Hospital of Tomorrow

The design perspective

Catherine Lennon, Managing Partner RRP architectsengineers and CEO DANDCA DesignConsult Alliance Healthcare Projects Germany

The speciality of the Hospital of Tomorrow will be a combination of features for the well-being of not only the patients and their relatives, but the doctors, nurses and all the staff of the hospital as well.

The field of healthcare designs is currently undergoing an exciting transformation that will significantly change the appearance of our hospitals. More and more healthcare administrators and medical professionals are becoming aware of the need to create a healing environment that supports the needs of patients, family and staff. The key factor motivating this awareness has been growing scientific evidence supporting the view that physical environment in which medical care is provided has an impact on health and well-being.

This knowledge base contains some evidence for the health impacts of classical elements of healing environments, such as nature, daylight, and fresh air. Hospital architecture has to create a comfortable space for nursing and treatment, thus contributing to a patient’s positive mental attitude. A healing environment for spaces designed can affect both the physiological and psychological well-being of the patient.

We are facing a time-shift in the design of modern hospitals. Hospital management and design teams of architects and engineers have to consider short term circumstances such as the rapidly changing technical aspects of medical treatments; and long term building parameters—providing space and flexibility for future upgrades, improvements, and adaptations of the existing facility to future requirements which can not be anticipated only a few years earlier when the “new” hospital is being planned.

The Hospital of Tomorrow is supposed to be a green hospital. Architects have to make developments on the site for macro and micro expansion. The speciality of the Hospital of Tomorrow will be a combination of features for the well-being of not only the patients and their relatives, but the doctors, nurses and all the staff of the hospital as well. Other exciting features would include good connection and way-finding, the walkway to the hospital, shopping malls and the location where teaching facilities as well as natural features could be combined in the holistic approach of the new hospital.

Environmental pollution and resource exploitation are vital issues in many countries as they are dependent on foreign energy and resources, and are just as much in need of a healthy environment as any other nation. The development of buildings and building systems has been characterised for many years by linear thinking and planning. In the past, single products and systems were targeted at specific building components and is still practised to some degree although it has been proven to be unsustainable in the future.

It is high time, therefore, to remember what we do know, or rather what we must know in the future, so that we may find solutions for the problems that we face, some of which are clearly of our own doing. Environmental protection, sustainable resource management, re-usable instead of single-use buildings, utilisation of natural resources and flexible real estate use will be the key. Integrated planning is a challenge and an opportunity for architects and engineers. Integrated planning, however, goes beyond the long established, and at least partially fulfilled, mandate of integrating building systems into architectural concepts. Here integrated planning for the Hospital of Tomorrow means full and unified collaboration between different disciplines in the pursuit of truly optimum total building concepts.

Hospital Design - A holistic approach

The architecture of a hospital is the shell for all operational processes, the room for recovery for patients and the daily workplace for doctors and staff. You might compare a hospital with a city—having all the functions from the residential area next to the park, over the workplace for hundreds of employees up to the disposal area and energy central. Cities are always changing, they have to adapt to new technologies and new requirements, which means that the hospitals have to be able to change as well.

Teaching facilities must also be designed to encourage learning and exchange of information with a pleasant and longer stay for teachers and students.

Hospital architecture has to create a comfortable space for nursing and treatment, thus contributing to a patient’s positive mental attitude, in an atmosphere of a healing environment, for spaces designed can affect both the physiological and psychological well-being of the patient.

All experts, managers and planners agree that flexibility must be a basic feature of any healthcare facility to keep it safe from rapid obsolescence and ready to face changing needs and technologies. Needs of healthcare facilities are evolving rapidly, and the direction of that evolution is difficult to forecast with any certainty.

If we consider and compare the hospital architecture conditions today to tomorrow’s conditions, there are a few aspects which must be considered in the design brief of the Hospital of Tomorrow:

  • Rapidly changing needs and technologies, reason: direction of evolution is nearly impossible to forecast
  • Changing regulations (government, insurance) with direct impact on the hospital design
  • Lifecycle-costs determining a changed method of construction and architecture
  • New standard of the inpatient wards: Short Stay (Day-Care), Inpatient Ward up to 5 days,
  • low and high-class hotels, nursing home, home for the elderly (long stay)—which means more variety in inpatient wards
  • More focus on preventive medicine
  • Patients with complex diseases and more than one disease (comorbidities) will determine the functions of future hospitals
  • Hospitals have to be able to attract medical tourists
  • Hospitals must be capable of handling patients of all cultures and religions
  • Clinical Patient Path Way Implementation is a MUST
  • Hospitals have to cope with the implementation of information and communication systems, IT networks like HIS, RIS and PACS
  • Changed room requirements, e.g. imaging PACS, due to new workflow procedures (film-less / paperless / wireless hospital)
  • Rapidly growing expectation of the patients / customers
  • The healing environment is playing a central role
  • Architecture as a branding tool—architecture must be updated and upgraded
  • Natural light—natural ventilation for most of the buildings, especially for the inpatient wards and workplaces
  • More importance of easy way-finding
  • No more a place for sickness and sick people but a place for health and recreation!

As a first result, it is already proven that changes in a hospital's architecture have to be considered as a constant need and that the flexibility of a house is a parameter of economy and affects the economic success of a hospital directly. Today, the rate of change is occurring more frequently with even more uncertainty. Increasing pressures form technology, changing business strategies and changes in the overall healthcare system are, especially in parts of Europe and Asia, more obvious than before.

The rate of change is becoming a constant part of a building’s life. The focus on the overall lifecycle-costs of a building like a hospital is also a more static parameter, not able to give predictions or exact estimates about the very important ability to change departments or even whole parts of a house.

To make sure that the change of parts of the hospitals will be appropriate, in terms of the level of change of interiors, technical installation and medical equipment in general, hospital planners have to be able to distinguish between the following categories:

  • Departments like OT, ICU, nuclear medicine, ambulant surgery, emergency department and laboratory
  • Less installed parts like wards
  • Departments like administration, offices, OPD consultation rooms with less technical installation or medical equipment, training facilities etc.

To respect the compliance of the technical environment, the diversification of the different levels for interior planning and the life-cycle aspects of the three categories must be considered in every healthcare and hospital project, starting with the phase of the master-plan itself.

The Hospital of Tomorrow will pay respect to all these issues and also define a new quality in hospital design—for India, South-East-Asia and rest of the world­—by combining all features of hospital design, environmental protection, energy saving and healing environment design, included in an highly economic hospital following clinical patient path ways and defined workflow procedures, for the benefit of quality control, for patients and staff.

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