HEALTHCARE DESIGN
Better design for clinical isolation
Jamie Brewster, architect at MJ Medical, has spent the last 25 years designing clinical spaces for hospitals around the world. When he was diagnosed with leukaemia in 2020, a three-week stint in hospital isolation for stem-cell transplantation led him to question every room he had ever designed. He is now on a mission to understand others’ experience of clinical isolation and to figure out how, through better UK design standards, we can improve them. In this piece, he shares his own experience of isolation and what his initial research has taught him.
What is an inpatient isolation bedroom? Is it not essentially the same as any inpatient bedroom, but with a small lobby attached to regulate air quality? In reality this is not the case – a conventional bedroom and an isolation bedroom are, in fact, very different.
Dealing with infection risk Isolating patients has been a method of treating disease for many years. Since Old Testament times and the establishment of leper colonies, isolation has been seen as an effective means of dealing with infection risk. Sometimes, patients are subject to ‘source isolation’ because they present a hazard to others, for example because they carry a highly infectious disease such as Ebola virus or because they present a radiation risk due to iodine 131 treatment for thyroid problems. In other cases, the patient may be severely immunocompromised and needs protective isolation from all sources of infection. In either case, the term ‘isolation’ is key and perhaps indicates the main difference between this type of inpatient room and other more conventional types. Isolation demands removing the patient from almost all
human contact, often for a considerable period of time. It is true that there are numerous examples of patients remaining in hospital bedrooms for extended periods. The difference with isolation is that the patient is confined. Here, regardless as to whether the patient feels well or extremely ill, they must remain within the room for the duration of their treatment. Unlike a patient in a standard bedroom, their choice to vacate the room for a period is not available. It is common for an isolated patient to have to spend many weeks residing in a single small bedroom, very often with relatively minimal social contact with others.
An architect/patient perspective In 2020, I was admitted to an isolation bedroom after being diagnosed with leukaemia. Spending three weeks in isolation receiving a stem-cell transplant highlighted just how different it was from the typical inpatient experience. The combination of a gruelling treatment burden with fear and social separation created a unique set of factors that maybe are not fully considered by designers. My combined experience as both a healthcare
architect and a patient led me to review the design of this type of hospital room and also the guidance used by designers. How have designers tackled this type of space in recent hospital developments, and how has NHS design guidance helped and informed them? Following my time as an inpatient, the word experience has emerged as the most important factor and one which
I now realise has been somewhat absent in my own and other designers’ approach to healthcare design. While ergonomic, technical, and aesthetic matters are important, I now realise that understanding human sensory and experiential factors is also critical. My patient experience taught me that in the context of ‘person-centred care’, where clinicians might now be encouraged to ask, ‘what matters to you?’ rather than ‘what is the matter with you?’, there is an equal need for designers to adopt a more ‘person-centred’ approach. The question ‘what will it feel like to live in this space?’ is now just as important as asking ‘what will the space look like and how will it perform?’. The drive to address these issues has motivated me to undertake a PhD research project to understand the experiential needs of the immunocompromised inpatient and to explore how they might be addressed through design. Finding solutions to these issues may have the potential to influence future design guidance and, through tackling the needs of a unique and complex patient group, also provide some answers for other patients whose needs are perhaps not as acute but whose experiential response to space is just as important.
Practicalities of isolation – the design guidance The most common need for patient isolation is related to treatment for blood cancers and the transplant of stem-cells. The pre-conditioning, chemotherapy-induced
September 2026 Health Estate Journal 45
Designers should ask themselves how it would feel to live in the space.
AdobeStock / ImageFlow
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