The healthcare environment design is based on innovative approaches and modern architectural trends

such as:

Evidence-based design;

Healthcare approach centered around children and their families;

Therapeutic environment;

Health awareness;

Sustainable development.

Our proposed Hospital strives to fulfill its vision for excellence, innovation and responsible development
in a context of sustainable development and improved quality living for its patients, staff members and
the community.

The design and development plan aims to:

Foster accessibility;

Reduce the use of road vehicles by facilitating other means of transport;

Enhance the comfort and energy efficiency of its pavilions;

Increase green spaces. (The paved portion of the area which currently represents 50% of our site will
represent only 14% of the space, after the completion of the project);

In the hospital building, where patients seek medical treatment and hospital staff provide continuous
support, creating a healing environment is an imperative. However, it appears that the ultimate aim to
create a healing environment is not given due attention by healthcare designers. Patients’ negative
experiences of the existing physical environment of a hospital building describing as depressing,
confusing, dull, little natural light, stressful, noisy causing sleep deprivation, anxiety, isolation and
physical restraint were noted in many studies of the built environment. Most of these criticisms are also
experienced by the patients in the case studies of hospital buildings in Malaysia, particularly on thermal
(too warm) and visual (glare) discomfort. Therefore, the term ‘Healing Architecture’ is adopted to invoke
a sense of a continuous process; creating an environment physically healthy and psychologically
appropriate for patients’ well-being. A majority of the literature on the healing environment has reached
a consensus that the physical aspects of built environment could contribute indirectly to the health
outcomes of patients and staff in a hospital building. These include shorter length of stay, reduced stress
and increased patients’ satisfaction. Among the physical aspects, daylighting is considered one of the
most influential factors to achieve visual comfort contributing to a healing environment. The thesis aims
to explore daylighting performance of a four-bed ward by means of a parametric study of design
variables in order to achieve the visual as well as thermal comfort in creating a healing environment.
Conflicting issues of ‘physical to physical’ (e.g. daylight vs. solar heat gain) and ‘physical to psychological’
(e.g. daylight vs. undesirable glare) are analysed. With the theme of daylight and health, previous
studies related to the factors of the physical environments in hospital buildings that influence health
outcomes are reviewed. The physical factors affecting daylighting to achieve visual comfort are also
analysed. Reviews of the project briefs of the completed public hospital buildings in Malaysia are also
conducted and seven hospitals are selected as the case studies to investigate daylighting conditions of
the existing four-bed ward environment. Triangulation by means of analyses through questionnaire,
measurement and computer simulation is the method adopted for the investigation. Available
simulation programs are reviewed for suitability and compatibility of the study. The simulation software
(validated) used for the study is Integrated Environmental Solutions – Virtual Environment (IES–VE).
Based on the qualitative and quantitative analyses, it can be concluded that visual comfort in the
existing four-bed ward environments of public hospital buildings in Malaysia is not achieved. Factors
contributing to the failure are that the conflicting priorities (i.e. ‘physical vs. physical’ and ‘physical vs.
psychological’) were not analysed by healthcare designers when designing a window (size and position),
there is clear evidence of glare and daylighting design failed to meet the daylight factor (DF)
requirement of 1% at the (innermost) bed-head. The finding is that a healing environment in the four-
bed ward is not achieved. The results of the analysis also confirmed that the key physical factors
affecting daylighting in the hospital ward are orientation, window design (size and position), external
shading device, glass transmittance and indoor surface reflectances. Parametric studies of daylighting
design variables on the ‘base case’ unit are formulated in order to find the remedy as well as to arrive at
design guidelines. The Subang TRY weather data set is used and examined and found the two worst
conditions days of the year: the hottest (day 60) and the cloudy (day 299). Evaluation criteria for
measuring thermal as well as visual comfort are established to critically analyse the consequences of the
variants in the permutations. A total of 186 simulations are run to appraise the comfort condition of the
computer model of the four-bed ward environment. The simulation of daylighting conditions in a four-
bed ward environment would take into consideration the magnitude of solar heat gain of one exposed
wall (opaque wall and glass window) for the two selected worst days of the year and the ‘best’
orientation (other enclosing elements are taken as adiabatic). The results of the parametric study are
analysed by adopting the process of elimination for the selection of variants. The variants of design
variables that satisfy the evaluation criteria for comfort criteria set in the study are identified. Design
recommendations are made and guidelines on how best to achieve visual comfort through daylighting
design strategies in the hospital ward environment in the future are established. The findings arrive at
two crucial conclusions in creating a healing environment. Firstly, visual comfort can be achieved
through appropriate daylighting design.The second is that in order to achieve visual comfort in the four-
bed ward environment there is a need to find a balance between the acceptable magnitude of solar
heat gain and satisfying the requirement of daylighting (i.e. the acceptable limit of glare not exceeding a
luminance ratio of 10 and 1% DF).