HOSPITAL DESIGN
and efficiency for those working in hospitals, while also designing spaces which support patient recovery and care. For example, former consultation rooms can now be become office space for hospital staff, or converted into virtual consulting suites. A standard HBN- compliant consulting room usually requires around 16 m2
of floor space.
Manser has designed a virtual consulting ‘pod’ that would be approximately half this size, saving valuable space. The space that has been freed up can be used as a multidisciplinary office, training, or meeting space, to provide efficient communication and consultation advice, whilst minimising travel distances for staff.
Standardisation of room types Standardisation of room types and layouts is one way to approach designing flexibly for changing requirements in the future. While this may mean that rooms have additional infrastructure not previously planned for, it will enable the space to be utilised for a range of different functions. Already we are seeing shifts towards this line of thinking in an urgent care village we are designing, where bays are being equipped with medical gases and ventilation that will enable this area to ‘transition’, and be used in the event of major incidents and future pandemics.
New layouts of spaces are also being devised to allow for alternative uses and segregation of routes in the event of major incidents. Segregated zones will need to have their own dedicated suite of support rooms, such as utilities, in order to minimise transmission of disease. This can be supported by the smallest of design changes, or by a complete redesign of a building. Either way, physically altering the space and layout will help to make healthcare buildings more flexible.
Digital technology’s role Digital technology will need to support this flexibility of space. With the allocation of red (COVID-impacted) and green (non-COVID) areas, staff need to be able to manage buildings ‘virtually’ to minimise transmission and respond quickly to any problems. At present we are seeing several solutions, including embedding facilities management technology in the fabric of a building, or through portable devices managed by staff. This is not only impacting the patient areas in hospitals, but also the support areas. The current situation has again forced a review of these areas, and we, as a practice, have also been looking at office areas within hospitals, and at changing from more cellular space to open plan flexible working; then adding in flexible working at 20% (all members of staff working from home one day a week)
34 Health Estate Journal July 2021
Figure 2b: This concept axonometric diagram illustrates how hexagonal pods can be used to create efficient, adaptable, and interactive spaces.
increasing capacity out of the same area by between 100 and 125%. Even taking into account pandemic spatial measures and flows, the increase is still circa 75- 100%.
Ultimately, it is our responsibility as the architects and designers of healthcare buildings to ensure that we are designing for the needs of our stakeholders, as well as anticipating how their needs could change in the future. We have a responsibility to put forward designs that support clinicians and other staff as they care for and save the lives of people, and also, of course, to consider the diverse needs of the many thousands of patients each hospital or healthcare unit serves.
Existing
Clinical exam 285 m2
Meet/ training 25 m2
Staff office 48 m2
Treatment 96 m2
Support 49 m2
Treatment 96 m2
Wait/ public services 60 m2
32 m2
Encouraging outpatients to arrive ‘just in time’
While increasing digitisation of outpatient consultations and other healthcare services will limit the number of people going into hospitals, there will always be those who must still physically attend consultations. We anticipate that these patients will continue to be encouraged to arrive ‘just in time’ for appointments, and to use waiting areas minimally. This will see hospitals and surgeries increasingly using ‘app’ technology to let patients know when to move to the consultation room, with dedicated waiting spaces for each room, rather than communal waiting areas full of people. Internal circulation is
Virtual
Clinical exam 120 m2
Staff office 96 m2
Meet/ training 50 m2
Virtual
consultation pods 120 m2
Wait/ public services 60 m2
Legend
Clinical exam/consulting rooms Treatment rooms Clinical support Wait/patient facilities Meet/training space
Virtual consultation pods General office space Breakout space Reception/admin
Figure 3: Along with Figure 4, the above shows how the pods can be reconfigured to create alternative layouts, freeing space for other services while minimising transmission.
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