The positive effects of green spaces on the health and well-being of patients and healthcare staff in care facilities are gaining increasing attention. This has led to a rise in green initiatives in healthcare, such as gardens designed to support treatment, care, and overall well-being. “However, these interventions often fail to be used as intended,” explains Rosanne Steensma. The reason? There is frequently an assumption that once a green space is created, patients and staff will automatically use it. “What is missing is a focus on integrating these green interventions into practice—their implementation.”
Steensma and her colleagues decided to explore how green interventions can be effectively implemented in healthcare settings. Their research particularly focused on hospitals, elderly care facilities, and rehabilitation centres. The findings have been published in Urban Forestry & Urban Greening.
Garden pavilion
In the article, Steensma provides an example of the underutilisation of green interventions: a garden pavilion at a Dutch hospital specifically designed for patients undergoing chemotherapy. “Although patients were enthusiastic about the idea of receiving their treatment outdoors, the pavilion was used far less than expected. Initially, issues such as insufficient shade, unsuitable pathways for medical equipment like IV poles and wheelchairs, and poor weather protection were major barriers. Even after these obstacles were addressed, the pavilion largely remained empty,” says Steensma. “Patients reported that a lack of shelter during bad weather, inadequate comfort and safety, and restrictions related to their treatments were reasons for avoiding the pavilion. This underuse not only diminishes the benefits of these interventions but also incurs additional costs for an already strained healthcare system. It made us wonder: what if we had collaborated with patients and staff during the pavilion’s development phase to consider its implementation? Could we have prevented many of these obstacles?”
Recommendations
In the article, Steensma offers detailed recommendations for healthcare facilities and green space designers. “When designing green interventions, consider accessibility, safety, and target group-specific adaptations right from the start.” Moreover, the entire organisation must support the use of these spaces. Finally, it is essential to ensure that users are aware of the possibilities and benefits of green interventions and that they have sufficient knowledge to engage with them. Steensma adds: “By involving key stakeholders, including end-users, early in the implementation process, you not only build support but also gain valuable insights into potential obstacles. This is crucial for successful integration into practice. Additionally, we recommend that researchers place greater emphasis on the implementation process when studying green applications in healthcare.”
Steensma has developed practical tools to assist healthcare facilities with this challenge. “We have created an implementation method and tool to support healthcare facilities and landscape designers in both designing and implementing green interventions.”
For more information about this method and tool, contact Rosanne Steensma at r.s.steensma@vu.nl.
If you want to know more about Rosanne Steensma's research, listen to this podcast.