This dissertation examines the cross-cultural circulation of the cruciform design for hospitals as the early modern architectural response to charitable and urban crises, considering the emergence of the plan in Italy and its rapid dissemination during the Age of Exploration (1400-1700). Despite recent media attention on makeshift hospitals, refugee camps, and reconstruction efforts worldwide following natural disasters, wars, and pandemics, the urgency of devising architectural and urban responses to human crises associated with poverty, disease, and migration is not a new phenomenon. While today these issues are often addressed in isolation, during the early modern period, they factored into a broader, ‘ecological’ understanding of health that drove the construction of hospitals and shelters for the sick poor, enmeshing these institutions into larger social, public health, and environmental strategies.</DISS_para> <DISS_para>Using the cruciform design as a connecting thread, I investigate links among port cities in Italy, Iberia, and the New World as they struggled with unprecedented challenges in sanitation, poverty, and medical assistance. As a result of intensified contact and circulation, ports are ideal sites for a study of architectural and urban innovations targeting urban crises. My project employs sociologist Immanuel Wallerstein’s model of ‘world cities’ to construe early modern ports as globally-networked cities that actively imported the latest advancements to achieve cultural and political centrality. Moving away from a formalist analysis, I integrate the building fabric with the contexts that inflected its adaptations, considering the role of the cruciform design in hospitals whose architecture and infrastructure promoted medical and sanitary innovations in the building itself and surrounding urban area, including developments to facilitate the disposal of human waste and the removal of dead bodies. My study combines archival evidence, archaeological data, and architectural and urban plans with contemporary knowledge of public and environmental health. This interdisciplinary approach highlights why political authorities sought and re-interpreted the cruciform design, isolating the innovative aspects responsible for the fast spread of this typology across Europe and Latin America. </DISS_para> <DISS_para>My Introduction (Chapter 1) examines the development of the cruciform typology as a result of charitable reforms occurring in northern Italy in the mid-fifteenth century. Building on early modern medical knowledge, I introduce the innovations associated with the design and consider the role of Filarete’s Treatise on Architecture (ca. 1460-64) in the circulation of architectural concepts during the period. Chapter 2 addresses the Ospedale di Messer Gesù Cristo (1474) in Venice in a longer history of Venetian reform. More specifically, I investigate the change in the mission of the Ospedale, as well as its architecture, from the perspective of military and urban crises faced by the Republic in the late fifteenth century. My discussion expands to Iberia in Chapter 3, with a study of the Hospital Real de Todos-os-Santos (1492) in Lisbon, an institution commissioned by the Portuguese monarchy to solve Lisbon’s crises of social welfare and public health. In particular, this chapter analyzes the Portuguese adoption of foreign and local strategies in charitable reform and the architecture of the hospital in view of larger public health strategies. Chapter 4 centers on the Hospital de las Cinco Llagas (1503) in Seville, especially considering the upsurge of at-risk women in Seville due to Spain’s male-driven colonization endeavors in the New World. Investigating the move and expansion of the hospital in 1549, I demonstrate how the architecture of the institution balanced innovations with the necessity to guarantee the invisibility and isolation of the institution’s female patients. Finally, Chapter 5, which also serves as a conclusion, addresses the translation of the cruciform typology to the New World. I compare the adoption of the plan in the Hospital San Nicolás de Bari (1503), located in the Spanish colony of Santo Domingo, with the different strategies of the Portuguese monarchy in colonial Salvador as evidenced by the Hospital da Cidade (1549).