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Cheryl Atkinson discusses some of the harder-to-measure qualitative aspects of design and the effects of design on the psychological well-being of patients in a hospital setting.

Image courtesy of interviewee. May 12, 2024

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This video video discusses a post-occupancy evaluation of a new chronic care hospital building in Canada, replacing an older facility. It highlights the unique opportunity to compare responses from staff and patients who transitioned from the old building to the new one, emphasizing the importance of architectural design on human experience, particularly in healthcare settings.

The evaluation aimed to assess how the new building’s design, which included more individual and accessible spaces, affected the psychosocial well-being of patients. Researchers observed factors such as wayfinding, social interaction opportunities, and the emotional impact of the environment.

Findings indicated that although patients and staff generally enjoyed improved brightness and cheerfulness in the new facility—enhanced by ample windows and meaningful views—there were fewer chances for social interaction compared to the older building, despite the increased volume and space.

Key takeaways include the significance of design in healthcare environments: well-lit, sociable spaces are beneficial to patient well-being, and people are drawn to areas with more social activity. The research reinforces the idea that while the quantity of facilities is important, the quality and accessibility of common areas significantly impact patient experience. Overall, the study affirms the influence of architectural design on healing and mental health in care settings.

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X-TIMESTAMP-MAP:LOCAL=00:00:00.000,MPEGTS=900000

00:00.265 --> 00:04.565
It was an incredible opportunity to look at a

00:05.325 --> 00:08.485
building, with a control population.

00:09.065 --> 00:13.525
Um, so oftentimes post occupancy evaluations are done with,

00:14.105 --> 00:15.245
new buildings,

00:15.305 --> 00:20.045
but they don't have, a lot of comparables so

00:20.045 --> 00:24.445
that you can have, a clean kind of experiment.

00:24.985 --> 00:28.605
And, because this building was a new build,

00:29.265 --> 00:31.525
and the new build was happening on the site of the old

00:32.485 --> 00:35.645
original building, and we had many of the same staff people,

00:35.905 --> 00:37.485
and many of the same patients

00:37.555 --> 00:39.805
because it's a long-term care hospital

00:40.295 --> 00:41.645
going over to the new building.

00:41.865 --> 00:45.845
So, it was a really great opportunity to,

00:46.075 --> 00:50.845
conduct an a, an, an evaluation like this, understanding

00:51.415 --> 00:53.525
human response to architecture.

00:54.185 --> 00:56.205
Um, so a unique experience.

00:56.205 --> 00:59.045
And it was, it had a lot of attention.

00:59.225 --> 01:01.045
It was one of the biggest, if it, well,

01:01.045 --> 01:03.445
it was the biggest chronic care facility in

01:03.585 --> 01:05.285
Canada at the time.

01:05.585 --> 01:08.605
And, it was well funded.

01:09.025 --> 01:11.445
The, the government

01:11.585 --> 01:16.285
and the, hospitals themselves wanted,

01:16.515 --> 01:18.045
this information and they wanted

01:18.045 --> 01:19.645
to design a state-of-the-art building.

01:20.165 --> 01:24.125
I think that hospitals have become kind of factory-like in,

01:24.185 --> 01:25.245
in the 20th century.

01:25.865 --> 01:27.245
Um, they've gotten bigger

01:27.505 --> 01:30.485
and further, more internalized.

01:30.705 --> 01:35.205
Um, there's, they're added to incrementally

01:35.585 --> 01:38.085
and very difficult to find your way around.

01:38.465 --> 01:41.925
And, for acute care, maybe

01:41.925 --> 01:44.445
that doesn't matter quite so much.

01:44.845 --> 01:47.005
Patients are in and out, quite quickly.

01:47.185 --> 01:51.085
But for chronic care facilities where patients have,

01:51.235 --> 01:54.525
long-term chronic diseases, like diabetes

01:54.865 --> 01:58.525
or, they're going through stroke, therapy

01:58.785 --> 02:03.245
or cancer therapy, the PE people are in those institutions

02:03.245 --> 02:04.285
for quite a period of time.

