Hospitals in the US are typically built as thick buildings due to a desire to optimize travel distances and functional relationships within and between clinical and supporting departments. However, this building configuration disconnects building occupants in core work areas from daylight and views to nature. It also promotes high energy consumption due to excessive use of artificial lighting and air-condition. Yet, having access to daylight and the view to nature in buildings is important for human health and wellbeing, especially in hospitals. Daylight regulates the body´s circadian rhythm, is necessary to produce Vitamin D, affects mood, lowers stress, increases concentration, and enables performance of visual tasks. Additionally, having access to daylight can improve the recovery process, it is effective as an antidepressant, and reduces pain. Furthermore, daylit hospitals have a great potential for energy savings, if their design integrates appropriate daylighting strategies and recognition of local climatic conditions.
Future generations of hospital design need to become healthier places to deliver care, and become healthier for the planet by minimizing their significant impact on carbon driven climate change. Therefore, improving access to daylight and connections to nature should be a major design driver for hospital buildings and other large healthcare building typologies to protect the health of building occupants and support the 2030 challenge to protect global health and natural resources.
An extensive literature review was conducted to study the impact of daylight in buildings on human health and wellbeing as well as the potential for energy savings. Architectural typologies used for hospital buildings in the US and Europe were explored for daylight penetration. Current hospital designs illustrate chances and challenges for providing daylight and views to the outside in core clinical areas. The increasingly dense and compressed footprints of US hospitals make it difficult to integrate daylight without moving to more perforated plans or narrow wings as employed in other parts of the world. The study of global best practices, together with literature research, were used as basis for the development of daylight design guidelines for future US hospitals, that meet the requirements of contemporary programs and codes. Guidelines that were developed include 1) Orientation and location, 2) Narrow building footprint, 3) Perforated thick building footprint, 4) Courtyards in patient, staff and public areas, 5) Shading, and 6) Skylights and clerestories in patient, staff and public areas.
A design-proposal for a mid-size [146 bed] community hospital (one of the most common hospital types in the US), implementing the developed daylight-design guidelines, is presented as a test case. The Montgomery hospital replacement project in Norristown, Pennsylvania was picked to implement the thesis proposal on a challenging tight urban site to create a hospital based on the proposed concept:
"Form Follows Daylight".