The effort to promote and support population health and wellness has few rivals in its influence on healthcare today, inspiring the planning, design, and construction community to create environments that help providers deliver on that mission. The solutions being brought to the table vary widely, though, each in its own way answering the call. Healthcare Design asked industry members how wellness is being defined in their work—and they showed us. In this special report, "All Is Well," (to be published in the May 2016 issue of the magazine and in installments online in April and May), find a sampling of the myriad innovative and inspiring approaches being taken.

Healthcare Design: How has the conversation on wellness and sustainable healthcare design changed in the last five years?
Sharon Woodworth: I don’ think that sustainability is segueing to wellness, but we are seeing a great deal more interest in wellness. One of the reasons is the economic pressure on our clients to keep not only their patients but their staff healthy and to conserve resources both in terms of the caregiver and the care receiver. Wellness is also a topic we’re seeing throughout society. Our culture, especially in the U.S., is indoors more, sitting at computers, and as a result we’re seeing a rise in childhood obesity, diabetes, and asthma. So there’s a social pressure to look at wellness.

How can sustainable design help create healthier healthcare environments?
There are some basics, such as noise and light that have always been of concern to patients, physicians, and nurses. When we talk about light, we often refer to it from a sustainability standpoint as “natural light” and “access to natural light,” and we try and set metrics to achieve a percentage of natural light throughout the square footage.

But from a wellness endpoint it’s the artificial lighting that we’re specifying that should be more sensitive and more tuned in to the circadian rhythm of our bodies. We’ve known about this since the 1970s but now there are finally photobiologists who are encouraging healthcare architects to specify lights bulbs that go from very cool blues in the morning to much warmer reds in the evening. We’re even at a point where we can specify the nanometers, or wavelengths, of those bulbs. But I can reference only one client who has actually built a facility with that kind of lighting, and we need to do more of that.

Beyond access to daylighting, what are some wellness elements healthcare projects should consider?
I’d like to see more clients think beyond their building and parking lots to create healthcare districts. Some cities are encouraging them by giving a healthcare entity some financial incentive to do things on their campus, like bike paths, safe pedestrian zones, or circulation routes that allow people to walk from one point to another. It benefits healthcare organizations in many ways by attracting consumers that they normally wouldn’t have in their catchment area and sending the message of health and activity to the community.

How can guidelines and codes be developed or updated to focus on wellness and not just the medical or safety aspects of the built environment?
We’re reliant on codes but they don’t get into improving outcomes. For example, the code shouldn’t be how big the window is to bring in natural light but how much daylighting comes in. We also have to find a way to balance the safety aspect from fire and exit codes with active building elements, such as open stairs in high-traffic areas. These don’t just focus on the healthy body but also the healthy mind, because they’re one of the best places for people in other disciplines to meet each other. The other aspect to that is we have to include destinations in the codes. It’s one thing to put an open stair right at the front door, but to encourage people to use it you need to create destinations along the way, such as places to stop or sit, or spaces that engage the senses. People can be attracted away from an elevator if they smell coffee or hear music floating from above.

Where would you like to see the wellness conversation go next in healthcare design?

I think atriums can do so much for a space, and I don’t mean a soaring one like in a Guggenheim museum, but your average three-story atrium. These spaces allow for inspiration and gathering and help significantly with wayfinding, and I’d love to see financial incentives to allow our buildings to have them. Right now, clients don’t view them as cost-effective because they’re unrentable or unusable space that has to be air conditioned. In healthcare architecture, we’ve lost that place where people can go and hear music some days, take a yoga class, or sit around and have coffee.