</DISS_para> <DISS_para>This dissertation contributes to the field in three ways. First, I demonstrate the actual reasons for the cruciform plan’s success rather than assuming the ‘natural’ replication of an Italian design as has been traditional in scholarship centered on this topic. Second, my case studies show the mobility and circulation of scientific and technological knowledge across southern Europe and between the Old and New Worlds, innovatively recognizing the impact of this flux on the built and urban fabrics of early modern cities. Finally, by shifting the scholarly discourse from Italy to the agency of Iberian and New World patrons, my dissertation opens the field for contributions from the so-called historical periphery, promoting a global understanding of early modern architecture and urbanism. / Art History

In 1897 John Sibbald, Commissioner in Lunacy for Scotland, stated that ‘the construction of an asylum is a more interesting subject of study for the general reader than might be supposed.’ This thesis traces the development of the public asylum in Scotland from 1781 to 1930. By placing the institution in its wider social context it provides more than a historical account, exploring how the buildings functioned as well as giving an architectural analysis based on date, plan and style. Here the architecture represents more, and provides a physical expression of successive stages of public philanthropy and legislative changes during what was arguably one of the most rapidly evolving stages of history. At a time when few medical treatments were available, public asylum buildings created truly therapeutic environments, which allowed the mentally ill to live in relative peace and security. The thesis explores how public asylums in Scotland introduced the segregation or ‘classification’ of patients into separate needs-based groups under a system known as Moral Treatment. It focuses particularly on the evolving plan forms of these institutions from the earliest radial, prison-like structures to their development into self-sustaining village-style colonies and shows how the plan reflects new attitudes to treatment. While many have disappeared, the surviving Victorian and Edwardian mega-structures lie as haunting reminders of a largely forgotten era in Scottish psychiatry. Only a few of the original buildings are still in use today as specialist units, out-patient centres, and administrative offices for Scotland’s Health Boards. Others have been redeveloped as universities or luxury housing schemes, making use of the good-quality buildings and landscaping. Whatever their current use, public asylums stand today as an outward sign of the awakening of the Scottish people to the plight of the mentally ill in the nineteenth and early twentieth centuries.

Thesis is submitted in partial fulfilment for the degree of Master of Architecture (Professional) to the Faculty of Engineering and the Built Environment, School of Architecture and Planning at the University of the Witwatersrand, Johannesburg, 2017 / The aim of the facility being designed is to focus on the resident by utilizing healing architecture, the notion that architectural elements and design effect ones well being. The disease Tuberculosis will be used as a platform for this exploration. After much research, it is evident that the Tuberculosis (TB) problem is worse today due to inadequate health care facilities and ineffective treatment methods, which do not handle the issue with the urgency it deserves. Currently, TB is treated for a very limited period of time in hospitals. Once this time is up, most patients are able to return home where they have to be self medicated. This is a dangerous, expensive and unreliable practice, as neglecting to take ones medication regularly can result in other strains of TB being developed. This is clearly a weak and irresponsible method of treatment, and therefore this report proposes that the health sector returns to the traditional methods of treating the disease, which is through isolation and a long period of confinement in a recovery setting. This investigation will be performed through analysing forms of health architecture and how to achieve a humane space for long term patients. Plants featured strongly in this investigation, and therefore research into the role planting has in healing architecture has been emphasised. / XL2018