02:04.675 --> 02:09.245
They're anxious, they're depressed, they have, a lot

02:09.305 --> 02:11.925
of downtime on their hands, their stress.

02:12.425 --> 02:14.765
And so in that situation,

02:14.795 --> 02:16.765
environment does matter quite a bit.

02:17.305 --> 02:20.365
And, so there has been a fair amount

02:20.365 --> 02:23.925
of research happening over the past 20 years,

02:23.925 --> 02:28.805
looking at the impacts of, of design on,

02:29.775 --> 02:31.125
human state of being.

02:31.545 --> 02:35.725
And it's particularly important in healthcare,

02:35.955 --> 02:39.685
because, well, it's a publicly funded thing,

02:39.945 --> 02:42.965
and at least in Canada, and I think the UK too.

02:43.425 --> 02:47.005
And, it's, we felt,

02:47.185 --> 02:49.565
and many people feel that there,

02:49.705 --> 02:51.005
is strong evidence out there

02:51.075 --> 02:55.365
that design does impact your motivation, your sense

02:55.365 --> 02:58.525
of wellbeing, and your ability to heal,

02:58.665 --> 03:01.725
Faster, at least feel better while you're, while you are,

03:01.985 --> 03:03.805
managing your, your disease.

03:04.505 --> 03:08.725
The architects, were kind of following the mandate

03:08.825 --> 03:13.285
of the administration, which was to,

03:13.665 --> 03:15.845
create a, a campus of care

03:15.845 --> 03:18.645
that would be knitted into the urban community.

03:19.075 --> 03:22.525
They wanted to deinstitutionalize the, the hospital as much

03:22.525 --> 03:25.405
as possible, with in

03:25.405 --> 03:28.245
and out, patient staff, visitors

03:28.245 --> 03:29.925
and researchers coming and going.

03:30.705 --> 03:34.805
Um, they wanted to, normalize it,

03:34.805 --> 03:36.845
create a variety of facilities

03:36.845 --> 03:38.765
and programs for rehabilitation

03:38.785 --> 03:41.085
of the patients, that were there.

03:41.365 --> 03:43.885
Blurring, blurring, leisure

03:44.065 --> 03:47.205
and rehabilitation with gardens,

03:47.735 --> 03:51.165
facilities like gyms, pool, a therapy pool

03:51.165 --> 03:54.365
that's quite beautiful set into the garden,

03:54.475 --> 03:56.245
library and lecture hall.

03:56.905 --> 04:01.045
Um, so they wanted patients to be motivated, motivated

04:01.045 --> 04:04.925
by the environment to socialize, to move around,

04:05.385 --> 04:07.805
the building as part of the rehabilitation,

04:08.465 --> 04:12.045
and to, with the hope that in doing that,

04:12.155 --> 04:14.405
that would improve their mobility,

04:14.665 --> 04:16.765
but also help stave off the depression

04:16.765 --> 04:19.325
and anxiety that accompanies,

04:19.355 --> 04:21.565
chronic disease and its treatment.

04:21.905 --> 04:23.845
The design objectives in a big picture

04:23.905 --> 04:25.045
way came from the client.

04:25.745 --> 04:28.925
Um, and, our

04:30.045 --> 04:33.525
research then was based on what they wanted

04:33.585 --> 04:34.925
to achieve with the new building.

04:35.665 --> 04:39.885
And, we used the, the built form

04:40.225 --> 04:43.385
and the, the

04:44.215 --> 04:48.745
architect's drawings, and e even their process drawings

04:48.745 --> 04:51.745
and preliminary drawings as a theoretical basis

04:51.885 --> 04:56.545
for the development of our methods and measures of the POE.

04:57.405 --> 05:00.045
Um, so,

05:01.275 --> 05:03.605
they were interested in daily view.

