A Conversation With Roger Ulrich

Roger Ulrich, PhD, is perhaps the most cited and influential evidence-based healthcare design researcher in the world. His studies have been lauded for their scientific rigor, and his findings continue to be readily implemented by healthcare managers, clinicians, design practitioners, and policy makers in the United States and abroad. Without question, Ulrich's work has directly impacted the design of many billions of dollars of hospital construction, and improved the safety and health outcomes of patients across the globe.

A Beale Endowed Professor of Health Facilities Design at Texas A&M University (TAMU), Ulrich is a professor of architecture and landscape architecture, and a faculty fellow of the Center for Health Systems and Design, an interdisciplinary center housed jointly in the colleges of architecture and medicine at TAMU.

He is a sought-after speaker and consultant, having worked extensively in Scandinavia, the United Kingdom, Canada, Australia, and the United States. In Sweden, Ulrich carried out research at the Karolinska Institute of Medicine in Stockholm, Uppsala University, and Lund Institute of Technology. He has also served as visiting research professor in healthcare architecture at the University of Florence, Italy; visiting professor at The Bartlett School of Architecture, University College London; and as invitation research fellow at the Japan Society for the Promotion of Science.

In 2005, Ulrich was invited by Britain's National Health Service to serve as senior advisor for its program to create scores of new hospitals-a true reflection of his knowledge and leadership in the evidence-based design (EBD) field. In addition, he was a member of The Joint Commission's task force on the hospital of the future, is an adjunct scientist with the Ontario Agency for Health Protection and Promotion, and serves on the Board of Directors of The Center for Health Design (CHD) as well as the Editorial Advisory Board of HEALTHCARE DESIGN.

I interviewed Ulrich on a rainy day in Chicago at the Hyatt Rosemont after a CHD board meeting. We first met each other in 1990 when he spoke at the Symposium on Healthcare Design, San Francisco. Shortly thereafter, he joined the Symposium's advisory board and in 1993 became one of the founding board members of CHD. We sat down in a meeting room after everyone else had left and spoke for two hours.

Sara O. Marberry: When did you first become interested in healthcare design research?

Roger Ulrich, PhD: About 30 years ago. I had started as an assistant professor doing research on environmental aesthetics, whether beauty mattered in terms of affecting emotional well-being and physiological stress. My interest in research was from a basic science perspective with no practical applications in mind. When I learned that most nature scenes produced positive emotional states and helped to calm stress, it fit with other work my colleagues and I were doing that showed reduced blood pressure and other physiological indicators of stress reduction.

In the early 1980s, I began to wonder about practical applications and asked myself, “Which groups of people experience a lot of emotional duress and might benefit from a view of nature?” The answer was hospital patients and prisoners.

But there was something else in my background that was playing an increasingly powerful role in my interest in healthcare. As a teenager, I had serious bouts of nephritis, or kidney disease. Fortunately, I came out of it just fine, but there were long periods spent at home in bed feeling quite bad, looking out the window at a big pine tree. I think seeing that tree helped my emotional state. Like other kidney patients then and now, there were unpleasant experiences in gloomy, sometimes brutal, healthcare buildings.

Marberry: And how old were you when this happened?

Ulrich: The first time I was 10 or 11 and the second time-the worst, was at age 16. My own experiences with clinics and procedures and seeing other patients in duress motivated me to try to do something to improve the environments where patients were treated.