Made available in DSpace on 2016-03-15T19:21:37Z (GMT). No. of bitstreams: 1 Carolina Nunes Melendres.pdf: 22718552 bytes, checksum: 153685d063d28a72cdd62a2cad1e7b10 (MD5) Previous issue date: 2011-08-10 / Fundo Mackenzie de Pesquisa / This essay discusses the concept of humanization applied in hospitals, examining its connection to the healing process and well-being, plus the link between the concept and design methods that improve architecture of hospitals and health promotion. Over time, hospital architecture has undergone various transformation supported by the evolution of medical knowledge and technology, as well as the appreciation of health and patients. The hospital went from a lifeless and absent building for an instrument to promote active assistance to medical practices and needs of its users, both physical and psychological. The shaping of this so called therapeutic places, seeks to synthesize this new hospital building dynamic that approach the figure of man and its complexities, in order to make it more receptive and personal: humanized. The careful examination of the design process and hospital production of architect Rino Levi whose thoughts are representative within the illustrated scenario reveals its close relationship with the principles of humanization in hospital architecture. Specifically, the case of Manoel Tabacow Hidal building designed by Rino Levi s team, in 1958, is deepened as the object of investigation / O presente trabalho versa sobre o conceito de humanização do espaço hospitalar, analisando sua conexão com os processos de cura e bem-estar humano, ademais seus vínculos com os métodos projetuais e o aprimoramento da arquitetura de hospitais em prol da saúde. A arquitetura hospitalar, ao longo dos tempos, atravessou variadas transformações apoiada na evolução do conhecimento médico e da tecnologia, bem como na valorização da saúde e de seus pacientes. O hospital passou de lugar inanimado e ausente para instrumento promotor de assistência ativa às práticas médicas e às necessidades tanto físicas como psicológicas de seus usuários. A formação desse espaço chamado terapêutico, busca sintetizar boa parte dessa nova dinâmica hospitalar aproximando o espaço construído à figura do homem e suas complexidades, a fim de tornálo mais receptivo e pessoal: humanizado. O atento exame do processo projetual e da produção hospitalar do arquiteto Rino Levi cujas reflexões são representativas no cenário ilustrado revela sua estreita relação com princípios de humanização do espaço hospitalar. Especificamente, o caso do Edifício Manoel Tabacow Hidal projetado por sua equipe, em 1958, é aprofundado como objeto de investigação

Made available in DSpace on 2016-03-15T19:22:52Z (GMT). No. of bitstreams: 1 Ana Carolina Cabral dos Santos.pdf: 51538368 bytes, checksum: e322e509ccd6637a8d91e63c82edc976 (MD5) Previous issue date: 2015-01-30 / With the density of large cities and the shortage of urban space, the right-rise buildings has become the rule rather than the exception; and this rule applies in hospitals increasingly frequent way. Considering the complexity of flows and the variety of processes that are routinely developed in a hospital, in what ways skyscraper buildings began to affect both the architectural design and the use management of these buildings? This dissertation aims to contribute to better understanding this issue through a referenced and comparative study on three significant cases of vertical hospitals, two in São Paulo and one in London. The cases were select from a large list of works studied, and given a set of objective criteria, defined by the survey. / Com o adensamento das grandes metrópoles e a escassez de espaço urbano, a verticalização edilícia passou a ser uma regra e não mais a exceção; esta regra aplica-se nos hospitais de maneira cada vez mais frequente. Considerando-se a complexidade dos fluxos e a variedade de processos que são cotidianamente desenvolvidos em um Hospital, de que maneiras essa verticalização passou a afetar tanto o projeto arquitetônico como a gestão de uso desses edifícios? Esta dissertação de mestrado se propõe a colaborar para melhor compreender essa questão por meio de um estudo referenciado e comparativo sobre três casos significativos de hospitais verticais, sendo dois em São Paulo e um em Londres. Os casos foram selecionados a partir de uma ampla listagem de obras estudadas, e atendendo um conjunto de critérios objetivos, definidos pela pesquisa.

