Dec 18, 2019
The foundation of all architectural design is the layout of a building. This is especially true when it comes to hospitals. A hospital’s layout directly affects the efficiency of staff, safety of patients and even the profitability of the company. Its importance cannot be understated.
Looking back at some of the first known hospitals in the country, it’s easy to see how a building’s layout was planned; buildings were shaped to fit as many patients as possible. Today, the role architectural layout has played in hospital design has evolved to mean so much more than simply making more room for additional beds. New research and trends are fundamentally changing the way hospitals are designed, and many great things are coming out of these new state-of-the-art facilities.
Although the number from studies vary, general estimates place the number of steps nurses take in any given hour at about 1,000. In a twelve-hour shift, this means anywhere between 10,000-12,000 steps, or 4-5 miles traveled throughout the day. This “4-mile shift” has not only become the poster child for the “over-worked nurse”, it’s also a sign of the inefficient design of older hospitals and healthcare facilities.
Using evidence-based practices, architects are constructing new facilities that cut down on travel time and allow healthcare professionals to work more efficiently. Researchers are mapping out where nurses need to go, and how far they have to walk, in order to access supply closets, nurses’ stations, etc. The idea behind this research is to shape facilities and lay out essential locations in a way that minimizes the distances nurses travel to get to and from key locations. This cuts down on travel time, increases efficiency and allows nurses to have more bedside time with patients. This can lead to higher HCAHPS scores or the ability to oversee more patients, both of which can increase revenue generated by facilities.
One such facility design trend that accomplishes all of this is centralized nurses’ station surrounded by patient rooms. This open format, shaped almost like a wheel with the nurses’ station at the center (acting as a hub), allows nurses to stay in a centralized location, reducing the number of steps they must take to reach any patient room. It also allows them to cut through the nurses' station rather than traversing long corridors to reach rooms on the other side of the facility. All of this reduces travel time while increasing efficiency across the entire facility.
There are two major concerns when it comes to safety in hospitals: falls and infections, and the layout of patient rooms is helping to combat both concerns. While hospital acquired infections are generally the result of poor communication, they can also result from poor cleaning practices. Sometimes the shape of a patient room simply works against proper cleaning and makes it more difficult to completely sanitize. A major shift in hospital design over the years, particularly in patient rooms, is to shape the room as simply as possible. This makes the room easier to clean, reducing the chances of bacterial growth. Rooms with excessive nooks, corners and other obscure areas mean more places for bacteria to cultivate.
Patient rooms are also being designed to reduce injuries due to falling. Bathrooms are being placed within plain sight of patient beds, with a direct line of travel between them, to reduce the distance traveled and the amount of turns necessary to get there. This allows for patients to more safely traverse the room, greatly reducing their risk of falling.
This simplicity in patient room design also allows for greater communication. Simple patient room design allows providers to maintain close proximity to patients and a direct line of sight no matter where they are in the room. Whether providers are typing notes on a computer, gathering supplies from storage or writing on communication whiteboards, they will never be hidden from a patient’s view. This can help increase patient engagement in their care and ultimately leave them feeling more attended to and satisfied during their stay.
While design trends may change, the structural build of facilities will last decades. In order to ensure that patients are safe and comfortable, and that hospitals staff have the tools they need to provide better care, facility architecture will have to continue to evolve alongside the needs of the healthcare industry.