Adapting hospital care to children of all ages

Designing hospitals for children is a unique challenge that requires a balance of the functional aspects of care with creating an environment that is psychologically and emotionally supportive for young patients. These buildings have to cater for children from all age groups, and their distinct needs. A well-designed hospital can significantly impact their recovery and overall hospital experience.

We cover the following topics, as well as introducing you to additional resources you may find useful during your design journey:

• Understanding the needs of children
• The EACH Charter
• Distraction Theory
• Jak inspirujete léčení uměleckým dílem?
• The power of colour
• Finding a balance between form & function

Understanding the needs of children in healthcare involves a comprehensive approach that encompasses not just their physical well-being, but also their emotional, developmental, and psychological needs.

Children, depending on their age, exhibit different levels of understanding, emotional responses, and physical needs. For instance, the care and communication styles required for toddlers differ significantly from that needed for adolescents. This necessitates the use of age-appropriate language and a keen awareness of the child’s emotional and social needs.

Hospitals, often perceived as intimidating by young patients, can become more welcoming through the integration of playful and familiar elements. This can significantly reduce anxiety and fear. Introducing medical procedures gradually and in a non-threatening manner is essential. Recognising and addressing signs of stress, anxiety, or depression in young patients is crucial, often necessitating the involvement of child life specialists, counselors, or play therapists.

The role of play in the healthcare setting is multifaceted, serving as a therapeutic and educational tool. It allows children to express their feelings, understand their treatment, and maintain a sense of normalcy, especially for long-term patients. Continuing education and activities that stimulate learning and development are also vital for these patients.

Communication with children in healthcare settings must be clear, simple, and reassuring, avoiding medical jargon and tailored to their level of understanding. Listening to the child’s concerns, validating their feelings, and providing honest, age-appropriate answers are important aspects of care. Moreover, the involvement of the family in the treatment plan is critical. The child’s well-being is often closely linked to the emotional state of their family, making it essential to provide support and resources for parents and siblings, and to accommodate their presence during hospital stays.

The design of healthcare spaces plays a critical role in a child’s recovery. Spaces that are bright, welcoming, and non-clinical in appearance, equipped with play areas, educational materials, and comforting elements, significantly contribute to a positive healing environment. Safety and accessibility are paramount, ensuring that the environment caters to children of all abilities with age-appropriate furniture and equipment. This holistic approach to paediatric healthcare acknowledges that healing is not just about treating the illness but involves nurturing the overall well-being of the child.

The EACH Charter is founded on the key principle that the best interests of the child should always be the priority. It also references the UNCRC General Comment No 15 on children’s right to health and General Comment No. 4 on adolescent health and development.

The charter sets forth several essential principles to ensure the well-being of children in hospital settings. These principles include: ensuring hospital admission only when necessary, allowing parental presence and accommodation without additional costs, and upholding the rights of children and parents to be suitably informed. It also advocates for the involvement of children and parents in healthcare decisions, and protection from unnecessary medical treatments.

Furthermore, the charter stipulates that children should be cared for in environments suitable for their developmental needs, emphasising the importance of not placing them in adult wards, and should be allowed unrestricted visitor access. It underscores the necessity of providing opportunities for play, recreation, and education in environments designed for children’s needs.
The charter also mandates that children receive care from qualified caregivers who are trained to meet their physical, emotional, and developmental needs. Continuity of care is highlighted as essential, along with respect for the child’s privacy and dignity.

Overall, the EACH Charter is a comprehensive framework that aims to safeguard the rights and welfare of sick children in hospital settings. It stresses the significance of family involvement, appropriate information sharing, and specialised paediatric care, ensuring a holistic approach to paediatric healthcare.

In paediatric healthcare, the creation of a healing environment extends far beyond the scope of medical treatment. It’s about crafting an interior design that supports the emotional, psychological, and developmental needs of children. This approach is fundamental in alleviating stress, fostering recovery, and offering comfort not just to young patients but also to their families.

The essence of a child-friendly hospital environment lies in its ability to transform a typical medical setting into a space that echoes a child’s imagination and comfort – Distraction Theory. Bright colours, playful designs, and interactive elements are more than just aesthetic choices; they are crucial in making the hospital feel less like a clinical facility and more like a world specifically designed for children. Themes such as forests, oceans, wildlife, outer space, or popular storybook characters help instill a sense of calm and wonder. They transform hospital walls and corridors from intimidating spaces into areas of familiar, story-driven adventures, making the environment less daunting and more engaging for young minds.

Interactive and educational elements are key components in these environments. Features like educational games in waiting areas, interactive floors or walls that respond to children’s movements, and technology-based activities provide entertainment and education. These tools not only distract from the clinical setting but also aid in children’s learning and cognitive development.

The design of paediatric healthcare facilities must also include play areas, both indoors and outdoors. Indoor play areas equipped with toys, books, and art supplies offer a controlled environment for safe play, while outdoor spaces allow for physical activity and interaction with natural elements, contributing positively to mental and physical health. These play areas should be inclusive, catering to various age groups and ensuring safety, accessibility, and stimulation for children with different abilities. This holistic approach to hospital design underscores the importance of a nurturing environment in the healing and well-being of young patients.