05:03.675 --> 05:07.005
They were interested in, way finding

05:07.625 --> 05:12.325
and, the navigation of the building in a,

05:12.745 --> 05:17.165
in a clear and, and pleasurable way for, for patients.

05:17.825 --> 05:21.965
Um, and so they were interested in the program, the,

05:22.105 --> 05:24.845
the spatial configuration of the building, et cetera.

05:25.145 --> 05:28.885
So we looked at a lot of those issues,

05:29.275 --> 05:31.285
both qualitatively and quantitatively.

05:31.825 --> 05:35.205
Um, so, the, the project was split into two sections.

05:35.765 --> 05:38.965
I studied with my team, the architecture and,

05:39.465 --> 05:42.405
and, quantified it as much as possible

05:42.405 --> 05:46.085
through a whole diagramming process and, and,

05:46.385 --> 05:48.085
and, analysis process.

05:48.865 --> 05:52.525
Um, graphing, graphing information as well,

05:52.945 --> 05:56.495
and the social scientists, they

05:57.175 --> 05:58.345
interviewed patients.

05:58.735 --> 06:03.465
They, observed patients and, and staff and, before

06:03.485 --> 06:07.865
and after and at a third control facility that we use,

06:08.365 --> 06:13.185
to kind of even out the, the potential bias

06:13.325 --> 06:16.065
of, of the before and after of this one building.

06:16.805 --> 06:20.345
So, yeah, we had a control building.

06:21.525 --> 06:25.985
We looked at, quantity, location,

06:26.045 --> 06:29.425
and proximity of things like meaningful views for patients,

06:30.085 --> 06:32.305
which were important to the architects.

06:32.645 --> 06:35.345
We compare the number and proximity of lounges

06:35.345 --> 06:38.425
and other key recreation spaces for patients and staff,

06:39.205 --> 06:41.145
and documented their popularity

06:41.145 --> 06:42.665
and liveliness at various times

06:42.725 --> 06:44.265
of the day and days of the week.

06:44.925 --> 06:47.705
The social scientists, over a period of several years, pre

06:47.705 --> 06:49.585
and post-construction, interviewed, observed

06:49.585 --> 06:52.465
and collected impressions from both patients

06:52.465 --> 06:55.585
and staff in a, in a range of methods

06:55.685 --> 06:58.145
and ways, again, to eliminate bias

06:58.365 --> 07:00.745
and, as much as possible.

07:01.325 --> 07:06.185
Um, and looked at patients in the space

07:06.605 --> 07:09.185
as they were interviewing them in these kind

07:09.185 --> 07:11.585
of things they called go along interviews.

07:12.445 --> 07:17.265
Um, so they also took into account variables like the,

07:18.085 --> 07:19.585
the jobs,

07:20.165 --> 07:22.385
or the, you know, the kind of employment,

07:22.815 --> 07:25.785
socioeconomic status, age, cultural background

07:25.885 --> 07:29.345
of both patients and staff as well, to eliminate bias

07:29.485 --> 07:30.545
as much as possible.

07:31.245 --> 07:35.505
Um, and they focused on the response of

07:36.065 --> 07:40.505
patients to their space with a huge range of questions,

07:40.645 --> 07:43.705
but directed at understanding their mood, their sense

07:43.705 --> 07:45.985
of connectedness, sense of wellbeing,

07:46.485 --> 07:51.265
and, while also observing improvements clinically

07:51.405 --> 07:53.105
to their mobility

07:53.685 --> 07:57.145
and, ease of navigation through the building, their

07:57.855 --> 08:02.665
express mental states and, and their self-efficacy

08:02.685 --> 08:04.705
and in managing their own care.

