Hospital Building Design Research Articles

Seismic Design of Hospital Buildings : A Comparative Study of Base Isolated Systems Using IS 1893 (2016) and ASCE-7 (2022)

Seismic Design of Hospital Buildings : A Comparative Study of Base Isolated Systems Using IS 1893 (2016) and ASCE-7 (2022)

Construction of a Spatial Equalization Assessment System for Medical Facilities

The spatial equalization of medical facilities can alleviate the wastage of medical resources and improve the efficiency of medical services. Therefore, it is necessary to carry out spatially balanced planning and assessment of medical facilities in cities. Existing studies on the balanced planning, design, and evaluation of medical facilities have been conducted from the perspective of hospital buildings in terms of spatial utilization efficiency, service satisfaction, and their physical environment on one hand, and from the perspective of regional planning of medical facilities in terms of spatial accessibility to medical facilities and the suitability of medical facilities to the social environment on the other hand. This study hopes to break down the boundaries of each perspective and effectively integrate the architecture, planning, and social well-being of medical facilities, taking spatial equilibrium as the core, in order to establish a spatial equilibrium system for medical facilities and achieve a spatial equilibrium-based assessment of the current state of medical facilities. First, the factors influencing the spatial equilibrium of hospital buildings with the support of the system and environment of hospital buildings are determined. Second, the indicators of the spatial equilibrium of hospital buildings are extracted through the consideration of influencing factors, and the indicator weights are determined by discussing the degree to which they contribute to the influence of the operation of hospital building spatial equilibrium systems, thus forming a system of equilibrium indicators for hospital buildings. Finally, a spatial equilibrium evaluation model for hospital buildings is established to assess the effects of equilibrium. The results obtained in this study provide insights into the regional planning of medical facilities and the design of hospital buildings.

A new children's hospital with a larger floor space, single rooms, and V-shaped ward design: A pre-post evaluation of nurse time providing patient care and nurse, patient, and family experiences.

The impact of hospital building design on patients, families and nurses related to nursing care interactions is not well understood. This study reports a pre-post intervention study to understand the effects of the move to a new children's hospital in Perth, Australia, on nurse workflow activities and on patient, family, and nurse experiences. We used a pre-post explanatory sequential design involving observation of nurse work tasks; measurement of the Practice Environment Scale and Nurse Work Index; weekly surveys of nurse, patient and family experiences; and nurse focus groups and interviews with patients and families. Survey data were analysed using linear regression; qualitative data analysis used a thematic approach. Nurse time spent walking almost doubled (p < 0.001), from an estimated 10 min at T1 (pre-move) to around 20 min at T4 (12 months post-move), but there was no difference in nurse time providing patient care (p = 0.114). The Practice Environment Scale and Nurse Work Index showed significantly reduced scores for nursing foundations for quality of care (adjusted mean difference -0.08, p = 0.016) and staffing and resource adequacy (adjusted mean difference -0.19, p < 0.001).This fall was mirrored in nurse experience surveys with a reduction in mean scores from T1 to T3 (3 months post-move) of -0.7 (p < 0.001) and from T1 to T4 of -0.4 (p = 0.002). Thematic analysis of qualitative data found that initial challenges appeared to reduce over time. Nurses reported difficulties managing workflow in the new wards and feelings of exhaustion at T3, but this changed to more positive accounts at T4. For patients and families there was a tension between leaving the old and familiar, enjoying the light and space of the new and shared observations that nurses appeared to be busier at T3. At T4, these experiences had changed to 'being a family in hospital' and confidence that a nurse was always close by. Both benefits and challenges of the new hospital design were encountered from the perspective of nurses, patients, and families. Nurses spent double the time walking in the new environment, but time spent providing patient care was unchanged. Over time, the initial practice challenges reduced as nurses adapted to working in the new environment. ACTRN12618000775213.

An evaluation of knowledge of circular economy among Therapeutic Radiographers/Radiation Therapists (TR/RTTs): Results of a European survey to inform curriculum design

IntroductionGlobal warming and the increase in greenhouse gases are a current concern worldwide. The healthcare sector constitutes about 4.4% of all emissions. This study aims to evaluate the knowledge, awareness and attitudes of Therapeutic Radiographers/Radiation Therapists (TR/RTTs) regarding environment-related concepts to inform the development of educational curriculum. MethodsA validated self-designed survey was distributed to TR/RTTs across Europe by the SAFE EUROPE partners and via social media between October 2021 and February 2022. The survey was divided into six sections: (i) demographics, (ii) knowledge of Circular Economy (CE) and Green Skills (GS), (iii) personal attitudes, (iv) TR/RTTs attitudes, (v) the importance of CE, and (vi) education. Questions consisted of mostly Likert scales complemented with other closed- and open-ended questions. Results31%–42% of participants are aware of national and departmental policies in CE and GS concepts. Even though half of the participants considered that they advocate and practice CE, the open questions indicated that participants only focus on waste management, ignoring all the other dimensions of CE in healthcare. Personal attitudes and lifestyles also did not reflect CE.TR/RTTs considered CE practices and GS development essential. However, the suggested academic level at which these skills should be developed was split between High School (44%) and Bachelor's degree (32%). ConclusionIt is essential to raise awareness among TR/RTTs about the various dimensions of CE applied to healthcare: “green transportation”, “environment-friendly procurement”, “hospital building design”, “food process optimisation”, “water reduction”, “energy efficiency”, and “waste management”. Implications for practiceThese GS must be developed by TR/RTTs to decrease their impact on the environment. Their training may need to be lifelong, starting during basic high school education and continuing as healthcare professionals after graduation.

