PATIENT-CENTRED DESIGN


PHYSIOTHERAPY AND OCCUPATIONAL THERAPIST TASKS Single room tasks


Transfers from bed to chair, chair to wheelchair Bathrooms assessments – washing and dressing,


toilet transfers, accessing shower


Standing and walking assessments utilising adjuncts and ceiling hoist


Exercises such as sit-to-stand, upper body and standing exercises


Acute inpatient gym tasks


Stair assessment – 13 steps required Advanced walking assessments and


mobilisation using parallel bars Kitchen assessments – accessing cupboards (high


and low), making a cup of tea, using appliances and fixtures (e.g., taps, oven)


Lying down work – a firm surface provided


from a plinth is needed Front door assessments critical for low-risk discharge


Mobilisation, cardiopulmonary tests, functional capacity assessments using exercise equipment


Table 2: Single room and acute care rehabilitation gym task lists for physiotherapy and occupational therapist.


wheelchair, wheeling them to the gym (including waiting for lifts) and then reversing the journey at the end of the session. Of note, the less mobile a patient is, the more likely they are to take longer to transfer. By embedding an acute inpatient gym closer to the wards, that travel time dropped to five minutes allowing for up to seven assessments daily.


Defining the right space The team worked with 35 physiotherapists, occupational therapists, rehabilitation assistants, and students to define what a functional therapy space should include. They reviewed four areas: orthopaedics, acute medical unit (AMU) and frailty, respiratory and surgery, and general medicine. Through a workshop and task-mapping exercise, they identified which assessments and rehabilitation could take place in a patient’s single-bedroom, which required specialist space (Table 2), and the equipment requirements. They identified base requirements for all areas and then equipment for each specialist area (Table 2 and 3). These informed both the space assumptions and the room data sheets. After the team identified the base components, they


looked at their specialist area and defined the function and specific requirements. Each specialty brings distinct rehabilitation needs that shape the design of inpatient therapy spaces. Orthopaedic patients often require riser recliners, walking aids, and floor markings to rebuild strength and confidence after surgery, alongside small


aids and exercise bands to restore fine motor skills and functional independence. In contrast, the acute medical unit and frailty require equipment that encourages safety and confidence, such as baths with seats, high-backed chairs, and manual handling tools along with group exercise areas and kitchen trolleys that stimulate social interaction and provide support with day-to-day tasks. For respiratory and surgical patients, therapy focuses on cardiorespiratory capacity and resistance exercise, so ergometer machines, weights, balance boards, and gym balls enable safe training and strengthening, while height-adjustable tables and wheelchairs ensure inclusivity. Finally, the general medicine cohort requires spaces tailored to fall prevention and practical readiness for discharge, with movable stairs, plinths, multi-surface falls assessment areas, and balance equipment enabling therapists to test real-world mobility in a controlled environment.


Design for functionality and flexibility Guided by clinical engagement and operational priorities, a design brief was developed to ensure therapy spaces uphold patient dignity, safety, and outcomes while remaining space-efficient and adaptable. Each unit was sized at 40 sqm for the gym and 10 sqm for storage, which should be compact enough to sit within the ward core yet large enough to accommodate essential rehabilitation equipment. The design emphasises a therapeutic environment, particularly for patients with cognitive impairments. Quiet,


BASE COMPONENTS EQUIPMENT LIST/REQUIREMENTS Emergency call button x2 Bin


Height adjustable plinth Stool on wheels


Upright or recumbent exercise bike Walking treadmill Mobile mirror


Pulley exercise system, wall mounted Parallel bars


Mobile privacy screens x2


Hoist, electric, 24V, H track ceiling mounted Piped medical gases


Kitchen sink


Microwave/air fryer Refrigerator


Storage unit, lower x2 Storage unit, upper x2 Wall mounted television Desk benching Computer x2


Telephone: handset, handsfree Chair x2


Drawer unit, 2 drawers, lockable Front door and step, including multi locking systems Table 3: Base equipment components for an acute inpatient gym. October 2025 Health Estate Journal 147


Iona McAllister


Iona McAllister is a registered clinical exercise physiologist and Associate director at MJ Medical, with extensive experience in hospital operations and healthcare design. She leads on clinical modelling, models of care, schedules of accommodation, and integrating operational efficiency into healthcare environments. Iona has contributed to large- scale projects, including regional cardiac centres and the NHS New Hospital Programme, ensuring hospitals are safe, effective, and operationally ready from day one. Combining clinical and planning expertise, she bridges frontline healthcare delivery with strategic estates planning, understanding how design impacts patient flow, staff efficiency, and overall quality of care.


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