08:05.965 --> 08:09.145
So the, you know, to summarize I guess the objectives

08:09.145 --> 08:13.105
of the, of the clinical scientists, it was about social

08:13.985 --> 08:18.705
psychosocial wellbeing, so depression,

08:18.705 --> 08:22.585
social connectedness, sense of community motivation, mood,

08:23.365 --> 08:25.705
stress, re reduction in coping,

08:26.205 --> 08:28.625
and, some functional health.

08:29.285 --> 08:31.185
So they tried

08:31.185 --> 08:34.905
to observe whether it actually impacted their experience

08:34.905 --> 08:39.545
of pain or their ability to, to move about the building.

08:39.965 --> 08:44.745
And, whether it actually had Im impact on,

08:45.485 --> 08:50.265
organizational efficiencies like their predilections

08:50.325 --> 08:54.585
to falls, reduction of infections and

08:55.485 --> 08:56.725
Reduction of medical errors.

08:57.275 --> 08:59.445
There's some very interesting,

09:00.245 --> 09:01.445
outcomes and observations.

09:02.205 --> 09:04.725
I mean, one of the things that was quite interesting about

09:04.725 --> 09:08.965
going from a building built in 19, 63

09:09.505 --> 09:13.085
to a building for the same number of patients,

09:13.545 --> 09:17.725
opened in 2014, was that the, the,

09:17.945 --> 09:21.525
the new building, contemporary buildings are much bigger

09:22.305 --> 09:25.125
and, there's,

09:25.395 --> 09:27.645
there's just a lot more volume.

09:27.715 --> 09:29.845
This building is four times the volume

09:29.865 --> 09:31.045
of the heritage building.

09:32.265 --> 09:36.445
It is, twice as big in terms of its floor plate.

09:37.505 --> 09:41.485
So, well qualitatively there,

09:41.575 --> 09:44.245
there are a lot of observed improvements.

09:44.505 --> 09:46.685
Um, and, and patients, clearly, patients

09:46.685 --> 09:50.365
and staff both clearly enjoyed, the,

09:50.625 --> 09:52.085
the design of the new building.

09:52.425 --> 09:57.245
So the impact of, the abundance of Windows,

09:57.665 --> 10:00.525
the attention to the location of those windows to,

10:00.985 --> 10:03.765
to address meaningful views in the building.

10:04.505 --> 10:09.045
Um, the huge variety of, spaces that

10:09.555 --> 10:12.405
were, are, were now available in the new building.

10:12.785 --> 10:15.965
Um, this beautiful therapeutic pool with

10:16.535 --> 10:21.445
glass opening onto the park, setting the,

10:21.635 --> 10:25.245
gymnasium, multiple lounges of library activity spaces.

10:25.275 --> 10:26.845
They all enjoyed it.

10:26.845 --> 10:29.645
It was clear that these were all beneficial things.

10:30.265 --> 10:34.565
Um, but I think the big takeaway was that,

10:35.145 --> 10:39.445
because the building was so much larger, we moved from,

10:40.505 --> 10:43.785
I think 60%

10:43.785 --> 10:47.105
of the rooms in the original building were quads.

10:47.165 --> 10:50.745
And in the new building, 60%

10:50.745 --> 10:54.465
of them were individual buildings and 40 individual rooms

10:54.525 --> 10:55.945
and 40% were doubles.

10:56.445 --> 11:00.825
So, it just meant that there was, a lack of density

11:01.205 --> 11:03.065
to, in the new building to a certain extent.

11:03.245 --> 11:07.905
So, well, people enjoyed the improved,

11:08.205 --> 11:12.225
brightness and cheerfulness of the, of the new building.

11:13.575 --> 11:17.025
They, there were some perceived,

11:18.335 --> 11:21.225
lack of opportunity for social interaction as much

11:21.225 --> 11:23.345
as there was in, in the older building.

11:24.005 --> 11:28.905
Um, I, I mean, I guess to be clear that there was,

11:31.205 --> 11:34.665
it wasn't, it was more that they didn't go to as many

11:34.685 --> 11:36.345
of the rooms that were provided.

