaluable contribution to healthcare design. 

There is also evidence to suggest that these strategies can be smart for your facility’s financial well-being. In the ever-growing consumer-driven environment, these design strategies can become the differentiators that set your facility apart from others, increasing both client satisfaction and your return on investment. An easy way to ensure that your facility adopts the best industry practices discussed here is to pursue Fitwel certification, which verifies your building is optimized for health. This might be a good marketing opportunity, though is not required to achieve a healthy facility. 

With patient-centered design, everyone — staff, patients, families, and your bottom line — will benefit.  

Jacqueline Sipos, LEED Green Associate, is an interior designer in AE7’s Pittsburgh office.