Let the space tell a story.

For architecture to be meaningful, especially for children, it must tell a story and stick to the narrative, as Nathalie Dziobek-Bepler explains in her book Designing Spaces for Children: A Child’s Eye View. Dziobek-Bepler is the Director of the Berlin-based architectural and design firm Baukind, specialising in architecture for children.

When she works on an architectural project for children with her firm, she draws inspiration from the surroundings, clients and the teaching concept to write a new story. The aim is not to change the theme as you move from room to room but to have a central theme and be consistent throughout the building.

While children do not understand everything from an intellectual point of view, their instincts and senses are highly attuned. And so, the narrative aims to create a certain harmony between spaces. For example, for her “Into the Wild” nursery project (see below link), Dziobek-
Bepler and her firm created a journey leading from town (where you enter the nursery) to the jungle (the heart of the nursery). The further you go into the nursery, into spaces for children, the more you travel to a primitive,
wild environment.

Learn more about the “Into the Wild” project: https://www.baukind.de/en/portfolio/betriebskita-berlin/ 

You can purchase the book Designing Spaces for Children here:
https://www.ribabooks.com/designing-spaces-for-children-a-childs-eye-view_9783868597172#

For Laura Bender of SitePainters, making art is an inner exploration, an exploration of colour and beauty, particularly in nature. 

We interviewed Laura to gain an insight into her artistic process, the intended impact of her artwork on patients, and the materials she used for the Penn State Children’s Heart Group project.

Laura believes that art in healthcare facilities should be uplifting, calming, and engaging for both children and parents. Its role is to create a comfortable and relaxing environment.

For the Penn State Children’s project she was inspired by the image of the sun, associating it with courage, which she felt was important for both children and their families in the hospital setting. Her beautifully painted wall mural designs, depicting large sun rays, tree branches, birds, and clouds feature throughout the waiting areas and corridors of the facility.

Understanding the psychology of colour is crucial in creating a healing environment in paediatric hospitals.

The effectiveness of colour use hinges on a delicate balance between bright and neutral hues.

Bright colours, though engaging and stimulating for children, need to be used judiciously to avoid sensory overload, particularly for children with specific medical conditions or sensitivities. Therefore, they are most suitable for areas like playrooms or activity spaces, where stimulation is beneficial. These spaces can be enlivened with vibrant murals, colourful furnishings, and interactive elements to captivate young minds.

On the other hand, patient rooms should lean towards neutral tones. Softer shades like blues, greens, and earth tones can dominate these spaces, creating a calm & serene atmosphere that is conducive to rest and healing.

Moreover, some paediatric hospitals utilise specific colour themes for different wings or floors, not only aiding in wayfinding but also providing varied sensory experiences. This strategic use of colour throughout the hospital serves multiple purposes, from engaging children in active areas to promoting tranquility in spaces designed for rest.

In designing a children’s hospital, the selection of interior finishes plays a critical role in ensuring a safe, hygienic, and welcoming environment for young patients. Hospitals often use non-porous, easy-to-clean materials like stainless steel, medical-grade plastics, and laminates for surfaces. These products are chosen for their ability to resist bacteria and ease of disinfection, which is crucial for maintaining a sterile environment.

Designers often aim to minimise hard-to-reach places and intricate details where dust and germs can accumulate. This includes choosing furniture and fixtures that are simple in design, easy to wipe down, and maintain. Some hospitals go a step further by incorporating antimicrobial surfaces that actively inhibit the growth of bacteria and fungi.

Durability is also a concern in children’s hospitals, as high-traffic areas require furniture and fixtures to be robust, safe, and able to withstand rough use. Additionally, walls, doors and corners are often reinforced with impact-resistant materials or guards to prevent damage.
It’s important to ensure that design elements are chosen not only for durability but also for ease of maintenance, ensuring that repairs and replacements can be conducted quickly and without major disruptions to the hospital and its patients.

Acrovyn® Wall Protection solutions are particularly suited for hospital environments, offering protection to walls, doors and other surfaces, as well as mobility support in the form of handrails. The range is designed with safety and hygiene in mind, and also includes customisable options, allowing for creative expression in the hospital setting.

As previously discussed, the design of children’s hospitals should be inspired by the young patients they serve. Creating spaces that are both functional and appealing to children is essential. This can include integrating children’s artwork, such as wall mural projects, into Acrovyn by Design® wall coverings.

Brightening up walls and corridors with such artistic elements makes the environment more visually appealing, whilst also bringing a sense of positivity and energy, which can be beneficial for the healing and comfort of young patients.

Throughout this document we have emphasised the critical need for paediatric care environments to be tailored to the unique physical, emotional, and developmental needs of children.

We are strong advocates for hospital designs that go beyond medical efficacy, focusing on creating spaces that are comforting, engaging, and supportive of both the children and their families.

A holistic design approach is required to foster not just physical healing, but also psychological well-being in young patients. We’ve touched on many ways that this can be achieved, such as being considerate of appropriate colour schemes, incorporating natural elements, interactive features, and family-inclusive facilities.