n:w explains
July 19, 2021

Get well with wood

How nature, wood, and other organic materials can support healing and improve patient care. 

Interior daytime view of common space within the Yukon BC Ronald McDonald House showing children arriving into common space by way of a wooden staircase and an enclosed yellow tube slide

A home-away-from-home, the Ronald McDonald House BC & Yukon wraps sick kids and their families in the warmth of wood. | Photo credit: Ema Peter Photography, courtesy of MGA | Michael Green Architecture 

More and more, science is confirming the merits of the emerging concept of biophilia: that being exposed to nature not only calms our mind, it can contribute to a sense of health and well-being. There is perhaps no better place to apply this than health care architecture and design.

Branch out, breathe deep

Bringing nature inside

For most of human history, a connection to nature was a given, with our daily lives intimately tied to the cycles of the sun, the seasons, and the natural world around us. It’s only recently that we began to earn a living, go shopping, enjoy endless entertainment, and even socialize without ever leaving home. While it is convenient, this separation from the great outdoors may be taking a toll on our health. 

So, it makes sense that designers are increasingly looking for ways to incorporate more natural materials and a connection to nature into buildings. Often referred to as biophilic design, the idea is to make ample use of daylight, views and greenery, fresh air, and exposed wood to create a warm, inviting aesthetic that promotes health. This concept is increasingly being used in health care facilities. 

 

Skyward view of tall indigenous coniferous trees - Including Western Red Cedar (Thuja plicata) and Douglas Fir (Pseudotsuga menziesii), with sun shining through.
Natural connections

The biology of biophilia

As a building material, wood can play an important role in biophilic design, whether it’s as structural elements or interior finishes.

Dr. David Fell is a B.C. researcher who has studied the positive impacts of incorporating wood into the design of buildings and co-author of a report on how wood can be a restorative material in health care environments.

He explains, “the psycho-physiological reactions of human beings to wood are based on two major systems of reaction to stress, namely the autonomic nervous system and the endocrine system. One particular research project on the response of the autonomic nervous system to wood observed lower levels of blood pressure, heart rate in an environment where wood is present, compared with one where it is absent”.

The main stress hormone that is of concern to us is cortisol. In two separate studies, cortisol levels were lower in people who had visual contact with wood in an indoor test environment.

Ts’kw’aylaxw Cultural and Community Health Centre | Photo credit: Ema Peter Photography courtesy of Unison Architecture Ltd.

As Fell sees it, research is catching up with what architects seem to have known intuitively for decades. “In my opinion, the empathetic architect has always been aware of the connection between wood and humanity. In surveys carried out before the biophilic design movement, architects and the occupants of buildings described, without exception, materials composed of wood as being warm, natural, and good for our health.”

Interior view of Ts’kw’aylaxw Cultural and Community Health Centre circular social area showing comprised of Douglas-fir glue-laminated timber (glulam) columns and prefabricated light wood frame panels
Healthy Ageing

A century-old building material breathes life into long-term care

The world’s population is getting older and living longer. The need for assisted living facilities is expanding rapidly, to keep pace with a fast-growing ageing population. Globally, the number of people over the age of 65 is set to double by 2050, reaching over 2 billion. In B.C., the senior population is projected to steadily increase to represent almost 25 per cent of all B.C. residents. Thanks to advancements in science and medical care, people go on to live healthy, fulfilling lives well into their 80s and beyond.

Wood architecture can promote healthy ageing. It is well-suited to cost-effectively meet the need for versatile, flexible, and high-quality facilities that accommodate a wide spectrum of assisted living needs. Residents report higher satisfaction with interiors that include wood that is visible and exposed.

Holding elderly person
Long-term care

The warmth of wood and a room with a view

Such is the case with Gateway Lodge Long-term Care in Prince George—the facility provides 94 complex care beds using a decentralized approach that places small groupings of 14 to 20 residents into linear ‘home areas’. The residential rooms have views of the site’s interior gardens and courtyards. Natural ventilation, garden access and ample glazing ensure abundant access to sunlight, views and fresh air.

Faced with a long winter and a short construction season, the architects expedited the construction schedule by taking advantage of dimensional lumber and Douglas-fir plywood prefabricated wall panel system, which allowed the construction team to frame the entire 13,750 square-metre facilities in only 12 weeks. The exposed Douglas-fir glue-laminated timber (glulam) beams and columns create large spans over the social spaces, while the pre-assembled panelized walls create more private spaces. Maple wood—solid and veneer—features prominently in millwork and finishing elements, adding warmth and a domestic feel to otherwise institutional scales.

