HEALTHCARE DESIGN & CONSTRUCTION
A computer-generated image of Ireland’s National Children’s Hospital, which is under construction in Dublin.
rooms would look based on the different scenarios that the COVID-19 pandemic may bring.
7 Emphasis on knowledge-sharing Embracing cross-project sharing of knowledge gives us possibly the greatest opportunity to deliver the most cutting- edge healthcare facilities of the future. In designing the six Nightingale hospital facilities, we had a project management office (PMO) which defined and maintained standards across each individual site, ensuring that there was a unified approach in their delivery. The key to the rapid progress required for these types of projects is having a clear concept which can adapt to suit the availability of materials and construction teams. In the case of a Nightingale, to deliver this number of equipped beds in such a short timeframe requires all teams to have the experience and collaborative approach necessary to make rapid decisions, so that design and construction can take place in parallel.
BDP published the NHS Nightingale instruction manual, which set out its fit- out strategies and processes used at the first such facility at the ExCeL Centre in London. This then meant that teams could use this knowledge-sharing, and were provided with invaluable guidance for the construction of other facilities in the UK and globally. The result is healthcare facilities that are delivered on time, and with the precise features required to support both patients and staff.
8 Capitalise on the ‘virtual world’ There is an opportunity to exploit the innovative processes developed to help the NHS respond to COVID-19 in the way we design healthcare provision going forward. There had been a move to captitalise on IT solutions to deliver NHS services previously, for example, but the pandemic certainly made that a reality via the widespread availability of Wi-Fi and videoconferencing platforms. For many, virtual outpatient and doctor appointments via videoconferencing are becoming the norm, so in the future this could mean designing spaces with much
A computer-generated image of the new Heatherwood Hospital, currently under construction in Ascot, Berkshire.
less outpatient space required. Existing layouts could also be reconfigured to increase diagnostic and treatment space. The move to increased home working will also generate capacity in existing admin spaces, allowing soft space to be used to accommodate increased capacity, and assisting in the re- organisation of sites for the HIP (Health Infrastructure Plan) programme. This is a real opportunity for the healthcare sector, since with much more bed space, discrete areas can be created for COVID patients within existing facilities. This would result in the infection being controlled, and enable the rest of the hospital to carry on as normal.
9 Reduce patient movement What has become evident is that the pandemic has resulted in the need for more acuity-adaptable patient rooms. Such rooms enable a treatment model that allows all stages of patient care to come to the patient’s room, from admission to discharge. This obviously reduces patient transfers, and therefore potential infection rates within the hospital. An increase in the proportion of single rooms will improve operational flexibility; in the past BDP has been asked to demonstrate how a run of four-bed bays might convert to single rooms. The problem with this, however, is that high acuity rooms are very much bigger than a standard single hospital room, due to the amount of space needed for the equipment, and to nurse patients. Nested en-suites go some way towards achieving this, but it is increasingly evident that a new approach is needed here at the design stage, to account for a potentially larger area for each room. This obviously has an impact on space and cost, but there may well be more appetite for this in the future as a result of the COVID pandemic.
10 Design of standalone diagnostic and elective sites
One of the well-reported hidden costs of the pandemic is the backlog of planned care and reduced capacity going forward to tackle this. The use of planned care centres can be either through process
redesign in existing facilities, or through new facilities which offer a highly efficient throughput of patients without risk of disruption via unplanned cases (or COVID-19). An example of this is the new Heatherwood Hospital, currently under construction in Ascot, Berkshire, and due to open this year. The new facility will include six theatres for elective surgery, 48 inpatient beds, outpatients (and imaging), and endoscopy. Through its use of digital technology and flexible outpatient spaces, it will offer a one-stop shop for urology patients, reducing the number of visits to the site for patients. hej
Nick Fairham
Nick Fairham is Principal at BDP, a major international, interdisciplinary practice of architects, designers, engineers, and urbanists. He heads up BDP’s design studio in Bristol, and is appreciated as a talented designer and inspirational leader. He has significant experience in delivering major projects, and creates innovative architecture which meets the needs of NHS Trusts, clinical users, and the public. BDP said: “Nick’s clear communication and exceptional management delivery allow him to drive through the design and construction process with continued success.”
April 2021 Health Estate Journal 35
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