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Paediatric design


and design, and it really is. His leadership and attention to detail and advocacy for the needs of caring for children keeps them ranked as one of the top ten children’s hospitals in the USA by US News and World Report. And it is no surprise, that most of the top


ten children’s hospitals on this list have very recently renovated and/or constructed new unique facilities to better support the children and families they care for. The old idea of a ‘one size fits all’ in paediatric healthcare design has shown itself to come up very short in practice and here is why: These US organizations are now realizing


that children who are sick or injured need very special child and family focused environments, equipment and personal and familycare support solutions than adults do. It sounds logical and simple, but it is not.


UniqUe leadersHiP oPPortUnity In Western countries, like the US and EU, general healthcare codes that define and regulate healthcare facility design standards in their effort to best serve the majority adult and now growing elderly ‘baby- boomer’ patients, do not address the unique requirements for caring for children. So the Healthcare Facility designer can design a perfectly suitable facility per these general codes and the facility not support the staff and patients in the paediatric setting at all. Add to this situation, the cold economic


reality that children are the minority patient, has created a growing void in the knowledge of what is best for the child patient and a lack of support and funding for evidence and research on the impact the environment has on paediatric patient safety and improved outcomes. With low use percentages and little data to support development, most manufacturers of quality healthcare focused facility construction products; equipment and furnishings are being designed for adult patients. Facility design professionals working in the


Middle East and Asia, where often more than 50% of the populations are under the age of 25, are in a unique position to become leaders and catalysts for the change and improvement of women’s and paediatric care facility design, because the incentive and positive economics for properly serving the growing needs of the majority paediatric and young family populations in these countries. There is an urgent social and economic


need for the design and construction of new facilities specifically designed for providing


preventative and acute women’s and paediatric care. But provider organizations in these regions are not answering this growing need... Instead, they seem to be following the Western nation’s lead and are focused on building general and specialty hospitals for acute care of adults. This focus must be redirected and change soon to serve the young families and children who need these specialized facilities. It is my hope, that this article will hopefully raise a few of the issues involved with designing paediatric health facilities for the future and educate and encourage the readers of Hospital Build to do so.


evidence for innovation: transforming cHildren’s HealtH tHroUgH tHe PHysical environment The Center for Health Design (CHD) and the National Association of Children’s Hospitals and Related Institutions (NACHRI) in the USA have published a report document that contains some of the evidence-based research and design elements that are effective in paediatric healing and care environments. The document is called: “Evidence for Innovation: Transforming Children’s Health Through the Physical Environment” and is available for purchase from on the www.NACHRI.org website. It is the first comprehensive report of its kind to look at the impact of the physical environment on child patients in healthcare settings. Based on a scientific review of 320 evidence-based design studies in the academic literature that apply to the field of paediatrics, the report concludes that the physical environment of healthcare settings affects the clinical, physiological, psychosocial and safety outcomes among child patients and families. According to the report, minimising


or eliminating the harmful effects of such environmental factors as loud noise, high light levels and infectious pathogens should be the goal of children’s hospitals and other types of hospitals providing paediatric services. In particular, the neonatal intensive care unit has been the focus of many interventions proven effective in improving infant health outcomes. The report prioritise top design recommendations and breaks them out by those that can be implemented at any time at low cost and those that can be implemented during renovation or new construction at moderate to high cost. Much more data and research is needed


to best serve the unique needs of paediatric patients, their families and the specialised staff and procedures and equipment needed to 


Mount Washington Pediatric Hospital - Rosenberg Center Baltimore. Image © HYDE


Hospital Build Issue 3 2011 21


‘there is an urgent social and economic need for the design and construction of new facilities specifically designed for providing preventative and acute women’s and paediatric care


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