Right: Gateway Lodge Long-term Care | Photo credit: Derek Lepper Photography courtesy of Neale Staniszkis Doll Adams Architect

A selection of mass timber products, including glue-laminated timber (Glulam), are showing in this interior view of Gateway Lodge Long Term Care facility
Get the download

Case study on the benefits of wood in assisted-living facilities

As the need to accommodate an ageing population continues to rise, wood offers quick, easy to construct, and high-quality facilities that minimize a building’s carbon footprint while delivering additional biophilic benefits to its occupants. Explore five projects that show how wood is making assisted-living facilities both cost-effective and healthy, welcoming environments.

Dowel-laminated timber (DLT) detail | Photo courtesy of StructureCraft

Read more
International

Beichuan Qiang Maple Leaf Seniors Home

In the wake of a major earthquake in 2008, the Beichuan Qiang Maple Leaf Seniors Home was built using funds donated by the Government of Canada and the Province of British Columbia. These donations were part of a program set up to assist in the reconstruction of the devastated region and to showcase the advantages of wood-frame construction for energy efficiency and resistance to earthquakes. China’s senior population is growing exponentially and the national government has made building more senior care facilities a priority. This multi-purpose, multi-unit complex, comprised of four buildings of one- and two-storey construction with a total floor area of 5,600 square metres, features wood prominently and takes advantage of biophilic design principles. The building includes accommodation for more than 200 seniors, together with communal facilities.

Beichuan Qiang Maple Leaf Seniors Home | Photo courtesy of FII China and Canada Wood China

China Eldercare centre showing wood structure with Chinese and Canadian flag hanging together at the front of the building flanked by flags

The thermal and seismic benefits of wood are of particular importance in a country like China with climate extremes and where more than 60 per cent of the population live in areas prone to earthquakes.

Beichuan Qiang Maple Leaf Seniors Home | Photo courtesy of FII China and Canada Wood China

Beichuan Qiang Maple Leaf Seniors Home FII China Canada Wood
Podcast

Listen and learn about biophilic design

Dr. Graham Lowe author of Wood, well-being and performance: The human and organizational benefits of wood buildings sits down with Construction Business to explore wood and biophilic design’s impact on well-being and human performance in this 15-minute podcast.

Listen to the podcast
Healthy communities

A hub for general, multipurpose and speciality care

Many smaller communities throughout British Columbia rely on multipurpose health care facilities that bring together everything from physician visits and vaccinations to prenatal and addiction services. And a growing number of these are built with locally-sourced timber and reflect the cultural values of the community. 

Located just outside of Port Alberni on Vancouver Island, the Tseshaht Tribal Multiplex and Health Centre fulfils community, health, cultural, commercial, and social functions. Its design elevates its heavy-timber structure and follows the contours and outlines of the rocky bluff below. Cantilevering the wood structure over the Somass River’s edge doesn’t just make it appear to float, it allows for the concealment of the large services and equipment underneath the floor.  

Tseshaht Tribal Multiplex and Health Centre | Photo credit: Rasti Zabka, courtesy of Lubor Trubka Associates Architects

glue-laminated timber (glulam), millwork, paneling, and siding are all show in this cloudy exterior lakeside image of the Tseshaht Tribal Multiplex and Health Centre which highlights the abundant use of exterior wood for the column supports, wrap around balcony, window trim, roof trusses, eves, and more

The extensive use of wood was chosen for its cultural significance to the Tseshaht First Nation. As the sun travels its daily path, light floods into the carefully sited facility, bathing the many wood surfaces to create a warm and luminous ambiance. 

 

The structure is a combination of open-framed post and beam in-filled with glazing with strategically placed sheer walls to enhance seismic performance in the event of an earthquake. It uses a multitude of engineered wood and lumber products milled by the Tseshaht from wood harvested from their traditional lands. The design deliberately exposes every element of the wood structure as an architectural feature, requiring precision pre-manufacturing of each element, which was done on-site prior to assembly. 

