ARCHITECTURE & DESIGN
be added to when needed, helping to futureproof the building. These rooms have been designed to be adaptable to the different acute needs of different patients, again helping to reduce in-hospital travel. Wexham Park’s emergency assessment centre became fully operational in April this year, and the successful design is proving that, once under one roof, patients are now being assessed and moved through to diagnostics, treatment, and inpatient areas, much more quickly. Additionally, once they leave the main waiting area they do not return, helping them to feel like they are making progress, and reducing the usual frustrations.
The Grange Hospital
The Grange University Hospital in South Wales is the country’s first specialist critical care and emergency hospital, and has been commissioned as part of the Aneurin Bevan University Health Board’s ‘Clinical Futures’ Strategy. The aim was to centralise specialist and critical care services into purpose-built facilities for critically ill patients who require the most urgent, complex diagnostics, treatment, and care pathways. This new hospital will sit alongside a network of local general hospitals providing sub-acute, rehabilitation, elective, routine diagnostic, and treatment services.
The Grange is a 471-bed facility, and includes a 24-hour emergency department and assessment unit, a range of diagnostic services, specialist theatres, paediatric services, and a helipad, so that emergency cases can be transferred quickly. The anticipated completion date for The Grange University Hospital is September 2020. One of the key priorities identified by the Welsh Health Board’s ‘Clinical Futures’ team was that the design should enable rapid emergency and diagnostic care. The aim was to create a seamless pathway for emergency patients through diagnostics and surgery. Another priority was to create a significant single bedroom ward design that would accommodate the intensive nursing required for acute care. The single bedroom provision provides patient privacy, dignity, rest, recovery, and infection control. The layout cleverly maintains observation, through the design of carefully positioned nursing stations that optimise this configuration.
Lessons from European neighbours As part of the research phase, BDP compared major new-build hospital building projects in the UK with their French counterparts through the association with Groupe 6 (BDP’s sister healthcare specialist practice in Grenoble/Paris).
The findings presented an opportunity for the BDP team working on The Grange University Hospital (GUH) to visit a
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.
Wexham Park’s emergency assessment centre became fully operational in April.
number of hospitals in France and assess transferable benefits. Among other things, the research found that French hospitals deliver more benefit for less cost than UK hospitals.
Many of the cost advantages in the French models derived from the reduced mechanical and electrical engineering system specifications, as well as lower space standards. One key learning was the importance of designing the space to follow function – in other words, by approaching each patient service area as a distinct zone, we could design the space to be most efficient according to its needs. In addition, the building’s mechanical and electrical services provision could be tailored to suit each department, and configured to be flexible, enabling easy adaptation in future.
Preference for ‘zoning’ This approach fitted neatly with staff needs. During staff consultation it was identified that clinical and nursing staff required the different areas of the hospital to be zoned, so that services could be concentrated and dedicated. BDP produced a design concept for the Grange University Hospital based on four building ‘zones’ – each tailored to deliver the optimum architectural, engineering,
and construction solution. These were as follows: n Zone 1 – The diagnostic and treatment zone is a regular structural grid and simple rectangular footprint, with a dedicated engineering plant.
n Zone 2 – The rooms. These have a tapered ‘star’-shaped building form and ward footprint, which maximises the opportunity for window wall. Our French research showed that this access to light and privacy improves patient recovery times. The design accommodates the significant proportion of single bedrooms, while also minimising nursing staff travel.
n Zone 3 – This houses staff support, education, and administration accommodation, and is a non-patient zone of the hospital.
n Zone 4 – The energy centre is located in appropriate buildings away from the hospital accommodation.
At The Grange, the Emergency Department, Adult Emergency Assessment Unit, and Children’s Assessment Unit, and the relevant inpatient wards, flow into each other, and surround the diagnostic treatment zone, to enhance the emergency flow and clinical management.
October 2019 Health Estate Journal 107
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