11:36.485 --> 11:39.825
So what we learned was that quality was more important,

11:39.975 --> 11:41.345
important than quantity.

11:42.205 --> 11:45.265
Um, but the quantity was kind of an impact of

11:46.455 --> 11:48.495
creating more rooms, creating more floors,

11:48.745 --> 11:52.295
dispersing the rooms using contemporary,

11:52.475 --> 11:56.205
design parameters for mobility and equipment, et cetera.

11:56.355 --> 11:57.485
Just spread everything out.

11:58.065 --> 12:00.405
Um, but in, in both the new

12:00.405 --> 12:03.485
and the old building, one constant was

12:03.515 --> 12:06.445
that the favorite places were places

12:06.445 --> 12:07.885
where there were more people.

12:08.705 --> 12:12.125
Um, so people are drawn to people to places

12:12.135 --> 12:13.325
where there are other people.

12:13.905 --> 12:16.205
And, they were in the old building

12:16.265 --> 12:17.925
and they were in the control building.

12:18.185 --> 12:22.965
So the lobby space, the rooftop terrace,

12:23.705 --> 12:27.365
and the cafeteria were the most popular spaces for

12:27.965 --> 12:30.965
patients, even though they didn't always

12:31.475 --> 12:35.045
provide the most spectacular views,

12:35.345 --> 12:36.885
or the most daylight.

12:37.225 --> 12:39.485
So that, that was kind of an interesting thing

12:39.745 --> 12:41.125
to learn from the whole process.

12:41.865 --> 12:45.205
The implications for this work are that, you know, we,

12:45.385 --> 12:49.925
we certainly observed that there, that design does matter.

12:50.225 --> 12:53.925
People, people do feel better in brighter,

12:54.115 --> 12:56.805
more cheerful spaces in meet

12:56.805 --> 13:00.205
what we call meaningful views are, are quite important.

13:00.205 --> 13:01.445
People are drawn to them.

13:02.105 --> 13:05.125
Um, and we had a lot of them in this building.

13:05.265 --> 13:07.365
One of the advantages of the building being bigger

13:07.365 --> 13:11.205
and taller was we had we suddenly achieved in this building

13:11.355 --> 13:14.805
that was on the same site views to the, the lake.

13:15.105 --> 13:16.885
So expansive views, distant views.

13:17.465 --> 13:20.125
Um, so I think all of that is important.

13:20.665 --> 13:25.045
Um, and is a, is a, I think we're quite confident

13:25.045 --> 13:27.245
that the evidence proved all of that.

13:27.905 --> 13:32.205
Um, and, I guess the other major takeaway is

13:32.205 --> 13:35.725
that people value the proximity to other people

13:36.185 --> 13:40.965
and the opportunity that, design provides to,

13:41.585 --> 13:43.925
create crossroads for people.

13:44.225 --> 13:47.445
So think that, you know, designed for hubs, places

13:47.495 --> 13:49.645
where people would congregate,

13:50.115 --> 13:54.245
because as, as I was saying earlier, people are drawn

13:54.245 --> 13:55.525
to other people and,

13:55.715 --> 13:58.125
it's just like the empty restaurants syndrome.

13:58.125 --> 14:00.165
People want to go to a place that's busy and lively.

14:00.745 --> 14:04.405
So, people also want, patients also want to engage

14:04.405 --> 14:06.245
with the general public.

14:06.465 --> 14:09.365
And so, again, just as in the old building,

14:09.365 --> 14:12.245
people tended to hang out by the entry lobby

14:12.385 --> 14:14.045
to the building quite a bit.

14:14.365 --> 14:16.925
Patients would spend time in that lounge,

14:17.275 --> 14:18.925
because that's where the comings

14:18.925 --> 14:21.925
and goings were of the non-resident population.

