ARCHITECTURE & DESIGN
Sarah Walter
Sarah Walter is managing director of the Charleston, South Carolina office of Page Southerland Page, an architecture and engineering firm specialising in the programming, planning, and design of healthcare facilities. As a registered architect and senior medical planner, her experience includes strategic facility planning, campus transformation, and the programming, planning, and design, of healthcare facilities.
Bright lighting and external glass stairwells that are well lit enhance visibility and discourage security threats that may otherwise occur in isolated, poorly lit parking garages.
or garden walls to create a visually appealing campus edge. Security fences may be softened by layering landscape design elements, such as privacy trees, shrubs, and other garden elements.
3: Separate vehicular flows Clearly mapping and
and effective security plan. Too often, security planning is deferred to the end stages of design, and strategies are limited to camera placement, card readers, and security desks. Engaging a multidisciplinary stakeholder team early in the planning and programming process encourages a more thorough, integrated, and layered approach to security. Ideally, these conversations involve a variety of perspectives – including those of the hospital’s Planning, design and construction team, Security team, registration and front desk personnel, frontline staff and clinicians, and even family advisory members. It’s important to develop a security philosophy early in the design process. The most effective security plan takes an integrated approach that layers design strategies, physical security measures, technology, and training and protocols.
Roof gardens allow for clearly defined and inherently secured outdoor therapy and play areas with excellent vistas and views for patients and families.
2: Establish campus boundaries Security measures begin well before arriving at the hospital’s front door. Best practice considers the entire hospital campus, including edges, parking structures and lots, walkways and paths, and all building entrances. Factor in the urban or suburban context of the campus, as boundaries and functional zones are defined on site. It is necessary to determine how porous the campus will be, as well as the accessibility of campus amenities to different populations. Perhaps the community is welcome to enjoy the hospital’s gardens and walking trails, but indoor and outdoor dining areas are secure and only usable by screened visitors. When defining campus boundaries, consider leveraging topography
separating vehicular traffic so that the public is guided to visitor parking areas and public entrances will limit unauthorised access to service yards, loading docks, staff entrances, and ambulance drop-offs. A variety of subtle and more overt cues can be leveraged to reinforce the distinction between public and non-public parts of campus. These include signage, lighting, vegetation, hardscaping, narrowing of drives, and security gates.
4: Plan for after-hours Hospital staff regularly change shifts in the middle of the night, so the path walked from the building to the parking area and vice versa is critically important. With the reduced number of security personnel on campus at night, lighting and well-maintained landscaping become critically important to maintaining staff safety. Parking facilities are among the most dangerous areas of any campus. Technological enhancements like parking deck automation, licence plate readers, and artificial intelligence threat detection, can enhance security in these high-risk areas.
5: Secure outdoor play areas Paediatric environments often feature outdoor play areas that may be enjoyed by patients and siblings, and sometimes visitors from the community. Establish a clear perimeter, with controlled access and visibility. In more urban settings, elevating play areas to rooftops can be an excellent strategy to maximise safety, privacy, and access control, while also optimising vistas and views for patients and families.
6: Minimise building entry points It is common for hospital campuses that have grown over time to have multiple public entrances. However, having too many opportunities for public entry creates more opportunities for unauthorised access to secure or sensitive areas. Where possible, limit the number of building entrances, separate public and back-of-house entries, strive to have eyes on all public points of building access, and provide the ability to lock down all entrances from a remote location.
7: Define the level of openness desired In planning public spaces, it is essential to understand the healthcare facility’s philosophy on security and accessibility, particularly when the children’s hospital is located within, or shares, a campus with an adult hospital. Many children’s hospitals require guests to check in at a centralised security desk for a cursory background screening before accessing hospital patient care areas
30 Health Estate Journal August 2025
Jonathan Hillyer Photography
Jonathan Hillyer Photography
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