Tseshaht Tribal Multiplex and Health Centre | Photo credit: Rasti Zabka, courtesy of Lubor Trubka Associates Architects

glue-laminated timber (glulam), millwork, and paneling are all show in this sunny interior image of the Tseshaht Tribal Multiplex and Health Centre which highlights the wooden floors, wooden ceilings, timber beams, and wood accents

Traditional and modern healing become one

Traditional and modern healing become one in the Ts’kw’aylaxw Cultural and Community Health Centre, a multi-purpose facility, serving the Ts’kw’aylaxw First Nation. Wood’s presence is extensive throughout the three-storey facility. The first floor is comprised of Douglas-fir glulam columns and prefabricated light wood frame panels. Featured on the second floor are glulam beams, nail-laminated decking, and wood fibre acoustic panels. Birch veneer plywood and acoustic panels are part of the second floor’s multi-purpose space. An aspen feature wall is on the third floor in the Elders’ cylinder gathering space.

The three levels are connected by a circulation atrium with hemlock panelling and a glulam grid supporting a low-profile veneer curtain wall. A peeled western red cedar colonnade and soffits, as well as solid birch entrance doors, are visible from the exterior of the centre.

Similar integrated community health care facilities throughout the province—such as Yunesit’in Health Centre and Kitsumkalum Health Centre—showcase made-in-B.C. timber construction and were built and assembled by local craftspersons. 

Ts’kw’aylaxw Cultural and Community Health Centre | Photo credit: Ema Peter Photography courtesy of Unison Architecture Ltd.

 

glue-laminated timber (glulam), lumber, millwork, nail-laminated timber (nlt), and paneling, are all featured in this interior upward vertical daytime image of the Ts’kw’aylaxw Cultural and Community Health Centre which highlights the multi storey wooden switchback staircase
Stress test

Measuring the impact of wood interiors

In four different independent studies, the presence of wood was found to have an immediate effect of lowering sympathetic nervous response, akin to reducing stress and anxiety. A study of stress levels in students found long-term exposure to wood interiors was correlated with an activation of the parasympathetic nervous system, which acts to reduce overall stress levels and promote healing. And in studies of wood in office environments, participants self-report a preference for wood interiors and believe that it promotes health and well-being.

BC Passive House Factory meeting room | Photo credit: Ema Peter Photography courtesy of Hemsworth Architecture

Learn more about wood and health
Acute and hospitals

Bold biophilic design with mass timber

An increasing number of acute health care facilities in B.C. are incorporating wood, including the use of structural mass timber. Patients and visitors to the Surrey Memorial Hospital’s emergency department are greeted by tree-like wood columns, each consisting of four thick glulam ‘branches’ that extend from floor to ceiling and support a panelized atrium roof.

“The expansion looks fantastic. It was built based on the latest research that says wood can be calming and comforting, and that lots of daylight and views of green spaces can potentially help people recover faster,” said Robert Bradley, energy conservation manager for Fraser Health when the project was completed.

Nanaimo Regional General Hospital takes a similar approach with its bold use of mass timber. Its emergency entrance features a striking heavy timber canopy, comprised of several large Douglas-fir glulam struts that support glulam beams. A substantial secondary structure of solid Douglas-fir purlins and canopy decking sits atop the beams, forming an instantly striking structure of exposed wood.

Nanaimo Regional General Hospital | Photo credit:  Artez Photography courtesy of Stantec

“A goal of the project was to create an environment that would be great for patients and staff, and a very important aspect of that was a connection with nature. This was achieved with the courtyards bringing daylight in, as well as being able to get outside and experience the healing and calming effects of the outdoors,” said Bruce Raber, vice president and health care sector lead at Stantec.

Douglas-fir glulam struts support the glulam and heavy timber canopy in the exterior view of the Nanaimo Regional General Hospital Emergency Department

The BC Cancer Agency Centre for the North gives B.C. residents of the region a 3,080 square-metre radiation facility, eliminating the need to travel long distances to Vancouver or Kelowna for treatment. It includes two linear accelerators that are used in the delivery of radiation therapy, a computerized tomography (CT) simulator, a chemotherapy treatment department, a pharmacy, outpatient clinics, staff offices and an underground parkade for secure, weather-protected entry.  

Upon entering the facility, visitors are greeted with an expressive canopy built of glulam and rounded heavy timber post-and-beam construction. A double-height atrium draws light into the timber and western red cedar-clad interior. Patients are wrapped in the warmth of wood, contributing to a calming, health care experience.

Right: BC Cancer Agency Centre for the North interior | Photo courtesy of HDR © 2012 Bob Matheson

Below: BC Cancer Agency Centre for the North exterior | Photo courtesy of HDR © 2018 Dan Schwalm

Interior daytime view of low rise BC Cancer Agency Centre for the North showing glue-laminated (glulam) timber, solid-sawn heavy timber, wood paneling and accents
Must-have download

All the biophilic research summarized in one convenient report

Learn more about how biophilic design is influencing how we design and construct our buildings in our latest research report Wood, well-being and performance: The human and organizational benefits of large wood buildings, by Graham Lowe, PhD.

