ARCHITECTURE AND DESIGN
Considering the ‘seven flows’ of healthcare
Amy Krause, Architectural Design manager at private healthcare company, Mediclinic Southern Africa, takes a look at what she describes as ‘the seven flows’ of healthcare, what each contributes to a hospital or other healthcare facility, and the challenges in aligning them with stringent regulations and end-user expectations.
As an Architectural Design manager specialising in healthcare facilities, I prioritise the critical importance of the seven flows of healthcare – patient, staff, equipment, medication, waste, information, and supply chain, in every project, from small theatre upgrades to remote 22-bed clinics in Africa, and large-scale 350-bed masterplans in city centres. These flows form the backbone of efficient, compliant, and patient-centred healthcare environments. In this article, I delve into each of these flows,
highlighting their complexities, and the challenges in aligning them with stringent regulations (building and Department of Health) and end-user expectations. Often, these elements face pushback due to a lack of understanding or regulatory constraints, making clear communication vital. I emphasise the importance of presenting a comprehensive visual outline early in the process to ensure that all stakeholders share a common vision. This approach not only streamlines project execution, but also optimises the design, to enhance safety, workflow efficiency, and overall functionality.
Patient flow. The author says that ‘the most crucial flow in a healthcare facility is the movement of patients, from initial arrival to discharge’.
Objectivity the key Over my years of experience, I’ve learned that the key to successful healthcare design is objectivity – approaching each project without personal opinions that may not reflect end-user needs or future realities. By adhering to these principles, I aim to create healthcare environments that are not only compliant and functional, but also truly supportive of healthcare professionals and patients alike.
The ‘seven flows’ of healthcare.
1: Patient flow The most crucial flow in a healthcare facility is the movement of patients, from initial arrival to discharge. There are many elements within this process that can cause confusion and frustration. I consider patient flow to start from when a patient enters the site – from the street, through parking, and into the main reception. First impressions count. The priorities are always clear directional signage, easy access, and a friendly face to greet patients. Effective design ensures smooth and efficient patient
pathways, minimising waiting times and optimising the patient experience. If directional signage is unclear on the way to an appointment, it can cause anxiety. Our goal is to keep every patient or visitor calm and at ease upon entering the facility. Patient flow also includes movement between units, such as to theatres, delivery rooms, or radiology. In very old facilities, the limited options for vertical circulation can be a challenge, but there is always a way to make it work. Regulations address passage widths, room sizes, and more. In some instances, where buildings are very old and passages cannot be widened, creativity is required. For example, forming a ‘lay-by’ in a passage can help alleviate congestion in restrictive areas.
2: Family/attendant flow The phrase ‘family heals faster’ highlights how supportive family relationships can positively impact recovery from physical and emotional injuries or illnesses. As a designer, I always consider the needs of families. The proximity of waiting areas to critical care units,
theatres, and emergency centres, is crucial – both for open and closed spaces. The layout and design intent of waiting areas are critical. I always consult with my interior designer to ensure that a consistent ‘design theme thread’ runs throughout the facility. This can be subtle, but is important for creating a sense of calm. Patient rooms are also designed to avoid interfering with clinical care. Each room is divided into clinical/patient and public zones. This ensures that clinical providers can access the patient easily without having to move visitors.
3: Doctor/Care provider flow This flow is vital to the efficiency of a facility. If the movement of medical staff, doctors, nurses, and other healthcare professionals is hindered, it can cause significant problems. Regulations require central nurse stations, and some designs include satellite stations. We ensure that staff rest
24 Health Estate Journal August 2025
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