00:00 - It was an incredible opportunity to look at a building, with a control population. so oftentimes post occupancy evaluations are done with, new buildings, but they don't have, a lot of comparables so that you can have, a clean kind of experiment.

00:24 - And, because this building was a new build, and the new build was happening on the site of the old original building, and we had many of the same staff people, and many of the same patients because it's a long-term care hospital going over to the new building. So, it was a really great opportunity to, conduct an a, an, an evaluation like this, understanding human response to architecture. so a unique experience.

00:56 - And it was, it had a lot of attention. It was one of the biggest, if it, well, it was the biggest chronic care facility in Canada at the time. And, it was well funded. The, the government and the, hospitals themselves wanted, this information and they wanted to design a state-of-the-art building. I think that hospitals have become kind of factory-like in,

01:24 - in the 20th century. they've gotten bigger and further, more internalized. there's, they're added to incrementally and very difficult to find your way around. And, for acute care, maybe that doesn't matter quite so much. Patients are in and out, quite quickly. But for chronic care facilities where patients have, long-term chronic diseases, like diabetes

01:54 - or, they're going through stroke, therapy or cancer therapy, the PE people are in those institutions for quite a period of time. They're anxious, they're depressed, they have, a lot of downtime on their hands, their stress. And so in that situation, environment does matter quite a bit. And, so there has been a fair amount of research happening over the past 20 years, looking at the impacts of, of design on,

02:29 - human state of being. And it's particularly important in healthcare, because, well, it's a publicly funded thing, and at least in Canada, and I think the UK too. And, it's, we felt, and many people feel that there, is strong evidence out there that design does impact your motivation, your sense of wellbeing, and your ability to heal, Faster, at least feel better while you're, while you are,

03:01 - managing your, your disease. The architects, were kind of following the mandate of the administration, which was to, create a, a campus of care that would be knitted into the urban community. They wanted to deinstitutionalize the, the hospital as much as possible, with in and out, patient staff, visitors and researchers coming and going. they wanted to, normalize it,

03:34 - create a variety of facilities and programs for rehabilitation of the patients, that were there. Blurring, blurring, leisure and rehabilitation with gardens, facilities like gyms, pool, a therapy pool that's quite beautiful set into the garden, library and lecture hall. so they wanted patients to be motivated, motivated by the environment to socialize, to move around,

04:05 - the building as part of the rehabilitation, and to, with the hope that in doing that, that would improve their mobility, but also help stave off the depression and anxiety that accompanies, chronic disease and its treatment. The design objectives in a big picture way came from the client. and, our research then was based on what they wanted

04:33 - to achieve with the new building. And, we used the, the built form and the, the architect's drawings, and e even their process drawings and preliminary drawings as a theoretical basis for the development of our methods and measures of the POE. so, they were interested in daily view. They were interested in, way finding and, the navigation of the building in a,

05:12 - in a clear and, and pleasurable way for, for patients. and so they were interested in the program, the, the spatial configuration of the building, et cetera. So we looked at a lot of those issues, both qualitatively and quantitatively. so, the, the project was split into two sections. I studied with my team, the architecture and, and, quantified it as much as possible through a whole diagramming process and, and, and, analysis process.

05:48 - graphing, graphing information as well, and the social scientists, they interviewed patients. They, observed patients and, and staff and, before and after and at a third control facility that we use, to kind of even out the, the potential bias of, of the before and after of this one building. So, yeah, we had a control building. We looked at, quantity, location, and proximity of things like meaningful views for patients,

06:30 - which were important to the architects. We compare the number and proximity of lounges and other key recreation spaces for patients and staff, and documented their popularity and liveliness at various times of the day and days of the week. The social scientists, over a period of several years, pre and post-construction, interviewed, observed and collected impressions from both patients and staff in a, in a range of methods

06:55 - and ways, again, to eliminate bias and, as much as possible. and looked at patients in the space as they were interviewing them in these kind of things they called go along interviews. so they also took into account variables like the, the jobs, or the, you know, the kind of employment, socioeconomic status, age, cultural background of both patients and staff as well, to eliminate bias

07:29 - as much as possible. and they focused on the response of patients to their space with a huge range of questions, but directed at understanding their mood, their sense of connectedness, sense of wellbeing, and, while also observing improvements clinically to their mobility and, ease of navigation through the building, their express mental states and, and their self-efficacy and in managing their own care.

