ARCHITECTURE & DESIGN
Welcoming and safe children’s health facilities
Sarah Walter, managing director of Charleston, South Carolina-based architecture and engineering firm, Page Southerland Page, and Nora Colman, an Assistant Professor in Paediatrics in the division of Paediatric Critical Care Medicine at Children’s Healthcare of Atlanta, discuss some of the most important elements in the quest to balance an open and welcoming space with sufficient security when designing children’s healthcare facilities.
Security and safety incidents are occurring in healthcare environments with increasing frequency and severity. Recent statistics show that healthcare workers in the United States are five times more likely to experience violence than non-healthcare workers. Even more concerning is the prevalence of security incidents in maternity and paediatric environments. In 2022, paediatrics ranked third among the most dangerous units for US healthcare workers, with 84% of staff experiencing violence at work, according to Children’s Hospital Association (an organisation of children’s hospitals with over 200 members in the US, Australia, Canada, Italy, Mexico, and Puerto Rico).
A more vulnerable patient population Paediatrics represents a more vulnerable patient population that faces a range of security and safety threats – such as abductions, elopement, domestic disputes, mental health and self-harm, and active shooter incidents. In the face of disease complexity, poor clinical outcomes, or patient deaths, care providers are at higher risk of targeted aggression and anger. Hospitals are struggling to adapt to these growing threats while grappling with historic staffing shortages. The need for more inherently secure healthcare environments has never been greater. On the other hand, patients, families, and staff, have come to expect a warm, welcoming hospital experience filled with hospitality-based features – including bright, open, and spacious lobbies; lively cafés and dining areas that may be publicly accessible; family lounges and sibling play areas; family and community resource centres, and outdoor healing gardens and wellness trails. Healthcare facilities – and particularly children’s hospitals, are increasingly seeking to expand their mission to better serve their communities through wellness and education programmes, food pantries and healthy eating options, on-site childcare, and other social services. Obvious and overt security measures like metal detectors, security fences, and heavy patrolling presence, can be intimidating and off-putting.
Top right: Improve security and wayfinding by establishing clear public circulation paths that lead to destinations or control points, and limit access to secure, off-stage areas. Security desks should have clear lines of sight to all public entrances.
Right: Bright, open lobbies convey a sense of warmth and welcome, reducing anxiety and fear for patients and their families, and encouraging more active engagement in the visit.
August 2025 Health Estate Journal 29 As physical and psychosocial
barriers to health and well-being are broken down, there is a need to think more holistically and creatively to ensure safeness in a paediatric environment, without compromising the sense of warmth and welcome. Here are eight planning and design strategies to consider when enhancing safety and security on the hospital campus.
1: Specify security philosophy Embracing a culture of safety, and maintaining heightened risk awareness throughout planning and design, lead to a more comprehensive, integrated,
Jonathan Hillyer Photography
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