Social aspects and well ‐ being for improving healing processes ’ effectiveness

Access to healthcare is deeply conditioned by several social factors such as health policies and economic con‐ ditions, that vary from country to country. Undoubtedly, hospitals are recognized worldwide as the symbol of the healthcare system in its maximum complexity and they are services that will never decay. As Christine Nickl‐ Weller and Hans Nickl state: “sooner or later, all of us will enter in a hospital: to give birth to a child, to visit a sick relative, to receive treatment for an acute medi‐ cal emergency or, indeed to say farewell to a loved one. Everyone will have to enter a hospital at some point in their lives” [1]. Since its origins, the hospital represents the social community and, in the socio‐cultural context, the origi‐ nal values of interdependence and solidarity. Moreover, it embodies the permeability and availability of enter‐ tainment and cultural activities in order to respond to the community’s needs [2]. Public health is a right that must be preserved and improved. However several analysis have demonstrated how existing hospitals, theoreticall born for preserv‐ ing public health, have indirect negative effects on the population, the community and the context. These im‐ pacts on the environment are increasingly more over upsetting the delicate balance between man and nature with direct consequences on health [3]. According to the World Health Organization (WHO), the environ‐ ment is defined as “an integrated system of human and physical factors exercising a significant effect on health, considered not only the absence of disease but as a complete physical, mental and social state” [4]. The public awareness and interest towards ecosys‐ tem’s issues have underlined the great attention to the environmental sustainability’s approach and, since hospitals were born as systems supposed to preserve people’s health, they must minimize negative impacts on the community [5, 6]. Currently, there are several tools that measure hospitals’ environmental sustainabil‐ ity and patients comfort and safety. These evaluation systems are respectively focused on energy aspects and clinical processes, totally neglecting users’ perception [7]. On the contrary, the existing tools that evaluate social aspects are specific for urban contexts and their issues are related to public wellness, access and trans‐ portation, air and water quality, policies and adminis‐ trations, but they totally lack of citizens’ point of view [8]. Despite it is difficult to obtain objective informa‐ tion about users’ perception, these data might be useful to support hospital design and management processes. Healthcare facilities, as healing places, require spe‐ cific consideration in the project design and planning to mitigate the sense of isolation and disorientation, to ease concerns and promote the recovery. The quality and efficiency perceived as well as the re‐ liability of the provided services are indeed closely relat‐ ed both to health, technological and innovative aspects in the care processes and to several indirect factors. Meanwhile, they are important as social aspects, just like the ability to ensure environments with high levels of comfort. Humanisation and environmental quality become key points and up to date issues, whose effects closely influence people’s health [1, 5, 6]. In the last years, the approaches of medical knowl‐ edge have changed from the scenario of treating the disease to treating the person [9], with reference to a holistic perspective focused on users. The previous approach, based more on a functional point of view than on a social one, met the operators’ needs (such as doctors, nurses, technicians, managers, economists, etc.). Hos‐ pitals were considered as machines to heal and cure the sick [10]. The current approach is completely different. Health‐ care facilities are spaces for care, research, education, workplaces and health promotion for healthy people.