Healthcare Design - March 2017 - 44

In Focus

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In short, designers should seek to leverage the principles of the natural world-and not simply use images of nature as decoration-to instill
a sense of calm, safety, and well-being in behavioral healthcare spaces.
The range of biophilic strategies for behavioral health runs from the general to those that more closely represent the natural setting of a facility's
region. For instance, incorporating a paced experience of visual textures
inspired by the rhythm of walking through a forest provides the brain with
desired moments of interest while simultaneously instilling calm. Biophilic strategies also serve to orient through the strategic use of light, with
colors and intensity mimicking the sky, and through the selection of interior patterns and colors that allude to relationships found in nature, such
as that between earth and sky.
ZGF Architects' interior design of the Swedish Ballard Behavioral
Health Unit in Seattle, a renovation of two floors within an existing
hospital completed in spring 2016, uses this approach, focusing on how
patients move through the space. The design introduced green and
blueish hues and vertical patterns that subtly compress and expand
color and pattern variation to provide a sense of movement through a
forest (corridors) and toward a clearing (the activity spaces).
In this case, patients don't have access to the outdoors, so the onus
was even greater on the design to provide ties to nature. Wallcoverings with a slight roughness composed of vertical banding change in
both width and frequency while revealing slight color variations as occupants move through the area. The color and pattern orient patients
to the Pacific Northwest while also stimulating the brain. Pattern provides a predictable rhythm that also soothes. As in natural environments, the ground plane is darker and the ceiling plane lighter, with the
walls mediating the two. This grounds patients with a familiar pattern
for a greater sense of orientation and also offers a degree of randomness
like the natural environment's variability; no one scale or one color is
experienced in nature at any given moment.
LIGHT SHOW

Because of our millennia-long relationship with nature, humans are
attracted to the brightness at the end of perspectives-in the case of
Swedish Ballard, at the end of corridors. Lighting strategies cue patients to move through the metaphorical forest toward the clearing of
activity spaces, where a circadian lighting solution is focused.
Circadian lighting works to support natural sleep/wake cycles in building occupants to foster both healing and well-being. Numerous studies
have illustrated that reinforcing circadian patterns to correlate with local
time can result in improved sleep, improved mood, and increased pharmaceutical efficacy-all highly relevant to behavioral health patients.
Circadian lighting in this project was incorporated via cove lights in
the corridor that mimic changing lighting conditions, similar to glimpses of sky through a tree canopy. Because patients spend the majority of
their time in communal patient activity areas, those were prioritized
over patient rooms as the most appropriate location to deploy impactful
lighting. Light fixtures within the clearing are tunable white, as are the
cove lights in the corridors. The color of the light fixtures is programmed
to change from warm (orange-ish) white in the morning and evening to
cool (blue-ish) white in the midmorning and early afternoon, in concert
with the natural color variation of the sky that occurs from the blue light
of sunrise to the warm light of sunset. Light is the primary means of reg-

MARCH 2017

The Swedish Ballard
Behavioral Health
Unit's circadian lighting
is focused in the
patient activity area,
where patients spend
most of their time. The
lighting actively works
to support circadian
health by offering
intense blue light
during the morning
hours and gradually
shifting to warmer light
in the afternoon, akin
to the sun's natural
pattern.

ulating our sleep/wake pattern, and cool light
is most effective at shifting our circadian patterns, while warm light will have a negligible
impact.
The timing of exposure to these wavelengths
is critical to maintain a circadian entrainment
or sync the body clock to the local solar cycle.
Providing blue light in the midmorning to early afternoon hours has been shown to be most
effective at clock regulation, while exposure
to blue light later in the day can delay the body
clock, delaying the time one falls asleep as well
as reducing the quality of sleep. Warm light is
stripped of circadian impactful wavelengths
and can provide light for general tasks without
negatively impacting the sleep-wake cycle.
These color and intensity shifts are not just
experiential, but are used to influence physiology to reinforce patients' and support staff
members' circadian patterns. Research has
also shown that blue light provides an alerting effect, while warm light at lower intensities can have a calming effect. Using lighting
color and intensity to provide a less stimulating environment in the late afternoon
and evening hours can wind people down for
the day and lead to less disruptive behavior.
CHARTING THE COURSE

While the unit has been open for only a short

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BENJAMIN BENS CHNEIDER

SETTING THE SCENE

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Healthcare Design - March 2017

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