Effects of environmental design on patient outcome: a systematic review

HERD. Summer 2014;7(4):108-19. doi: 10.1177/193758671400700410.


Objective: The aim of this systematic review was to assess how inpatients were affected by the built environment design during their hospitalization.

Background: Over the last decade, the healthcare system has become increasingly aware of how focus on healthcare environment might affect patient satisfaction. The focus on environmental design has become a field with great potential because of its possible impact on cost control while improving quality of care.

Methods: A systematic literature search was conducted to identify current and past studies about evidence-based healthcare design. The following databases were searched: Medline/PubMed, Cinahl, and Embase. Inclusion criteria were randomized clinical trials (RCTs) investigating the effect of built environment design interventions such as music, natural murals, and plants in relation to patients' health outcome.

Results: Built environment design aspects such as audio environment and visual environment had a positive influence on patients' health outcomes. Specifically the studies indicated a decrease in patients' anxiety, pain, and stress levels when exposed to certain built environment design interventions.

Conclusions: The built environment, especially specific audio and visual aspects, seems to play an important role in patients' outcomes, making hospitals a better healing environment for patients.

Keywords: Built environment, evidence-based design, healing environments, hospitals, literature review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Health Facility Environment / organization & administration*
  • Hospital Design and Construction / methods*
  • Humans
  • Inpatients
  • Interior Design and Furnishings / methods
  • Music
  • Noise
  • Patient Reported Outcome Measures
  • Patient Satisfaction*
  • Plants
  • Sunlight