Effects of spatial configuration on the patient’s journey to the Emergency Department

Abstract

Reaching the destination, users often encounter complex interfaces created between hospital spaces and the urban tissue. The literature highlights the influence of spatial configuration on the performance of external and internal spaces of healthcare settings. In this regard, studies related to Emergency Department (ED), mostly focus on internal spaces, without specific research on the accessibility of the structures themselves. By extending the research area to the entire system of territory-hospital-ED relations, the study conducted at the University Clinical Center of Kosovo (UCCK) in the city of Prishtina aims to investigate the effects of spatial configuration on the performance of spaces in the patient's journey to ED. The paper attempts to understand the causes that have shaped the spatial configuration of the city and the hospital over the years and their impact on ED accessibility. Through configurational theory of architecture, the paper quantitatively examines the interactions between the levels of this relational system at various spatial scales and time intervals. A methodological framework of spatial requirements and corresponding indicators was developed. It was observed that the declined syntactic values of the city affected the degree of the hospital accessibility, deteriorating the continuity of movement from the city to the hospital, followed by a subsequent disruption due to the change in the spatial configuration of the hospital and the relative position of ED. The outcome shows that configurational changes affect the continuity of movement sequentially in each segment of the patient’s journey towards ED, with interrelated consequences at all levels.