Patient falls are the most commonly reported "adverse events" in hospitals, according to studies conducted in the U.S. and elsewhere. The rate of falls is not high (2.3 to 7 falls per 1,000 patient days), but about a third of falls result in injuries or even death, and these preventable events drive up the cost of healthcare and, clearly, are harmful outcomes for the patients involved. This study of a private hospital, Dublin Methodist Hospital, in Dublin, Ohio analyzes data about patient falls and the facility's floor plans and design features and makes direct connections between hospital design and patient falls. This particular hospital, which was relatively recently constructed, offered particular advantages in investigating unit-layout-related environmental factors because of the very uniform configuration of its rooms, which greatly narrowed down the variables under study. This thesis investigated data about patients who had suffered falls as well as patients with similar characteristics (e.g., age, gender, and diagnosis) who did not suffer falls. This case-control study design helps limit differences between patients. Then patient data was correlated to the location of the fall and environmental characteristics of the locations, analyzed in terms of their layout and floor plan. A key part of this analysis was the development of tools to measure the visibility of the patient's head and body to nurses, the relative accessibility of the patient, the distance from the patient's room to the medication area, and the location of the bathroom in patient rooms (many falls apparently occur during travel to and from these areas). From the analysis of all this data there emerged a snapshot of the specific rooms in the hospital being analyzed where there was an elevated risk of a patient falling. While this finding is useful for the administrators of that particular facility, the study also developed a number of generally applicable conclusions. The most striking conclusion was that, for a number of reasons, patients whose heads were not visible from caregivers working from their seats in nurses' stations and/or from corridors had a higher risk of falling, in part because staff were unable to intervene in situations where a fall appeared likely to occur. This was also the case with accessibility; patients less accessible within a unit had a higher risk of falling. The implications for hospital design are clear: design inpatient floors to maximize a visible access to patients (especially their heads) from seats in nurses' stations and corridors.

The natural light presents countless advantages. Among them the variability, which serves as source of physiological and emotinal stimulation to the human being. In environments where people are interned in a hospital, the long stay and the physical vulnerability ask for not only efficient environmental conditions, but also capable of providing positive reactions in the patient recuperation. In Brazil, the norms that rules the hospital's projects don't talk specifically about the natural light subject. In this case, the levels of ilumination are treated throught the recomendations related to artificial lights. On the other hand, studies about the visual confort estabilish parameters throught the relations of brightness of the surfaces. Moreover, the National Policies of Humanizations of the Attention and of the Administration of the Unic Health System talks about the eviromental comfort as a priority, making it important to know, with the population that uses it, their opnion about the enviromental conditions. Before this context, this research has the objective of analyzing the patient satisfaction about the conditions of the natural ilumination and, specifically, evaluate the visual comfort considering the behavior of the natural light and its levels, the condition of the sky, the opennings, the use of colors on the surfaces and the visual needs. The studies took place at the Infirmaries 28 and 35 of the Hospital Santa Casa de Misericórdia de Maceió. The Evaluation Post-Occupation (EPO), method chosen by this evaluation, approaches a comparative analysis between the conditions of natural ilumination and the degree of satisfaction of it's users. The results show that the conditions to the visual comfort are not exclusively based upon estabilished quantitative indexes and that the user's visual satisfaction at infirmaries goes throught a series of aspects from the patient‟s clinical conditions and hospitalar routine to expectations and personal desires. Thus, it's hoped that this study is able to contribute in the discussion about the visual comfort and in the projectual process of hospital environments. / Fundação de Amparo a Pesquisa do Estado de Alagoas / A luz natural apresenta inúmeras vantagens entre elas a variabilidade, servindo como fonte de estímulo fisiológico e emocional para o ser humano. Em ambientes de internação hospitalar a permanência prolongada e a vulnerabilidade física solicitam condições ambientais não só eficientes como confortáveis e capazes de proporcionar respostas positivas na recuperação dos pacientes. No Brasil, as normas que regem os projetos hospitalares não tratam especificamente a questão da luz natural. Neste caso, os níveis de iluminação são tratados a partir de recomendações relativas à luz artificial. Por outro lado, estudos acerca do conforto visual estabelecem parâmetros através das relações de brilho das superfícies. Ademais, a Política Nacional de Humanização da Atenção e da Gestão do Sistema Único de Saúde apresenta o conforto ambiental como prioridade, tornando-se importante conhecer junto à população usuária deste sistema qual a sua opinião sobre as condições ambientais. Diante deste contexto, esta pesquisa tem o objetivo de analisar a satisfação do paciente em relação às condições de iluminação natural e especificamente avaliar o conforto visual, considerando o comportamento da luz natural e seus níveis, as condições do céu, as aberturas, o uso de cores nas superfícies e as necessidades visuais. Os estudos foram realizados nas Enfermarias 28 e 35 do Hospital Santa Casa de Misericórdia de Maceió. A Avaliação Pós-Ocupação (APO), metodologia adotada para esta avaliação, aborda uma análise comparativa entre as condições de iluminação natural e o grau de satisfação dos usuários. Os resultados mostraram que as condições para o conforto visual não se baseiam exclusivamente em índices quantitativos normatizados e que a satisfação visual do usuário em enfermarias perpassa por uma série de aspectos que vão desde sua condição clínica e rotina hospitalar a expectativas e desejos pessoais. Assim, espera-se que este estudo possa contribuir na discussão sobre conforto visual e no processo projetual de ambientes hospitalares.

