accommodated in hospital design in the UK, beyond the facility for parents of sick children to be offered a ‘put-me-up’ bed to comfort their child. This is because the presence of additional overnight guests carries infection control, security, and operational implications, and the drive for a more culturally aware and inclusive hospital environment must always be secondary to the facility’s core purpose of caring for the patient and maximising the potential for positive clinical outcomes.

‘Hotel-style’ accommodation for relatives As a ‘next-best-thing’ alternative, many hospitals incorporate hotel-style accommodation for visiting relatives. This is particularly prevalent in hospitals that offer specialist treatment and expertise for which patients may need to travel some distance from their home. However, there is an opportunity for hospitals to enhance their diversity provision by offering on-site accommodation to relatives, and this would enhance the wellbeing of patients who feel isolated when they do not have their family around them. Meanwhile, the on-site hotel would provide a source of revenue generation for the NHS Trust. Beyond patient and visitor overnight

accommodation, there is a clear rationale for creating communal social spaces where patients can gather with friends and family, or relax on a socially inclusive basis, defined by gender where appropriate. This concept extends the premise of the multi-faith centre, where diversity is based on religious definitions, to a social equivalent, based on cultural inclusiveness. While it would require the allocation of space to create these multi-purpose areas, the space investment would be much lower than creating larger patient rooms to provide social spaces on an individual patient basis.

Addressing varying cultural norms Design teams must also consider how cultural diversity can be accommodated within all aspects of a hospital’s facilities. An excellent example is the way in which the design of toilet facilities addresses varied cultural norms. Our Western preference for toilet basins and urinals as a standardised approach does not consider other cultural notions of hygiene,


Like the Guy’s and St Thomas’ Cancer Centre in London, the Cleveland Clinic’s Taussig Cancer Centre in Ohio has been designed around an ‘outpatient only’ model.

which make a latrine and washing facilities much more acceptable than a standard toilet and toilet paper for some. Including a variety of toilet and washing facilities not only offers patients and visitors the ability to select their preferred option, but also communicates an inclusive environment, where diversity is understood and accommodated where possible.

Improving understanding One of the major elements of transitioning healthcare design to progressive models that prioritise the patient experience alongside operational, financial, and clinical drivers, is the consultation process that all healthcare specialist architects use to fully understand the brief and the needs of all user groups – patients, visitors, clinicians, management staff, and ancillary services. As an international, interdisciplinary design practice, Stantec uses consultation with a variety of stakeholders to inform every element of the project; from planning and masterplanning, through to concept, detailed design, and interiors. Sharing the insights from consultations across projects and across teams within Stantec’s global network ensures that we build a knowledge base of cultural diversity, and what it means to different user groups in terms of facilities aligned to their cultural experience or religious beliefs. As a result, we can embed the expectations of service-users in the Middle East into the design development process of hospital facilities in the UK or the US, to ensure that, as a design team, we constantly question whether common assumptions are being rigorously tested against a more diverse and inclusive outlook.

Minority groups can be hard to reach This international experience is a significant factor in considering diversity as part of the design process, because it can be notoriously difficult to incorporate diverse stakeholder groups in the consultation process for UK hospital projects. Minority groups are often ‘hard to reach’ when it comes to user engagement for the consultation process. Often, it is possible to gain some insights into cultural and religious reference points of patient groups from discussions with clinical and managerial stakeholders, but, while their cultural or religious expectations may be similar, their experience of the hospital is that of a workplace, rather than a care and treatment environment. Consequently, diversity insights from hospital staff groups are helpful, but not sufficiently robust to truly form the basis of a diversity design strategy for healthcare environments.

Need for benchmarking Undoubtedly, more needs to be done to drive this agenda. The demographics of hospital users change from location to location, and from project to project, so data and insights gathered from previous projects and care team stakeholders must be combined with specific feedback from a representative cross-section of patients and user groups. The first step to achieving this is to acknowledge the wellbeing benefits of an inclusive patient environment, and to ensure that diversity is established as a clear and measurable objective in the design process, with all the benchmarking and post-occupation analysis that accompanies that goal. Healthcare is a sector where the

design process is supported by detailed guidance regularly updated to reflect advances in technology and trends in patient treatment. There is a lack of guidance on building more culturally diverse facilities or environments that offer choice. If we are truly aiming to embed a patient-centered approach into hospitals, perhaps it is time for diversity to form part of the guidance issued for compliant design or, at least, for a mandatory stipulation that this should be integral to the briefing, consultation, and design development process.


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106