hospitals. Increased clinical demand has resulted in a need for extra capacity and ventilation, and some system limits have been passed. However, the glassed roof brings Norwegian winter light into the main street of the hospital, and the extra energy that is required to keep the street at 17°C in the winter is more than outweighed by the positive effect on staff morale, said Bergsland. The hospital tries to be environmentally conscious about its energy use, and, despite a 20-percent increase in clinical services in 3 years, it reduced its energy use by 10 percent (Bergsland, 2005).

The positive feedback from the people who are using the building more or less corroborates the concept that the architects suggested, said Bergsland. A preliminary study on the effects of hospital design on patient attitudes, activity patterns, productivity, and staff morale at the Rikshospitalet was performed in 2004. The results showed that people liked the building because it was interesting and nonfrightening, and they thought the main street was perfect for interaction (Bergsland, 2005). Among other positive factors cited was daylight in working and patient spaces and good functional proximities between related departments. Also, the art made staff feel proud of their environment.

Patients ranked the Rikshospitalet highly. Furthermore, productivity measures increased, and absenteeism and turnover rates decreased. The average sick leave in Norwegian hospitals is approximately 8 percent. After moving to the new building, the Rikshospitalet personnel’s sick leave rate declined from 8 to 6 percent (Bergsland, 2005).

The building concept may have played a role in achieving patient and staff satisfaction, said Bergsland, but is difficult to determine the role of design on activity, productivity, or medical outcomes. Such factors as the Hawthorne effect, moving into new premises, organizational changes, and staffing levels may influence outcomes to a degree that is difficult to establish.

An increase in worker productivity produced by the psychological stimulus of being singled out and made to feel important.

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