Thesis (MPhil)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Problem Statement: From a sustainability point of view, hospitals offer their services without taking into consideration their impact on the environment, the interplay between various sectors, key elements of sustainable development and interconnectedness. This study represents an attempt to design a “virtual” green hospital facility that does more with fewer resources. Aims and Objectives: Contribute towards achieving sustainable and better quality healthcare services. To generate evidence and increase our understanding of the sustainability of hospital resource flows. Design a “virtual” green hospital. Research Method: The research approach consists of a comprehensive literature review, mixed with substantiated field research and interviews. The literature review provided an understanding, recommendations and interventions for the virtual project. These can be used to promote greater sustainability through WCRC’s healthcare system, energy efficiency and green hospital buildings. Interviews and questionnaires were used to collect the qualitative data. The interpretive technique was used to analyse the collected data. Consumption statistics of electricity, water and waste were used to collect the quantitative data. It was analysed using the green building rating tool. The rating tool awards points according to incorporated measures, and arrives at a total score after appropriate weighting. The green building rating tool was used to establish the rating of WCRC as it stands and what it could ideally be as a retrofit? The data was presented as demographic information in tables, charts and graphs, drawn from the collected data. Findings: The findings that emerged suggest that: a) green hospital buildings promote greater sustainability than the current modern healthcare hospital buildings at WCRC and retrofitting would promote greater sustainability; b) the majority of WCRC’s current healthcare provision is done in the conventional ‘business as usual approach’; c) the greatest weaknesses of the hospital is its heavy dependence (95% average) on nonrenewable energy sources of fuel, electricity and water; d) procurement isn’t focused in the bio-region; e) sustainability isn’t viewed as the cornerstone to influence policy; and f) the flow of resources gets conducted through socio-economic systems. Conclusion: The current design of the hospital needs to be retrofitted into a green building, which will promote greater sustainability. A higher rated green star building for WCRC would promote greater sustainability. Healthcare provision is done in the conventional ‘business as usual approach’. Therefore the healthcare system faces threats in the immediate future, which include the impact of climate change, over dependency on fossil fuels and increasing urban sprawl. A virtual green hospital is designed to reduce the overall impact of its built environment on human health and the natural environment by: • Efficiently using energy, water, and other resources; • Protecting occupant health and improving employee productivity; • Reducing waste, pollution and environmental degradation. Recommendations: In this sustainability criterion, a paradigm shift is required for WCRC hospital to go green and become sustainable. At a local scale WCRC needs to green the current hospital building by retrofitting. WCRC needs to energy switch from nonrenewables to sustainable renewable