Year: 2024
Type: article
Abstract: The establishment of the American Medical Association in 1847 launched medical practice standardization in the United States.Consensus on standards was hard won, however, and implementation was not immediate.Hospital design standards, specifically, were debated for decades and were ultimately ceded to nurses and architects.This article describes key moments along that trajectory. Hospital Structures and SpacesIn the 1800s, hospitals' designs were more products of trial and error than evidence based.Physicians then were the most frequent occupiers of hospitals, so they were well placed to share their insights about design features.The American Medical Association (AMA) and other physicians' groups got to work on establishing medical standards and guidelines but didn't directly engage in designing hospital structures and spaces.Decades after the founding of the AMA in 1847, AMA members and health care organizations continued to ask key questions about hospital design: How many stories should a hospital be? 1 What is the best method of ventilation? 2 Is a handwashing station really necessary?3 Early Hospitals (1600s-1850) The beginnings of the first public hospital in the United States dates back to the 1600s.4 Early hospitals had a very poor reputation, and any patients who could afford it were treated at home. 5 The first hospitals in the United States mainly served the military and the indigent (public hospitals grew out of almshouses 4 )-in other words, people without a choice.Generally, hospitals were viewed as dangerous bastions of infection and disease.5 Diseases like puerperal fever spread like wildfire through lying-in hospitals, as surgeons would perform autopsies in the morning and deliver babies in the afternoon without washing their hands.6 Even into the mid-19th century, hospital buildings were poorly ventilated, 7 overcrowded 8 and, due to the general lack of hygiene, smelled so terrible that nurses took to wearing perfumed masks.9 Hospitals were built without planning-some had very few windows, no lavatory and bathing facilities (as well as no proper drainage where these did exist), inadequate kitchens, and nowhere for doctors to see patients privately.8
Source: The AMA Journal of Ethic
Author: Jorie Braunold
Institution: American Medical Association
Language: English
Subfield: History
Field: Arts and Humanities
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W4405288267