home within 72 hours; while patients on the 16-bed surgical unit may be expected to be in hospital for up to 96 hours.
A psychological approach A range of 24-hour services on the first floor include an acute assessment unit (AAU) with 26 beds and eight assessment trolleys. This sits alongside the 20-cubicle ambulatory emergency care unit (AECU) where appropriate patients can be assessed, diagnosed and treated without being admitted overnight. Furthermore, the paediatrics and minors A&E is closer to the main entrance for enhanced outcomes. “We consulted extensively with staff on this project, using virtual reality imaging and physical mock-up rooms so they could ‘walk around’ the building during the design phase,” said Fairham. And standardising rooms is helping
to futureproof the building further, with areas able to be expanded or contracted in response to demand or staffing levels.
Fairham said: “Universal assessment
areas were all designed to exactly the same footprint to be acuity adaptable, so the patient is cared for in the same room which can adapt to suit their clinical needs.
“And the inpatient beds on the upper two storeys have outboard en-suites which improves observation.” Within several of the assessment and
treatment spaces, chairs rather than beds are used, giving patients who do not need to lie down the impression they are nearer to discharge, as well as offering space efficiency “It’s a very psychological approach,”
healthcaredm.co.uk 15
said Fairham. “Often if you are put into a bed you feel your condition warrants that and might be more serious. If you are able to sit in a chair you feel much more positive and as if you are progressing. “This progression was the centrepiece of the design.”
Learning lessons The team’s second project also uses this more-joined-up, patient-centric approach. Previously known as the Specialist and Critical Care Centre; the Grange University Hospital is the centrepiece of a new model of healthcare delivery serving over 600,000 people needing complex emergency or critical care. It will have 471 beds and will be home to more than 40 specialist services, with a helicopter pad for patients who arrive by air ambulance. Once again, careful modelling of staff and patient flows was carried out, enabling early streaming, and this is supported by dedicated circulation systems for front-of-house and back-of-
house services, enhancing patient privacy. The design also takes advantage of the landscaped setting, offering views across the surrounding countryside and access to therapeutic spaces to promote healing and wellness. And the workplace offers a highly- connected environment with high- quality staff spaces to attract and retain the best workforce. Fairham said: “This project is about centralising two sites and ensuring that assessment, diagnostics and treatment are all within easy reach.” He concluded: “In accident and
emergency units fast decision-making and timing are critical, so it is an obvious choice that this is where this new design approach is being seen initially. “But, having worked on these two
projects, there are definitely lessons to be learned and I can see it undoubtedly being used much more widely in healthcare.”
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