International research shows the many benefits that come from bringing nature into healthcare designs.¹ One well-known study² by Roger Ulrich found that hospital patients with a view of trees, compared to those of a brick building wall achieved improved recovery outcomes, including:

• Shorter post-operative stays
• Less need for pain medication
• Fewer negative evaluative comments recorded in nurses’ notes

In a New Zealand first, a newly opened public hospital project applies this research on scale. Tōtara Haumaru is a four-storey building at Auckland’s North Shore Hospital. It features a large-scale planted interior atrium, known as the Healing Garden, in its central atrium.

Jasmax developed the design concept for the Healing Garden with Outside In, Haumi and the Well Foundation. The plantscaping by Outside In recreates a natural forest canopy within this indoor environment, with greenery flowing across more than 110 square metres.

Wellbeing benefits from biophilia

The concept of biophilia acknowledges our instinctive positive response to nature and natural elements. Incorporating greenery into the built form is one of the most common applications of biophilic design.

Research has demonstrated which biophilic principles are most valued in a hospital setting among different types of users:³

• Patients – this included prospect and refuge, security and protection, light, and views of nature
• Outpatients – this included fresh air, light, and a comfortable temperature
• Medical staff – this comprised privacy, refuge, and quietness

Traditionally, incorporating greenery into healthcare projects has proved challenging, particularly in maintaining and growing the planting. However, simply weaving the shapes and colours of the natural world can offer biophilic benefits.

A one-of-a-kind New Zealand hospital garden

The Healing Garden is already gaining international interest for its transformative use of nature in a hospital and has seen Outside In win top honours for its plantscape in the US-based global Biophilic Design Awards orchestrated by i-Plants Magazine.

At Tōtara Haumaru, a visual and tangible connection to nature is fully accessible via the Healing Garden. Many patient recovery rooms have views of the greenery and it is overlooked from the hospital floors above.

In the Roger Ulrich study mentioned earlier, beneficial views of nature consisted of a window looking out to a small cluster of trees. At Tōtara Haumaru, patients have an outlook of more than 500 lush plants and direct access.

To balance proportions in this lofty atrium space, planting reaches up to two metres tall. Fifteen species are featured, including New Zealand natives. The Healing Garden’s form mimics those found in nature. It uses a purpose-designed product concept where ‘garden beds’ were formed from powder-coated, timber-toned aluminium.

Enhancing staff well-being and performance

Alongside patient wellbeing, medical staff also significantly benefit when nature is prioritised. Studio Elsewhere’s ‘Recharge Rooms’ highlight the possibilities from simply engaging our senses. They applied music, smell, lighting, and sound to envelope users in an experience of the natural world.

Research conducted on the project concluded that a single 15-minute experience in a Recharge Room reduced self-reported stress levels among participants by an average 59.6 percent.⁴ Imagine what the result may have been if living plants were included?

Supporting staff wellbeing was one of the key priorities in the Healing Garden project. The medical team has their own private and secluded pocket of nature where they can recharge during breaks in their busy work day.

While the Healing Garden was only recently opened, anecdotal feedback from staff and patients alike has already been overwhelmingly positive.

Delivering value for healthcare providers

Funding can prove a key issue when contemplating biophilic projects in the healthcare sector. The project realised a vision by the charity, Well Foundation, to inspire the local community in creating a world-class public health facility. The entire project was donor funded in another first for New Zealand.

Creative ideation by Outside In also shows how large-scale living planting can achieve the stringent hospital requirements and optimise cost-effectiveness. The project achieved the waterproofing, fire rating, and weight loading necessary to protect operating facilities on the floor below.

Shorter hospital stays and supporting staff wellbeing are just two examples of how these types of projects can deliver ROI for hospital providers. Hospital gardens not only create a more pleasant environment that supports healing, but they also create a resource for the wider community to enjoy and take pride in. The public areas become spaces that engage the senses, encouraging people to feel at ease and connected to nature.

Conclusion

Prioritising nature in hospitals can advance patient outcomes and wellbeing for staff and patients alike, as well as delivering value to healthcare providers. As the first of its kind for New Zealand, the Healing Garden demonstrates the psychological and physical benefits that can be achieved when we weave nature into healthcare design.

About the writer

Ryan McQuerry is co-founder and Creative Director of Outside In. Since the company’s founding in 2014, he’s played an integral role in its growth. Today, Outside In is New Zealand’s largest interior greenscaping business and the winner of prestigious international plantscaping and biophilic design awards.

Ryan’s career has revolved around horticulture and design. He is known for his innovative thinking to develop better ways of integrating nature into the built environment. Along with being a passionate advocate of biophilia, Ryan champions the benefits of integrating greenery into architecture — setting the standard for the greenscaping sector in New Zealand.

^References

^{1 Nieberler-Walker K., Desha C., Bosman C., Roiko A., & Caldera S. (2023). Therapeutic Hospital Gardens: Literature Review and Working Definition. HERD: Health Environments Research & Design Journal, 16(4), 260-295. doi: 10.1177/19375867231187154}

^{2 Ulrich, R. S., (1984). View through a Window May Influence Recovery from Surgery. Science, 224(4647), 420-421. doi:10.1126/science.6143402}

^{3 Tekin B., Corcoran R., & Gutiérrez R. (2023). A Systematic Review and Conceptual Framework of Biophilic Design Parameters in Clinical Environments. HERD: Health Environments Research & Design Journal, 16(1), 233-250. doi:10.1177/19375867221118675}

^{4 Putrino D., Ripp J., Herrera J., Cortes M., Kellner C., Rizk D., & Dams-O’Connor K. (2020). Multisensory, Nature-Inspired Recharge Rooms Yield Short-Term Reductions in Perceived Stress Among Frontline Healthcare Workers. Frontiers in Psychology, 11. doi: 10.3389/fpsyg.2020.560833}