ARCHITECTURE & DESIGN
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Top left and left: Following consent, the patient is allocated a medi-room for the duration of their stay. Above: Patients have access to a café and terrace, strategically located on the corner of the building to provide a woodland backdrop.
sides, offers a pleasant and relaxing view from the spaces that overlook it. Biophilic design was absolutely key to our approach when it came to Heatherwood Hospital, helping to create a calm and restorative environment that supports wellbeing and recovery. Hospitals can be stressful and intimidating places; we know that better environments secure better health outcomes.
A ‘purposefully compact’ layout Another key plank of our approach was to ensure that the layout and arrangement of the hospital was purposefully compact, minimising travel distances, both internally and externally. The Outpatients’ Department, and indeed the whole of the ambulatory entrance floor, operates as a digitally-enabled ‘one-stop shop’ of clinical services for patients, which is to say that the patient can have a consultation, imaging, and procedure, all in one visit, delivering patient-focused care with high levels of efficiency and safety – reducing stress and saving on car journeys. In most traditional hospitals, the patient would have an outpatient appointment, but if an X-ray or imaging were needed, they would need to go to another building or return another day. At Heatherwood, the idea is that patients have a consultation, then return to the central waiting zone, before being called for their diagnostic test or procedure. Meanwhile, the first floor is entirely
dedicated to surgery, optimising the flow, with expansion space designed in to accommodate two more theatres, if needed, meaning that clinical efficiency
74 Health Estate Journal January 2024
won’t be compromised. In fact, the Trust is already looking at taking advantage of this opportunity by expanding the unit next year to provide additional capacity. Theatres are paired so that staff can easily go from one to the other, resulting in optimum efficiency. Indeed, the hospital has introduced several innovative ways of working to increase the number of operations it performs, such as trialling orthopaedic ‘super weeks’, during which surgeons managed to double the number of weekly joint replacement procedures from 40 to 80. During the ‘super weeks’, some individual surgeons were able to perform 10 joint replacement procedures a day by working between two theatres, and operating on five patients one after the other in each.
A ‘medi-room’ model of care The day surgery unit itself operates a ‘medi-room’ model of care, and its design and layout are informed by Post Occupancy Evaluation analysis from the day surgery unit at Frimley Park Hospital. Following consent, the patient is allocated a medi-room for the duration of their stay. From this multi-functional room, they will change, meet with the anaesthetist and surgeon, and wait in a gown for their procedure. Following the operation and a short time spent in the first stage recovery unit, the patient will return to their medi- room for second stage recovery, before changing and being discharged. There are a number of benefits to this approach, including improved dignity, with no shared waiting in gowns; larger space to make changing easier, and the patient can be accompanied if desired; a patient-centred rather than consultant-centred approach, and better efficiency in terms of flow.
The centralisation of elective services
in Ascot, leaving space for enhanced acute and emergency care in other locations, forms part of the Trust’s wider goals regarding the rationalisation of their services across all its sites. Unlike other hospitals with A&E Departments, Heatherwood is not affected by the demands of emergency care. It can focus six days a week, morning to night, on operating, without having to manage emergency patients coming to this facility, stopping clinicians doing this elective work. Rakesh Kucheira, orthopaedic surgeon,
Frimley Health NHS Foundation Trust, said: “We’re working extremely hard to reduce the waiting lists and get patients the right treatment they need at the right time. As a dedicated planned care centre, we don’t have the same constraints as an acute hospital, and can continuously change the way we work to meet our patients’ needs and really push the system. The results have come from great teamwork, with everyone involved in the patient journey working together to improve care for our patients. The feedback we’ve had has been really positive, and by safely discharging patients they get to recover in their own homes with our support, surrounded by their loved ones.”
Discharged the next morning One patient, Amanda Leader, 62, from Wokingham, had a hip replacement before Christmas, and was discharged the following morning. She said: “I had waited four months after my X-ray for surgery, and the pain in my right hip was particularly bad at night time, so I couldn’t sleep. It’s amazing that I was discharged so quickly. I can go to my daughter’s house to recover, and I get to see my grandchildren
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