UBC Pharmaceutical Sciences Building | Photo credit: Ema Peter Photography courtesy of hcma and Saucier + Perrotte Architects

Download the report
ARCHITECTURE WITH EMPATHY

A home away from home for sick kids

A modern and contemporary two-story Ronald McDonald House for the B.C. and Yukon regions, not only makes timber its primary structure but reinvents the template for this home away from home for out-of-town families whose sick children are receiving critical care. With more than 350 Ronald McDonald Houses across North America and growing, these facilities provide shared kitchen spaces, dining facilities, common areas and private suites for families during an incredibly stressful time.

The project, designed by Vancouver-based architect Michael Green, is an advanced application of mass-timber construction, built of a hybrid cross-laminated timber (CLT) wall and high-performance light-wood floor system. The panelized construction enabled off-site prefabrication, with panels factory-cut to a precise size and fit. And because CLT can be left exposed, the floor-and-ceiling structure serves double duty, surrounding occupants in a warm aesthetic. This is architecture with empathy, decidedly non-institutional in its feel, a place where dignity and playfulness live side by side.

Ronald McDonald House BC and Yukon | Photo credit: Ema Peter Photography courtesy of MGA | Michael Green Architects

Exterior evening rooftop view of Yukon BC Ronald McDonald House showing innovative combination of cross-laminated timber (CLT), masonry and light-frame construction

It is the forest itself that Green looks to for inspiration. “Nature is incredibly efficient and uses the minimal amount of energy needed to survive and thrive. Take a tree branch for instances; its structure thickens where it connects to the branch and tapers along its length, and the fibre inside that branch is aligning to give it the strength it needs. It is pure, efficient structural shape created by nature.”

Ronald McDonald House BC and Yukon | Photo credit: Ema Peter Photography courtesy of MGA | Michael Green Architects

Interior daytime view of children playing within activity space of Yukon BC Ronald McDonald House showing wooden floor, wood trim, and 4 wooden playhouses - each on industrial castors

A hub for autism research, clinical practice and support

Not far from the Ronald McDonald House, the Richmond-based Pacific Autism Family Centre makes use of biophilic design principles. Its expansive, open-concept design includes the use of wood, a nature-inspired colour palette and organic materials, to evoke a sense of calm and empathy. As visitors enter the three-story building, its stately appearance gives way to a bright, spacious, and at times playful interior, punctuated by pops of colours and warm, exposed wood. As the first facility of its kind in Canada, the centre brings together state-of-the-art services for autism research, clinical practice, and family support.

Pacific Autism Family Centre | Photo credit: Derek Lepper Photography courtesy of NSDA Architects   

Exterior sunny view of three-storey low rise mass timber constructed Pacific Autism Family Centre showing warm exterior of Douglas-Fir and Western Red Cedar

 

“We wanted to use wood and its inherent warmth and beauty to reinforce the welcoming atmosphere we were trying to create for people and families living with autism,” said Larry Adams, principal architect for the project.

 

Wood is used abundantly inside and out. The building’s exterior is clad in a combination of metal panels and smooth-faced western red cedar, its unique stained finish giving it a deep red and robust aesthetic. Douglas-fir glulam columns and beams support either prefabricated nail-laminated timber (NLT) or wood I-joist floors, while laminated veneer lumber (LVL) beams are also used where additional strength is required. The undersides of the NLT panels are left exposed in common areas, and linear wood ceilings and acoustic panels are used throughout the interior.

Pacific Autism Family Centre | Photo credit: Derek Lepper Photography courtesy of NSDA Architects   

Bright sunny interior view of Pacific Autism Family Centre main hallway, showing exterior glass windows, and interior wood which includes glue-laminated timber (glulam) beams and columns, wood cabinets, wood trim, and dimensional lumber ceiling above
A natural conclusion

The next generation of health care design

While no indoor environment can replace the extraordinary experience of nature, research is showing that incorporating natural elements into our interior environment—whether in the form of sunlight and fresh ventilation, plants and greenery, or organic materials, such as wood—is linked with better occupant comfort, a decrease in stress and improved health outcomes. When it comes to the next generation of health care design—and creating spaces that heal and support wellbeing—designers are discovering there’s no better place to look for inspiration than nature.

Wooden blocks lined up to spell WELLNESS in black text, three rocks and green foliage featured

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