It also has an impact on a hospital's bottom line. Nursing shortages are perennial, and healthcare workers are prone to burnout. So the hospitals that can keep their staff satisfied - and thus keep their staff - can save thousands in recruiting and training costs. In fact, whether by speeding a patient's healing, stemming staff turnover, or increasing productivity, cutting-edge hospital design translates directly into dollars. A group of experts estimated that incorporating evidence-based design ideas into a new 300-bed hospital would add about $12 million to its cost, but could recoup more than $11.4 million of that within the first year of operation. (For more about this calculation, see "The Business of Better Hospitals," below). "And their estimates of cost savings and new revenues were very, very conservative," Cama adds.

Back in Austin, a nurse ushers my husband and me into my father's room. While we're talking, a monitor activates his automatic blood pressure cuff and takes a reading. The red digits dip and flash, and his blood pressure drops from 135 over 90 to 125 over 82. His pulse drops. Less stress, more healing.

On the way out, we pass through a newly renovated surgical wing.The waiting room is lined with windows, and even the hallways are flooded with light. I look back at the point where the new flooring merges with the old, and imagine the new design spreading throughout the hospital. I don't know what's planned, but I imagine private rooms with space for family, big windows, sunlight and cherry blossoms, HEPA filters and acoustic tiles, rooms for staff to concentrate on their work. My father will be home long before construction is done, but other patients will fill those beds, and with any luck, they'll look out their windows and see trees.



The Business of Better Hospitals
Sure, better-designed buildings might be more comfortable for patients and hospital staff, but who's going to pay for them? According to one study, they'll pay for themselves.

A group of experts created fable hospital, an imaginary 300-bed hospital incorporating the latest design features, and then estimated the added cost. Larger, private rooms added about $4.7 million; larger windows, $150,000; rooms that can adapt to one patient's course of illness, from ICU-level care to on-their-way-home care, more than $800,000. High-quality air filters ran another $270,000, while materials that reduce noise cost $430,000. These and seven other features together added $12 million to the hospital's estimated construction cost of $240 million.

Then the study's authors analyzed the financial effects of those features over the first year of fable hospital's operation. In addition to increased revenues from higher market share and increased philanthropic donations, they deduced that the design would help keep patients from falling, for a cost savings of more than $2 million; would cut the cost of transferring patients from room to room, saving more than $3 million; and, by speeding healing, would cut drug costs by more than a million dollars. The total: $11.5 million.

“We believe that the lesson for all healthcare organizations is clear,” the authors wrote. “Provide a built environment that is welcoming to patients, improves their quality of life, and supports families and employees — or suffer the economic consequences in a competitive environment.”