Book Review

Hospital Interior Architecture: Creating Healing Environments for Special Patient Populations

N Engl J Med 1993; 328:894-895March 25, 1993

Article

Hospital Interior Architecture: Creating Healing Environments for Special Patient Populations
By Jain Malkin. 478 pp., illustrated. New York, Van Nostrand Reinhold, 1992. $124.95. ISBN: 0-442-31897-9

Jain Malkin's book is a catalogue of the best of the best health care environments. Her aim is to improve the quality of the health care environment by offering the state-of-the-art design image to the health care administrator, physician, hospital staff, interior designer, and architect. The book establishes a benchmark of excellence for a variety of health care environments, with chapters on imaging centers, cancer centers, critical care, and facilities for ambulatory care, congregate care, and research. Each chapter is well referenced and organized; for each type of program or center, the psychological factors, specific activities, and design issues are analyzed. Malkin is an interior designer as well as author, and she exhibits her own work as part of the book. She is also the author of Medical and Dental Space Planning for the 1990s (2nd ed. New York: Van Nostrand Reinhold, 1989). To compile this book she worked with more than 500 professionals to catalogue the best work of the design profession in the health care industry nationwide.

The author's goal is to give health care administrators and potential clients a strong visual book, a coffee-table book of high health care aesthetics. The book exhibits the best work in the design field, but it does not attempt to critique the health care design industry. There are no comparative examples of poorer-quality projects reflecting the more restrictive design frequently found in health care work.

The compilation of descriptive material showcases such examples of high design as Morphosis' Cedars-Sinai Comprehensive Cancer Clinic in Los Angeles; Cesar Pelli's Cleveland Clinic; and the Corinne Dolan Alzheimer Center in Chardon, Ohio, by Frank Lloyd Wright's successors, Taliesin Associated Architects. More restrictively budgeted projects such as military hospitals or low-income projects were not of the caliber to be evaluated or included. In the evaluation of the high-quality projects, there are sophisticated discussions about the ambience of the environment for healing; the importance of color, fabric, lighting, and signage design all contribute to the subtle improvement of the patient care setting.

The photographic images are predominantly without people; the images are carefully posed, selected views of the design professionals. More meaningful photographs are those of the same projects after five years of occupancy. This criticism is not specific to this book, but to the design profession as a whole. There is limited and selective discussion of durability and maintenance of materials for various programmatic applications.

It is physically impossible to visit all the facilities compiled in this book. Therefore, the impressions of author and audience are based on the images and information carefully selected by the design professionals. The strength of Hospital Interior Architecture is the exciting palette of ideas offered to those yet to build. The analysis of color, graphics, lighting, way finding, and furnishings is the real backbone of this work. Malkin clearly states that this book's “measure of success is to stimulate alternative solutions.” She gives us the best images to provoke even better images in the future. The book ends without a conclusion; the real conclusion is that good health can equal good design.

George E. Marsh, Jr., AIA
Payette Associates, Boston, MA 02116

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