Recommended new hospitals to be built of materials that could easily be cleaned, promoted nursing as a more respectable occupation, introduced Pavilion style hospitals, implemented rigorous training for nurses, focused on cleanliness, believed in the miasma Theory, focused on preventing germs from getting in, encouraged modern hospital designs
By 1900, hospitals looked very different from those in Britain in 1700, with separate Wards for infectious patients and those requiring surgery, operating theaters, specialist departments, new medical equipment, cleanliness of utmost importance
By the early 20th century, physicians still visited the wealthy at home, Cottage hospitals and voluntary hospitals were set up to provide affordable healthcare, poor and disabled were sent to workhouses for healthcare
Attitudes towards the purpose of hospitals in the 19th century were shifting towards care and cure, quality of care was poor initially, Florence Nightingale revolutionized nursing and hospitals, improved hospital design, reduced death rates, established training hospital at St Thomas's in London, wrote "Notes on Nursing" in 1859