Healthcare Design - November 2014 - 102

R RESEARCH | 11.14
Planting with purpose
A half-million-dollar grant funds a new medical center garden with the express
goal of studying nature's effect on healing
By Larry Beresford
A new garden filled with a profusion of plants on a secondfloor terrace at Legacy Emanuel
Medical Center in Portland,
Ore., provides a lush setting to
test the impact-for patients,
visitors, and hospital staff-of
a therapeutic nature space on

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generate important knowledge about the value
of gardens and of access to nature in hospital
settings.
Three-hour design team
The Terrace Garden at Legacy Emanuel was designed with the same standardized interdisciplinary
design process that the six-hospital health system
has used for 10 other hospital gardens, most of
which are for specific patient populations, such
as hospitalized children or stroke or burn patients.
A 20-member team of key stakeholders, including a landscape architect, physicians, clinical and
administrative leaders from the hospital, community partners, and past hospital patients, met three
times in 2012 to develop their vision for the garden.
The Legacy system has emphasized therapeutic
gardens since 1991, when Teresia Hazen, a registered horticultural therapist, became its full-time
gardens coordinator. Best-practice guidelines
for these gardens, she says, are drawn from the

This view of the Terrace
Garden at Legacy Emanuel shows a ramp and
steps that are important
parts of rehabilitation
activities for patients
from the adjacent
cardiovascular ICU.

LEGACY HEALTH

hospital grounds. The Terrace
Garden, located adjacent to the
hospital's birthing center and
cardiovascular intensive care
unit (ICU), was constructed
between September 2013 and
March 2014, on an underutilized
terrace overlooking the medical center's central courtyard
and the fancifully designed
Children's Garden. Covering
a modest 6,900-square-foot
space, the new garden offers
sun and shade, with benches,
chairs, and tables in varied
configurations and areas to accommodate groups or provide
privacy. With well-designed
perimeters and an always-changing, four-seasons
array of plants, sights, and smells, it's open 24 hours
and accessible to patients and visitors with a wide
range of physical conditions and needs.
The benefits of access to nature have been shown
in a variety of settings and contexts, notes Roger
S. Ulrich, an international leader in evidence-based
healthcare design and a consultant to Legacy
Health's therapeutic gardens program. The Terrace
Garden project uses evidence-based design research tools, including randomized controlled clinical
trials and other techniques, to document outcomes
for mothers in early labor, family members of patients
in the ICU, and hospital staff who spend time in the
outdoor space. In some cases these groups are
compared to matched control groups that don't have
access to the gardens. When that's not possible, researchers simply observe interactions in the garden.
"The overall goal [of this project] is to assess
through rigorous study what, if any, benefits accrue
to individuals from such a garden," Ulrich says, to
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