08:05 - So the, you know, to summarize I guess the objectives of the, of the clinical scientists, it was about social psychosocial wellbeing, so depression, social connectedness, sense of community motivation, mood, stress, re reduction in coping, and, some functional health. So they tried to observe whether it actually impacted their experience of pain or their ability to, to move about the building. And, whether it actually had Im impact on,

08:45 - organizational efficiencies like their predilections to falls, reduction of infections and Reduction of medical errors. There's some very interesting, outcomes and observations. I mean, one of the things that was quite interesting about going from a building built in 19, 63 to a building for the same number of patients, opened in 2014, was that the, the, the new building, contemporary buildings are much bigger

09:22 - and, there's, there's just a lot more volume. This building is four times the volume of the heritage building. It is, twice as big in terms of its floor plate. So, well qualitatively there, there are a lot of observed improvements. and, and patients, clearly, patients and staff both clearly enjoyed, the, the design of the new building.

09:52 - So the impact of, the abundance of Windows, the attention to the location of those windows to, to address meaningful views in the building. the huge variety of, spaces that were, are, were now available in the new building. this beautiful therapeutic pool with glass opening onto the park, setting the, gymnasium, multiple lounges of library activity spaces. They all enjoyed it. It was clear that these were all beneficial things.

10:30 - but I think the big takeaway was that, because the building was so much larger, we moved from, I think 60% of the rooms in the original building were quads. And in the new building, 60% of them were individual buildings and 40 individual rooms and 40% were doubles. So, it just meant that there was, a lack of density to, in the new building to a certain extent. So, well, people enjoyed the improved,

11:08 - brightness and cheerfulness of the, of the new building. They, there were some perceived, lack of opportunity for social interaction as much as there was in, in the older building. I, I mean, I guess to be clear that there was, it wasn't, it was more that they didn't go to as many of the rooms that were provided. So what we learned was that quality was more important, important than quantity. but the quantity was kind of an impact of

11:46 - creating more rooms, creating more floors, dispersing the rooms using contemporary, design parameters for mobility and equipment, et cetera. Just spread everything out. but in, in both the new and the old building, one constant was that the favorite places were places where there were more people. so people are drawn to people to places where there are other people.

12:13 - And, they were in the old building and they were in the control building. So the lobby space, the rooftop terrace, and the cafeteria were the most popular spaces for patients, even though they didn't always provide the most spectacular views, or the most daylight. So that, that was kind of an interesting thing to learn from the whole process. The implications for this work are that, you know, we,

12:45 - we certainly observed that there, that design does matter. People, people do feel better in brighter, more cheerful spaces in meet what we call meaningful views are, are quite important. People are drawn to them. and we had a lot of them in this building. One of the advantages of the building being bigger and taller was we had we suddenly achieved in this building that was on the same site views to the, the lake. So expansive views, distant views.

13:17 - so I think all of that is important. and is a, is a, I think we're quite confident that the evidence proved all of that. and, I guess the other major takeaway is that people value the proximity to other people and the opportunity that, design provides to, create crossroads for people. So think that, you know, designed for hubs, places where people would congregate, because as, as I was saying earlier, people are drawn

13:54 - to other people and, it's just like the empty restaurants syndrome. People want to go to a place that's busy and lively. So, people also want, patients also want to engage with the general public. And so, again, just as in the old building, people tended to hang out by the entry lobby to the building quite a bit. Patients would spend time in that lounge, because that's where the comings

14:18 - and goings were of the non-resident population.

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