Impact of nature visibility on length of stay in the intermediate care unit: a quality improvement project

Abstract
Background The relationship between the natural environment and health outcomes has garnered significant attention in recent years. However, few studies have explored whether the benefit of nature visibility can be translated into measurable clinical outcomes in inpatient settings, such as length of stay.

Methodology This retrospective observational study investigated the impact of nature visibility from the patient’s window on length of stay. Patients were sampled from two intermediate care units in Sussex, and the nature visibility from their window was classified into three predefined categories. A generalised linear model was used to analyse length of stay, while controlling for potential confounding factors.

Results The final analysis included 459 patients. Nature visibility was a significant predictor (p=0.016) of an inpatient length of stay. However, seasonality (p=0.438) did not impact the effect of nature visibility on length of stay. Hospital location (p=0.020) and discharge age (p<0.001) had a significant impact, but sex (p=0.940), room type (p=0.619) and window view restrictions (p=0.756) did not have a significant impact on length of stay.

Discussion The results demonstrated an ~8.7% decrease in length of stay for every increase in nature visibility category, regardless of the season. The study findings emphasise the value of non-pharmaceutical interventions in patient recovery and contribute to the idea of patient-centred care.