Consideration of grand design for the care environment in hospitals--smell, lighting and sound.

We investigated grand designs for the care environment in hospitals, focusing on smell, lighting and sound, based on a database of observed domestic general hospitals (12 institutions), consisting of 1235 photographs and descriptive data. As a result, we identified four areas that should be incorporated into grand designs for this type of care environment: [1] The smell environment with (1) the exclusion of "odors", and (2) regulation of "fragrances"; [2] the lighting environment with lighting that successfully incorporates nature; [3] the sound environment that incorporates (1) pleasant sounds, and (2) the exclusion of excess noise; and [4] a natural environment and a healing space where individuals can feel at ease. The most important challenges in reform of the care environment are an emphasis on an approach that employs the senses, and the necessity of raising the awareness of healthcare providers in relation to this type of environment. Although current hospital care environments are being improved through the independent efforts of hospitals themselves, we anticipate that the future will bring about a care environment in which more attention is paid to air quality, lighting and sound, when assessing, hospital function.