HEALTHCARE ESTATES 2023 KEYNOTES
Suzanne MacCormick said today’s healthcare buildings must not only meet numerous standards – including those around Net Zero carbon, but must also be easily navigable, ‘totally accessible’, easy to maintain, improve outcomes, and be affordable and sustainable – ‘quite a big ask’.
we’re discussing buildings today – the NHS puts patients at the heart of everything else. So, to ensure world-class health, the NHS says it does all of this to ensure that the population has the staff and facilities the service needs for the future.”
Opportunity or catastrophe? This brought her back to what constitutes excellence in the healthcare arena. Her presentation would, she said, consider ‘excellence and excellent outcomes, what they are, and how we can all work together to achieve them’. To demonstrate how fundamental access to the right expertise is in achieving ‘excellence’ in healthcare planning and design, she used a hypothetical scenario, “Imagine,” she told delegates, “that instead of being here in this conference hall, we’re all on a plane going somewhere we’ve really wanted to go for some time. So, we’re all buckled up in our seats, and the captain announces: ‘Good afternoon, this is your captain speaking. Today, we’ll be flying to Bermuda, where the sun is shining brightly, and the temperature is currently 29 degrees. We’ll be flying at 31,000 feet, with a journey time of seven hours, 15 minutes, and landing at 3:30 pm local time. However, I won’t be flying the plane today; instead, Jane, the head of cabin crew for 20 years, who knows this aeroplane inside out, will be your pilot. She really knows how to look after her clients, has travelled many thousands of miles serving passengers from across the world, and knows all there is to know about planes. So, Jane, over to you.’ “How would you feel about this?,” Suzanne MacCormick asked delegates. “Personally, I would be straight off the plane. Jane is no doubt a critical part of the in-flight experience, but not flying the plane. Similarly, a critical part of delivering
32 Health Estate Journal January 2024
The speaker stressed that healthcare planning was ‘absolutely clinically-led’. She said: “The clinical model comes before anything; even before Stage Zero – what is it you want to achieve?”
excellence in healthcare planning and design is recognising that there are specific roles for specific people, and it is the quality of the interface between the various professionals that makes the excellence happen.” She added: “I’m now going to look at this both from my clinical perspective, working with our behavioural neurology, and from a healthcare planner’s standpoint. What we know about buildings,” she continued, “is that they absolutely can cause constraints and make us feel good, or indeed bad. On their own they don’t solve health problems; it’s the processes, flows, ergonomics, and the ‘soft’ things around them that make the difference. As part of a complex design team delivering healthcare buildings, I want to really nail down what credence we give to the impact of that environment on us, our wellness, recovery, and staff’s ability to perform. So, whether it’s working within the estate, or staying in hospital as a patient, what is the impact of that environment on our health?” Healthcare planning, Suzanne
MacCormick, stressed, was ‘absolutely clinically-led’. She elaborated: “The clinical model comes before anything; even before Stage Zero – what is it you want to achieve? We develop the clinical model around which we can develop excellence in design – based around excellence in flow and delivery. Once we have the model, our service needs emerge, and we can then properly understand the resources required.” With an ageing population, more people living into their 80s, and more multiple comorbidities, the aim shouldn’t, she argued, be to bring all these people into hospital if they can remain well in their own environment. “So,” she said, “it shouldn’t always be about the estate. Healthcare
clinical planning is about keeping people well, which should lead the agenda. As healthcare planners, we ask the existential questions to determine not just where the healthcare provider is on its journey, but also its goals, and how it plans to achieve them. Our job is to be the objective friend in perhaps challenging some of the standard ways you’ve done things, so that maybe you can be better prepared for the future.” This approach, Suzanne MacCormick
explained, harnesses ‘the seven flows of healthcare’ (see page 34). She said: “When planning a new healthcare building, patients should be at the centre of your considerations, with patient flows, and excellence in clinical delivery, the vital elements.” Nevertheless, a detailed understanding of the importance of ‘the other flows’, and how the building needed to be designed and shaped to facilitate efficiency and excellence, were also key. She continued: “The other key elements include the staff, and what they need within the space; how medicines come onto site, and reach the point of delivery, plus the equipment, and the process for replacing it. We then need to similarly consider ‘supplies’ and ‘information’.” Information was not, however, purely about paper or digital information, she stressed: “ ‘How do things get from one place to another?’ and ‘How do you notify somebody of something?’ ” There were then visitors to consider – not just those visiting the sick, but anyone else entering the healthcare space. These ‘seven flows’ were, she said, healthcare planners’ ‘bedrock for doing things really well design-wise’. She added: “We then work hand in glove with architects to ensure that all these elements are addressed. I’d emphasise, however, that ‘one size definitely does not fit all’.”
Courtesy of Suzanne MacCormick
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