Health Facilities Design Considerations for Future

As the COVID-19 grew into a global Pandemic, Hospitals struggled to adapt to the new requirements to suit the new functional changes, infection control criteria, patient flow and spatial demands. Healthcare Architects and interiors designers mobilized to reimagine ways to incorporate the changing requirements into current and future healthcare spaces.

Advancements in medical care, pharmaceuticals and medical technology, along with the mass transfer of information, have changed how people perceive healthcare services and experience. The environment that we have strived to develop has created new challenges for health facility designs.

While continuing the focus on infection control to reduce the Hospital acquired infections, emphasis had to be placed in revising various aspects such as safety, sterilization, capacity, flexibility of spaces, patient flow, automated doors and fixtures etc, thus leading to a major design shift in healthcare spaces. As our understanding of the pandemic continues to evolve, the design of healthcare planning & interiors will evolve too.

As we progress, it seems like the volume of outpatient care will increase significantly, and inpatient volume in general will decrease.

Technology will continuing to advance at extreme speed pushing the facilities to, but upgrade, replace and support equipment. Despite the fact that the caregivers will have the most advanced tools and best education, the volume of patients that can be treated and the levels of care required at the tertiary centers will drive a much higher level of stress. The future of healthcare is surely bright and healthcare architecture and planning is rushing to adapt.

Adaptability seems to be the keyword in current scenario. While we cannot yet lay any rigid criteria for changes to be made, following considerations can go a long way in adapting to the changing demands in functionality of healthcare.

·      In general, these are the elements, which, for now must be considered when planning health facilities for the future of healthcare delivery: flexibility, technology-led design, higher acuity levels in health facilities, growing requirement for outpatient care and repurposing of existing facilities.

·      Multipurpose spaces, mobile workstations, which adapt to changing demands.

·      Shell spaces with provisions to cater to increased capacities when needed based on the treatment types.

·      Reduction in common areas to discourage clusters of people and time spent in the common areas.

·      Ability to adapt spaces for negative air.

·      Automated check-ins and room bookings.

·      Change in how we wait for care and for loved ones in the hospitals.

·      Shared common spaces such as locker rooms or break rooms for staff will need to be spread out to limit the no of people within a space.

·      Encourage virtual consultations for routine check-ups, thus limiting people within the healthcare facilities and reducing the risk and the travel requirements of the patients. This will also limit the non-emergency patient surge.

·      Medical Office Buildings (MOBs) with services like Telehealth, which may become a common standard.

·      Introduction of finishes such as wood, furniture, which looks more residential, color themes and artwork, which creates an ambience of being at home.

·      Emphasis on design themes, which are more minimalistic, Zen, or themes with residential touch to help create a healing environment within the hospitals.

·      Create more space between people by having wider hallways and larger rooms.

·      Increased automation with touchless doorways, faucets and fixtures such as hand sanitizers etc.

·      Minimize Ledges, consider Smooth surfaces, and avoid vertical reveals and recesses in the details.

·      Cleanable and Durable products, which can stand decontamination, while maintaining the aesthetics.

·      Coved wall, floor, and ceiling transitions reduce inside corners and hard to clean areas.

·      Rooms designed to house typical low acuity to extremely high acuity patients without changing rooms and reduce risks and stress and provide better Patient experience.

·      Strict adherence to compliance of antibacterial surface finishes including the fabrics for sofas and seats.

·      Decentralized Healthcare: shift to manage contracts, clinic-based care.

·      Impact on facilities: shrinking of the hospital; smaller tertiary clinics; more retail clinics.

·      A form of bipolar ionization, needlepoint bipolar ionization (NPBI) is used by hospitals across North America in their HVAC air handling systems to actively disinfect air of viruses, bacteria, and mold spores and to remove odors and volatile organic compounds (VOC). It is currently being offered in main entrance air curtains to reduce the associated space’s airborne particulates. Air curtains are placed uniquely to provide a high ion density shower to actively deactivate viruses. 

·      Design for innovation by putting in a strong and flexible ICT infrastructure foundation. It will give us the ability to upgrade and replace components without the need to carry out expensive and destructive works in the facility.

·      More actively introducing automated guided vehicles, which take food, linen and other goods around the hospital through a series of tunnels.

Higher Acuity Levels in More Facilities:

·      While advancements in medicine, technology and treatment will keep more people healthy longer, the ones that will need to be hospitalized will be sicker. They will require a higher level of care for longer periods and generate a number of support space challenges.

·      Advancements in patient reception and tracking, along with a higher level of acuity, will create new types of outpatient treatment spaces. Integration with telemedicine within the ambulatory network can help in reducing the no of patients visiting health facilities physically.

Facility Repurposing:

·      A balance will need to be struck between new SMART construction and the re-use of viable facilities. It is not viable financially to build new facilities every time there is a need. Design teams will need to adapt by developing new tools, teams and processes for complete building repurposing. This new expertise will have to take a different approach than traditional renovation. 

·      The repurposed building will have to integrate the latest technology and IT backbone and connect to the system, think like its new counterparts and accept changing equipment. Structural modifications and mechanical system upgrades will be the most significant, and good design teams will have to work with the local regulatory agencies to be adaptable.

Flexibility:

·      As institution’s ability to constantly renovate, due to changing equipment or medical processes, will be limited, the ability to provide physical solutions that can adapt will be vital to make it work financially.

·      The level of flexibility will need to exist on multiple levels. Individual treatment rooms will need to have adaptable technology. Structural systems will need to be able to accept new technology and new layouts.

·      Mechanical systems will need to be able to adapt to potential security risks, isolate spaces and remain operational when necessity arises. Data system will need to be robust, accessible, adaptable and upgradable.

All of these changes will require a re-thinking of the standard inpatient/outpatient models. The challenge will demand senior-driven teams of experienced designers, partnered with their clients, dedicating real time to explore design-delivery methods for the future.

Sources:

https://philowilke.com/think-small-getting-down-to-details-with-infection-control-design-trends/

https://www.steelcase.com/research/articles/10-trends-and-the-next-10-years-of-facility-design-where-do-we-go-from-here/

https://www.healthcarefacilitiestoday.com/posts/Case-Study-Deactivating-the-Coronavirus-with-Doorway-Air-Curtains--25609

https://www.payette.com/healthcare-trends/the-future-of-healthcare-design/