resources. Bioregional consumption and procurement needs to be practiced whilst establishing a local health movement to engage suppliers and focus on sustainability. / AFRIKAANSE OPSOMMING: Probleem stelling: Gesien van volhoubaarheids oogpunt, bied hospitale dienste aan sonder om te besin oor die impak op die omgeweing, die tussenspel tussen verskeie sektore, sleautel elemente van volhoubare ontwikkeling en die onderlinge aanknopings. Hierdie studie verteenwoordig ‘n poging om ‘n skyn groen hospitaal te ontwerp wat meer kan doen met minder hulpbronne. Oogmerk en Doelstellings: Om ‘n bydrae te lewer om ‘n volhoubare en beter kwaliteit gesondheidsdiens te bereik. Om bewyse te genereer en begrip aangaande die volhoubaarheid van hospitaal bronne vloei to verhoog/ Ontwerp van ‘n “skyn” groen hospitaal. Ondersoek Metode: Die benadering in die ondersoek bestaan uit ‘n omvattende literatuurstudie met ondersteunbare veld ondersoeke en onderhoude. Die literatuurstudie voorsien in die begrip, aanbevelings en tussentredes vir die skyn projek. Dit kan gebruik word om groter volhoubaarheid van die WKRS se gesondheidsisteem, energie effektiwiteit en groen hospitale te bevorder. Kwalitatiewe data was ingewin met behulp van onderhoude en vraelyste. Interpretasie was die tegniek wat gebruik was om data te analiseer. Verbruikstatistiek van elektrisiteit, water en afval was gebruik on kwantitatiewe data te kollekteer. Die analise daarvan was gedoen deur die gebruik van die groen gebou graderingsinstrument. Die graderingsinstrument ken punte toe volgens opgeneemde maatreëls en bepaal die finale gradering na gepaste afwegings. Die instrument was gebruik om die gradering van WKRS te bepaal soos dit is en wat die ideale terugbou sou wees. Die data word in tabelle en grafieke voorgelê soos wat dit verkry was van die gekollekteerde data. Bevindinge: Die bevindinge wat na vore gekom het dui aan dat: Groen hospitaal geboue bevorder groter volhoubaarheid dan die huidige moderne hospitaal geboue van WKRS en terugbouing sal groter volhoubaarheid bevorder. Die meerderheid van gesondheidsdiensvoorsiening deur WKRS geskied volgense die konvensionele benadering van “besigheid soos normal” Die grootste swakheid van die hospitaal is die swaar afhanklikheid van die hospitaal op nie-hernubare energie (95%) soos brandstof, elektrisiteit en water, Verkryging is nie gefokus op die bio-streek nie, Volhoubaarheid word nie beskou as die hoeksteen om belied te beinvloed nie en Die vloei van hulpbronne word herlei deur sosio-ekonomies sisteme. Sluiting: Die huidige ontwerp van die hospitaal moet terugverbou word na ‘n groen gebou wat groter volhoubaarheid sal bevorder. ‘n Hoër groenster bougradering vir WKRS sal groter volhoubaarheid bevorder. Voorsiening van gesondheidsdienste volgens die “besigheid soos normaal” benadering veroorsaak dat die gesondheids-sisteem bedreigiongs in die gesig staar soos die impak van klimaatsverandering, oorafhanklikheid van fosiel energie en verhoodge stadspreiding. Aanbevelings: Volgens die kriteria is ‘n paradigma verskuiwing nodig by WKRS om groen en volhoubaar te raak. Op ‘n plaaslike skaal is dit nodig vir WKRS om die huidige hospitaal terug te bou om groen te raak. Dit is nodig om energie veranderings te ondergaan van nie hernubare tot volhoubare, hernubare energie bronne. Die Biostreek verbruiking en verkryging moet gepraktiseer word terwyl plaaslike gesondheidsbewegings gevestig word om te onderhandel met verskaffers en te fokus op volhoubaarheid.

