Traditional hospital design revolved for years around the dual concepts of hospital “productivity” and healthcare business economics. A few years ago a third design criterion emerged: patient safety. Since then, healthcare has pushed in a new direction—patient-focused and based on the wellness model—with its own implications for design. Increasing numbers of healthcare seekers are turning away from the traditional models and toward wellness centers/spas, most of which offer self-care strategies, healthcare coaching, and medically endorsed health- and beauty-enhancement services, delivered in environments designed to foster peace and tranquility.

The spa/wellness movement is starting to appeal to traditional providers as a means of competitive survival and market enhancement. Along with this, healthcare designers are finding that they must reassess the phrase “healthy environments,” both as a concept and in detail.

That is the purpose of this article: to discuss and illustrate some of the concepts and the practical considerations behind healthcare spa design. While the overall goal is to create an environment inspiring feelings of physical well-being and mental peace, achieving this requires specific knowledge and a professional approach.


The spa treatment experience is often conceptualized as an airline trip. It starts with the departure, where you are received by an attendant, divest yourself of baggage, and proceed to the waiting area. Then there's the trip itself (treatment experienced in a very personal way), followed by the landing and the arrival, where you retrieve baggage and go on your way, hopefully feeling more relaxed for having arrived.


Each of the “way stations” in the spa experience has specific characteristics that make for success. Let's take them in order:

“Departure”: The waiting area will feature plants, artwork, water features, calming music, and warm lighting (figure 1). Staff will offer a pleasant greeting and hassle-free admissions processing. Visitors should feel as though they are experiencing the comfort of home.

Preparation: All features are designed to appeal to the senses. Gowns, towels, and linens are fresh and soft; lighting is soft and low; color is used modularly, with earth tones shading from one area to the next; and signage is in large letters and easy to perceive (figure 2). Bathrooms are fresh and clean (figure 3), with a feeling of privacy. In corridors where natural light is available, the color of the light complements the floor and furniture, and shades become part of the décor (figure 4). Even quieter music than before pervades the area.

Experience (Treatment) Area: The bed has crisp linens and soft comforters (figure 5). Lighting is warm (figuratively, not literally; the “candles” often used are actually lighting fixtures with flicker-flame bulbs). Above the area is a “celestial ceiling” of eye-catching, soothing design (figure 6). Music becomes even quieter and more calming.

Post-Experience: This area helps ease the visitor's “re-entry” into the world. Towels and robes are offered, and the visitor is encouraged to relax on a comfortable sofa or chair, perhaps read a magazine and, in general, unwind (figure 7). Although floors are low-maintenance slate or cork throughout the spa, here they might be wood with a natural fiber overlay. Staircase carpeting in this area would be of complex, organic-appearing design (figure 8), because patterns using boxes and squares don't work in this natural-seeming environment. In this area, the music tends to be more stimulating and uplifting.

“Arrival”: The area is full of energy and life, with cheerful music playing. The visitor's billing and product purchasing are all handled here, in a relaxed format, and prescriptions (if any) are gone over and explained. The visitor is ready for the outside world.

As I mentioned, there are plenty of extremely practical decisions that must be made in designing a successful spa. For example, patient comfort, climate control, and noise abatement are prime considerations in this environment. So, too, are moisture control and mold prevention, particularly with the prevalence of water features in this setting. One practical consideration regarding moisture control is ceiling design—a flat ceiling should be coved (or pitched downward) at one end to allow condensation to roll to the side and down the walls. For the sake of quiet, mechanical systems should be housed in the basement, if at all possible. But there are more specific aspects that must be considered for the mechanicals, electrical, and plumbing (MEP) when designing a typical spa. These include:

Mechanicals: Individualized HVAC controls from room to room and space to space are a given. Air circulation is critical, and exhaust air must be handled efficiently, with outlet ducts designed to maximize velocity and minimize noise, both from mechanical operations and from cross-talk between rooms. Having treatment rooms under negative pressure, with air handling using variable speed motors, helps to achieve both objectives. Air diffusers should be installed and positioned to prevent drafts and to remove condensation from glass features.

Electrical: Because much of the equipment in a spa has direct contact with human skin, hospital-grade outlets should be used to provide proper grounding. Switches should be moisture/corrosion-resistant. Color-corrected fluorescent and incandescent lighting with dimmers should be used to adjust for the spa experience, yet provide enough light for cleaning during off-hours. The use of pinkish lighting is encouraged where possible to enable patients to retain a healthy hue and avoid the grayish, washed-out look often created by traditional overhead lighting.

Plumbing: One feature that spas have adapted rather frequently from hospitals is so-called “no-hands” plumbing fixtures, using electronic sensors to flush toilets and turn water on and off. Toilets should be wall-attached, making it easier to clean around them. Temperature-mixing devices should be used on faucet and shower outlets to prevent scalding, and water pressure should be at 50 to 60 lbs/square inch to operate some water features.

Clearly, the spa environment makes unusual demands upon the designer/architect. But the difference from the traditional design challenge is really more of degree than of kind. Modern healthcare designers are no strangers to many of these patient-pleasing amenities, and should feel completely at home when helping their hospital clients plan and execute a wellness center/spa. HD

Katie Hurley is President of Spa Hospitality Worldwide, Miami.