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. . . but hospital quality reaps rewards in patient behaviour

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The design of a psychiatric hospital by awardwinning architect Powell & Moya has dramatically cut incidents of threatening behaviour, according to groundbreaking research revealed last week at the RIBA's one-day conference, Design Quality: the Evidence.

The study compared the practice's purpose-built Mill View Hospita l in Hove w ith Br ighton Genera l Hospita l, located in a former Victorian workhouse. Architectural academic Bryan Lawson showed that over a three month period the number of incidents of 'high level' threatening behaviour in the Victorian hospital were 64, compared to only 22 in the hospital which was completed two years ago.

Lawson also found that 'high level' verbal and physical outbursts were 50 per cent less in the modern hospital.One of the key reasons behind the improvement is thought to be the dominance of single-bed rooms in the new hospital as opposed to open plan 'Nightingale'style wards. The design gives patients the power to control their own level of privacy. 'This is exactly what architecture is about, providing space for people, ' said Lawson.

Design considerations extended to colours and control of the environment by opening windows, adjusting blinds and controlling lights.

However NHS Estates, the body which looks after policy on hospital design, is reluctant to conduct research into hospital environments, ranking it 23rd in a list of 42 priorities submitted to it by the researchers.Patients ranked it number one and the trusts which look after the hospitals directly ranked it number two.

'There is clearly a problem in the way we commission these buildings and the different emphases we are using, ' Lawson said. 'The conclusion from our work is that hospitals can make a contribution to the welfare of patients. A badly designed hospital can cause distress.'

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