Ulrich's research influences 21st century hospital design

Reprinted from the Texas A&M University website
by Judith White

(College Station)—Texas A&M University architecture professor Roger Ulrich wants to build 21st century hospitals the same way physicians practice medicine, using the best evidence research and experience can provide.

This spring, he is carrying out research and working with architects and planners in the United Kingdom to improve patient care by helping to change the way British hospitals are designed, using the results of academic research projects focused on the interaction of environment and health outcomes to inform real-world practice.

"The healthcare system in the United Kingdom is undergoing major changes," Ulrich said. "The payment system is shifting closer to the one used in the United States, with government insurance reimbursements following the patient as he or she chooses a doctor, a clinic or a hospital. And as patient choice becomes linked to a facility's success, that facility is paying more attention to what patients want—and one thing most patients want is a room all to themselves.

"Research has shown that not only do patients prefer to have their own rooms, but single rooms are safer in terms of infection control and result in better medical outcomes. Staff also experience less fatigue and have higher morale when they care for patients one at a time. Patients who are satisfied with their experience at a particular facility tend to choose to use that same facility for subsequent hospitalizations or clinic stays, and these return visits contribute to a facility's financial success."

Such increased satisfaction by patients and caregivers and the resulting boosts to a hospital's bottom line are beginning to impact the way new hospitals in the United Kingdom are being designed.

"The British medical system is engaged in building facilities on an enormous national scale," Ulrich said. "Upwards of 100 new hospitals and thousands of new clinics are planned for the near term, with expenditures of more than $25 billion anticipated. Architects of these new facilities are abandoning the old four-bed-ward model for single-bed rooms, and making many other evidence-based design improvements.

“Since I first began working with British policymakers two and a half years ago, I've seen the requirement for single rooms rise from 20 to 30 percent of the total rooms of a facility, then to 70 percent, and I expect to see this demand continue to rise to the range of 80 to 100 percent."

Last year, Ulrich, who has received national recognition for his work on evidence-based facility design, took a faculty leave to study healthcare in the U.K. Now he's back there, doing research and advising the agencies that plan British hospital facilities.

He is also serving as a visiting professor of architecture at University College London. Ulrich brings his expertise in behavioral science and architecture to the study of how people and buildings interact.

In January, Ulrich participated in a conference of healthcare providers and policymakers that included the Prince of Wales; Ulrich delivered a talk on the interaction of the architectural environment and health. This semester, he also worked with another architecture professor, Susan Rodiek, who led a group of Texas A&M students who traveled to London to work on a project for a 750-bed hospital that will cost more than $1 billion.

"The hospitals and clinics being built in the U.K. are often larger and more expensive than those in the United States, so British policymakers and healthcare architects emphasize the need for the best possible information on which to base decisions," Ulrich said. "My experiences here have given me important insights into the intersection of the political and healthcare infrastructures. This program has offered the chance for an academic like me to bring research knowledge forward to influence government sponsored healthcare buildings on a massive scale."

Ulrich said he is looking forward to applying his research and decision-making findings to his classes at Texas A&M when he returns to the United States for the fall 2006 semester.

"I believe the time I have spent studying abroad has made the quality of my teaching and research much better," he said.