HOSPITAL LAYOUT


rooms could only be reached by going directly through one of the departments, with additional stress for the patients. In the same department, the genetic laboratories were accommodated in cramped rooms due to the quantity of medical equipment needed to deliver the service.


Besides the lack of dedicated spaces, The old department layout.


delivery of care together with the public system.


Hospital Di Venere is located in the outskirts of Bari and was first opened in 1923. The Hospital is a pavilion hospital and consists of 11 main buildings which have been subject to various refurbishments over the years. Technological advancement and health changes have put pressure on the existing built assets in which care is delivered. As such, maintenance and refurbishment play a key role alongside new design. The definition of maintenance implies two processes: retaining to avoid failure, and restoring after failure.2


The definition of


refurbishment brings up six dimensions: social, ecological, economic, cultural, architectural, and technical.3 Both definitions encompass the underlying concept of sustainability, which is key at a time when human relationships are becoming more ephemeral, energy production is facing economic and socio- political issues, and the environment is being undermined by several factors. In this context, patients and their needs


have acquired a more crucial role in the delivery of care and also in regard to the setting where the care is delivered.


Key issues in the old department The old department had an extension of 555 m2


general screening and patients coming in with high-risk pregnancies (e.g. already screened, genetic disease, congenital disease) crossing each other on their way in and out. This severely impacted the patients’ psychological condition and interaction, undermining their individual needs. One of the two separate reception


the overlapping pathways posed an even greater issue in terms of privacy, humanisation, and efficiency of care delivery, with the genetic counselling taking place in the ultrasound rooms or diagnostic rooms. GM and MFM staff shared one meeting room, again with a negative impact on organisational strategies.


Hospital space design Hospitals are extremely complex facilities in which there an interaction of multiple elements, including physical, technological, social, and economic.4 Hospital space has always been in a near-continual state of flux.5


Hospital


design layouts have been evolving since the Greek Asclepions (healing sanctuaries), and the Roman Valetudinaria (military fortifications), through the Medieval age and the Renaissance, until the 1850s, when Florence Nightingale codified the hospital space as the place where care was provided to patients in consideration of their needs as human beings, and contemporary times, when care can be provided in virtual spaces with seamless delivery. Hospital buildings change rapidly and


with one main entrance for the


public. GM and MFM had to share the waiting room, with patients coming in for


frequently, thus leading to spaces becoming unfit for purpose, with a potential impact on health service provision, increase in risk of harm to patients and staff, and unsustainable economic implications.3 Changes in healthcare conditions, in patient categories, in technological advancements, and in environmental conditions, have always had an impact on hospital design layout. This research topic has led to various theories. The open building approach allows hospitals to expand in size and


The new department working areas. IFHE DIGEST 2023 61


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