This is a study of the spatial affordances of buildings that allow them to organize and transmit cultural ideas and to support the performance of organizational roles. The particular affordances under consideration are those that arise from the manner in which buildings structure the visual fields that are potentially available to a situated observer. In studying directed visibility patterns, supported by the development of appropriate analytical tools, we focus on a previously specified set of visual targets and ask how many become visible from each occupiable location. Parametric restrictions concerning the direction into which a subject faces and the viewing angle sustained by the target object are also taken into consideration. The aim is to demonstrate how such refinements of visibility analysis, lead to more precise and penetrating insights as to how building users tune their behavior to the spatial affordances of environment, and how the environment impacts their understanding in turn. Three different studies were presented. The fist used directed visibility measures to evaluate the affordances of different nursing-unit designs relative to how well nurses are able to survey patients in different rooms as they go about their duties. The second study focuses on the manner in which nurses and physicians position themselves in a Neuro Intensive Care Unit (ICU), particularly when interacting. The third study investigates how aware exhibition visitors become of the visual structure of environment and how the visibility structure of exhibitions affects the ability of visitors to conceptually group paintings according to their thematic content. The case studies support the following conclusions. 1) The way in which people position themselves in an environment as they perform their assigned tasks is tuned to the way in which visual fields are structured. 2) The visual structure of environment is contingent upon the interaction between the underlying structure of visual fields and paths of movement. 3) Directed visibility analysis leads to stronger correlations with behavior and performance than generic visibility analysis. This implies that environments are layered. Their underlying spatial structure is charged by the distribution of the contents that are programmatically primary.

Healing and clinical work requires a complex choreography of architectural acoustic design in healthcare settings. In most healthcare settings, medical staff members conduct vital tasks that may have life-and-death implications. Patients visit the hospitals to heal. Their expectations include fast recovery, restful sleep, and privacy (i.e., speech privacy). However, sound environment qualities of the care settings often fall far from supporting the mission of hospitals. There is strong and growing evidence showing that effective soundscapes in healthcare settings potentially impact errors, healing and stress for patients, families and staff but it is still not clear what measures of the sound environment best predict key healthcare outcomes and what design strategies best impact those measures. By using a multi-method approach (i.e., objective and subjective noise level measurements, in-situ impulse response measurements, heuristic design analysis, theoretical studies, acoustic simulations and statistical analysis), this study aims to develop evidence based design strategies by statistically defining the relationships between three types of variables: (1) architectural floor-plate design metrics, (2) acoustic metrics, and (3) occupant response. The research is conducted in three phases. The first phase of the study compared the objective and subjective qualities of the hospital sound environments with different architectural designs, assessed the effectiveness of a newer acoustic metrics in capturing caregiver perceptions, and evaluated the impact of particular noise sources on caregiver outcomes. The second phase of the study tested the validity of an acoustic simulation tool in estimating the acoustic qualities of the healthcare soundscapes. The third phase of the study systematically explored the relationship between floor-plate design and acoustics of complex inter-connected nursing unit corridors. Even though the relationship between design and acoustics of proportional spaces (a.k.a. rooms with more traditional dimensions) has been well documented, the number of studies linking design and acoustics of complex non-proportional spaces such as inter-connected corridors still remains limited. The findings of the first phase show that critical care sound environments with different designs can vary drastically and impact caregivers` perceived wellbeing and task performance (e.g., patient auditory monitoring). Despite their extensive use, traditional noise metrics sometimes may not be effective in capturing unique characteristics of healthcare sound environments. This study validated the effectiveness of a new more detailed noise metric, "occurrence rate", in capturing the differences between acoustic characteristics of healthcare sound environments. Moreover, particular noise sources such as impulsive noises are likely to dominate the ICU sound environments and interfere with perceived caregiver health and performance. The findings of the second phase suggest the potential effectiveness of acoustic simulation tools (with hybrid prediction programs) in estimating the acoustic qualities of complex inter-connected hospital corridors. The findings of the third phase suggest the potential significant impact of design features of particular hallways (e.g., number of turns, corridor length, and number of branches) and overall floor-shape characteristics of inter-connected corridors (i.e., relative grid distance, and visual fragmentation) on reverberation time. Overall, in the units with shorter, more compact, fragmented corridors with multiple number of branching hallways, reverberation times are likely to be less. Moreover receivers located at the corridors with less number of turns from the sound source also potentially experience lower reverberation times. According to previous research, the human auditory system`s ability to monitor auditory cues is likely to be higher in the less reverberant sound environments.