An empirical investigation focused on person-window transactions in the physical medicine and rehabilitation environment. Attributes of windows, view, daylight, and spaces perceived as insufficient in these respects were studied in six hospitals. Preference, environmental documentation, and behaviorsassociated with windows and windowless rooms were the subject of a two-part interview and questionnaire. The respondent group numbered 250 persons. Nonmetric multidimensional scaling (MDS) was utilized, yielding an array of 21 cognitive dimensions. From evaluations of 56 photographs that sampled a broad spectrum of spaces ranging from highly windowed to windowless, 8 visual dimensions were identified; and 13 nonvisual dimensions distilled from 89 written response items were identified that addressed degree of satisfaction and associated behaviors. Among the findings, ideal window and view conditions frequently contrasted the actual conditions in one's hospital setting; informative views of urban life and nature beyond the hospital, accessible from one's typical viewing angle and position within the room, were desired; minimally windowed rooms wereequated with architecturally windowless spaces, and window-view substitutes in windowless rooms were distinguished from similar rooms without such compensatory measures. Implications for hospital planning and design are discussed.

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Several knowledge gaps as well as commonalities in the pertinent research literature were identified. Perhaps the overriding finding is that occupants' meaningful exposure to views of nature from within hospital circulation zones can potentially enhance wayfinding and spatial navigation. Future research priories on this subject are discussed.

Background: The intensive care environment in hospitals has been the subject of significant empirical and qualitative research in the 2005–2020 period. Particular attention has been devoted to the role of infection control, family engagement, staff performance, and the built environment ramifications of the recent COVID-19 global pandemic. A comprehensive review of this literature is reported summarizing recent advancements in this rapidly expanding body of knowledge. Purpose and Aim: This comprehensive review conceptually structures the recent medical intensive care literature to provide conceptual clarity and identify current priorities and future evidence-based research and design priorities. Method and Result: Each source reviewed was classified as one of the five types—opinion pieces/essays, cross-sectional empirical investigations, nonrandomized comparative investigations, randomized studies, and policy review essays—and into nine content categories: nature engagement and outdoor views; family accommodations; intensive care unit (ICU), neonatal ICU, and pediatric ICU spatial configuration and amenity; noise considerations; artificial and natural lighting; patient safety and infection control; portable critical care field hospitals and disaster mitigation facilities including COVID-19; ecological sustainability; and recent planning and design trends and prognostications. Conclusions: Among the findings embodied in the 135 literature sources reviewed, single-bed ICU rooms have increasingly become the norm; family engagement in the ICU experience has increased; acknowledgment of the therapeutic role of staff amenities; exposure to nature, view, and natural daylight has increased; the importance of ecological sustainability; and pandemic concerns have increased significantly in the wake of the coronavirus pandemic. Discussion of the results of this comprehensive review includes topics noticeably overlooked or underinvestigated in the 2005–2020 period and priorities for future research.

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Background: Circumpolar nations are experiencing unprecedented environmental and public health policy challenges due to global climate change, exploitation of nonrenewable natural resources, the endangerment of myriad wildlife species, and growing sovereignty disputes. In a call to action, the Arctic states’ health ministers recently signed a declaration identifying shared priorities for mutual international cooperation. Among agreed-upon collaborations, an enhancement of intercultural understanding and promotion of culturally appropriate healthcare delivery systems is to be of high priority going forward. Purpose and Aim: In far north Canada, health policies perpetuated for generations upon indigenous communities have, traditionally, often had adverse consequences for the medically underserved inhabitants of these communities. This discussion addresses the cultural disconnect between the colonial era and current indigenous, decolonialist health and healing design strategies. Method and Result: In response, two architectural design case studies are presented that synthesize ecological site planning precepts with salutogenic architectural design attributes—a behavioral health and substance abuse residential treatment center and three elderhousing prototypes for construction in Canada’s Northwest Territories. Conclusion: This conceptual synthesis is practicable, transferable, and adaptable to varied, extreme climatic conditions, as reflective of best practices in the delivery of healthcare facilities that express a synthesis of ecohumanist and salutogenic values and methodologies. The discussion concludes with a call for empathic, evidence-based collaboration and research that further examines the blending together of prefabricated off-site construction with on-site construction approaches.

In the past 5 years, U. S. hospitals have virtually abandoned the semiprivate inpatient room. The inconclusiveness of recent research, however, indicates that this room type remains a potentially viable care delivery setting in both developed and developing countries for specific patient cohorts and care scenarios during hospitalization. Although the U.S. healthcare industry has embraced the all-private room hospital, does the semiprivate room have a place at all in the 21st-century American hospital? Literature on the subject, both for and against, is summarized. This is followed by a proposal for a case study prototype and its functional integration within a conventional medical/surgical unit in a U.S. hospital. The results suggest that a tempered reintroduction of semiprivatism affords opportunities for socialization, patient-family transactions and amenities, and staff effectiveness without compromising patient safety. Implications for environmental stewardship with respect to the carbon-neutral hospital of the 21st century are cited, as are priorities for further evidence-based design research on this issue.

Ten territories for engagement are presented that both individually and collectively express salient themes and streams of inquiry in theory and practice, within an operative framework placing the patient, the patient's significant others, and the caregiver at the center of the relationship between the built environment and occupant well-being.