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PLANNING FLEXIBLE DESIGN


organizations, medical equipments and insurance companies, and lately driven by economic downturns. Therefore, healthcare facility planners and designers need to use their own judgment and social awareness when dealing with these trends in order to be able to make rational decisions about what to adapt. What to adopt? What to neglect or what to ignore? Out of the different trends in healthcare facility planning and design:  Patient preference to be treated out of hospitals  Healthcare could be provided out of hospitals  Technology impact  From acute to chronic and towards prevention  Urgent care provided locally  Centralized specialty care  Reduced hospital stay  Less available funds  Urban integration  Structure and form The healing environment Patient first Sustainability Diversity of healthcare facility types.


IS FLEXIBILIty a trEND? Flexibility is nothing else but the contingency plan for healthcare buildings that become functionally obsolete long before their physical life is spent. Flexibility is not a trend or a new idea. It is simply an old reinvented idea. Flexibility is an additional investment at the design stage that can have a great payoff, if and when the need arises. Flexibility is a traditional occupation used to face a definite uncertainty of growth and change that happen in every day life. The flexibility dilemma is even bigger


when dealing with rigid healthcare buildings that need to accommodate indefinite and unpredictable trends in growth and change that should be planned from the very beginning. Services most likely to grow are identified at the planning stage and future growth is planned either by allowing space on the side for expansion or internally by providing ‘soft space’, space that is easily displaced, located next to services most likely to expand. Vertical expansion is also possible in the tower-on-a-podium concept but is seldom used as it is associated with numerous problems. How can we become prepared? The


starting point is to explore a range of possible futures. Is this done sufficiently in the design process for infrastructure that is meant to


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serve for 30-50 years? Or are we all too confident to design and build a healthcare facility for a single projection of the future? Healthcare facility planners should be


aware of future forecasts, in particular long- term ones, and prepare for it by being flexible.


FLEXIBILIty aND SuStaINaBILIty: tHE wINNING comBINatIoN From another perspective, flexibility could be considered as the driver to ensure sustainability. The concept of sustainability could be helpful to understand the case for change, as healthcare facilities do not operate in a stable environment. This context in which healthcare facilities operates – a world of changing social norms, disease patterns and demographics – requires constant adaptation. Un- adaptive, inflexible healthcare facilities are not sustainable and they would not survive the constant change of the healthcare environment. It is all about the future. By accommodating future growth, change and needs, and by being flexible, healthcare facilities could be sustained. When healthcare facility planners consider sustainability they have to give equal value in their decisions to the future as well as the present. They have to accommodate the future within their present facilities by allowing these facilities to be convertible, adaptable and expandable. 


‘Flexibility is an additional investment at the design stage that can have a great payoff


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