ARCHITECTURE & DESIGN
Designing for seamless emergency care
Two innovative new hospital projects designed by healthcare specialist architects, BDP, feature what the practice’s Architect director believes are ‘among the most ambitious designs to date for seamless emergency care’. Here Adrian Hitchcock, who fulfils this senior role, and is also lead architect on one of the two schemes – The Grange University Hospital in Gwent – discusses a pair of projects that the practice hopes will act as exemplars for the future of healthcare design.
BDP is midway through a £193.5 million project to develop the new The Grange University Hospital in Wales, currently in delivery by construction and engineering experts, Laing O’Rourke, and has recently completed a new emergency assessment centre at Wexham Park Hospital in Slough in Berkshire. Both projects put the patient pathway at the heart of the design, with the aim of reducing patient internal travel times, streamlining assessment to treatment times, and reducing overnight bed occupancy.
The Wexham Park project was completed in partnership with construction giant, Kier, in late 2018, with the scheme part of the Frimley Health NHS Foundation Trust’s redevelopment of the Heatherwood and Wexham Park sites. The original single-storey building that the new emergency assessment centre replaced had been extended horizontally over the years, resulting in long travel times for both staff and patients. The priority for the new building was to create a four-storey assessment and emergency unit which brought together ‘ED’ services, 24- hour assessments, and short-stay medical and surgical services, for the first time. By co-locating the services there is improved opportunity for collaboration
between clinical teams, enabling patients to be diagnosed and treated faster, often without the need to be admitted overnight. In addition, the ambulance bay seamlessly connects to a resuscitation area, helping to improve emergency care times.
Patient progression ‘at the heart of the design’
Patient progression was at the heart of the design. By analysing patient flows, we were able to design the building so that patients are always seamlessly moving through from diagnosis to treatment. This is a key way of reassuring patients that they are on a pathway to treatment, and significantly reduces frustration and aggression. In addition, the key decision was made to put the waiting area at the centre of the Emergency Assessment Centre. In the traditional model, patients come through the entrance to a reception and waiting area. They are then called into triage or assessment, and often return to the same waiting area near the entrance. With the new centralised waiting area, when patients return to wait, they do not feel they are ‘going back to the beginning again’, and this simple change has the psychological effect of reducing patient dissatisfaction.
New patient pathways New patient pathways have been developed to make care more efficient, and allow patients to be cared for more quickly in the right place, often avoiding the Emergency Department (ED) altogether. For example, patients may be brought directly to assessment areas via a GP without going to ED, and can be given the necessary tests and medication during the day so they can safely return home for the night. The Emergency Department is located alongside a short-stay medical and surgical unit that includes a range of 24-hour services, an acute assessment unit with 26 beds, and an ambulatory emergency care unit where patients can be assessed, diagnosed, and treated promptly. This faster assessment and treatment has dramatically reduced overnight admissions.
Several of the treatment spaces in the short-stay area have chairs rather than beds, not just to save space, but also to help patients feel more positive about their condition. In a sitting position, they remain more mobile and closer to discharge, reinforcing the concept of progression, which is central to the design. For the patient rooms, the design team created a standard room design that can
The Grange University Hospital in South Wales, a specialist critical care and emergency hospital, has been commissioned as part of the Aneurin Bevan University Health Board’s ‘Clinical Futures’ Strategy. It.will be a 471-bed facility, and will include a 24-hour emergency department and assessment unit, a range of diagnostic services, specialist theatres, paediatric services, and a helipad.
106 Health Estate Journal October 2019
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