Future proofing for hospital building design: from research to practice

ABSTRACT The rapid increase of rates of change, disruptive events, risk and uncertainty increasingly threaten the long-term utilisation of hospital buildings. This challenge calls for an evolution in the lifecycle thinking that has always been integral to the hospital building design processes; or an approach that is termed ‘future proofing’. Yet the implementation of future proofing as an emerging design requirement is impeded by lack of holistic understanding of the concept, and clarity about its objectives. As such, this research aims to provide a conceptualisation of future proofing via a taxonomic hierarchy. We interviewed sixteen experienced hospital architects from leading consultant firms across Australia to explore their general perceptions, and implementation in practice, of future proofing. The semi-structured interviews were informed by and indeed tested a theoretical model of future proofing previously constructed via literature review and were analysed and validated via thematic analysis and member checking. Our findings align theoretical understanding with hospital architects’ practice-based perceptions and experiences of future proofing; elucidating future proofing as a dynamic meta-capability involving a multi-purpose hierarchy. Accordingly, a hierarchical integrated model of future proofing in practice was developed based on three axes (Survive, Evolve and Thrive), respectively defining three sets of spectrums with two extremes ranging from passivity to activity (Resilience-Mitigation, Maintainability-Improvement, and Changeability-Transition). While in previous research future proofing has been oversimplified and perceived largely in terms of adaptability, our findings support a more expansive definition of future proofing that includes various lifecycle design considerations.

Principles for the Sustainable Design of Hospital Buildings

Technological progress has had negative effects as well as positive effects if it affects the life industry and the entire ecosystem significantly through the great consumption of natural resources, and here the construction sector in general and the health sector, in particular, have a role in this. From the perspective of keeping pace with technological development, responding to environmental changes, and paying attention to hospital environments (especially since the emergence of modern epidemics), and because the construction sector is the largest consumer of energy in the world, which made international organizations move towards creating a sustainable environment in the construction of hospital buildings by reducing energy consumption. This research focused on studying the components and principles of sustainable design for hospital buildings and the environmental, economic, health, and social benefits of sustainable development in the healthcare industry. In addition to the research objective, which is to build a model as a guide to guide health care officials interested in applying sustainable design principles in hospital design, to achieve an ideal sustainable hospital environment. To achieve this goal, a comprehensive theoretical framework was built by adopting a descriptive and analytical approach and extracting the most important vocabulary and effective indicators for sustainable design in hospitals.

Lessons learnt for enhancing hospital resilience to pandemics: A qualitative analysis from Italy

The COVID-19 pandemic has outlined the need to strengthen the resilience of healthcare systems. It has cost millions of human lives and has had indirect health impacts too. Hospital buildings have undergone extensive modifications and adaptations to ensure infection control and prevention measures, and, as it is happened following past epidemics, the COVID-19 experience might change the design of hospital buildings in the future. This paper aims to capitalise on the knowledge developed by the stakeholders directly involved with the hospital response during the pandemic to generate new evidence that will enhance resilience of hospital buildings to pandemics. The research adopted qualitative research methods, namely literature review and interviews with Italian experts including doctors and facility managers to collect data which were analysed through a thematic analysis. The findings include the identification of new needs for hospital buildings and the related actions to be taken or already performed at hospital building and service level which are viable for long term implementation and are aimed at improving hospital resilience to pandemics. The results specify how to improve resilience by means of structural modifications (e.g. placing filter zones among different wards, ensuring the presence of airborne infection isolation rooms at least in the emergency departments), technological changes (e.g. oversizing capacity such as medical gases, information technology improvement for delivering healthcare services remotely), and operational measures (e.g. assessing the risk of infection before admission, dividing acute-care from low-care assets). The needs discussed in this paper substantiate the urge to renovate the Italian healthcare infrastructures and they can be considered useful elements of knowledge for enhancing hospital resilience to pandemics in the extended and in the post-COVID-19 era.

Analysis of Factors Historically Affecting Innovation in Hospital Building Design.

This article aims to complement the historical literature on the evolution of hospital buildings via a holistic analysis of the contextual factors triggering hospital design innovation over the past 100 years. Innovation in hospital building design should be considered as a complex ecosystem with a heterogeneous set of actors. A novel hybrid research design to the Mixed Grounded Theory methodology, with Charmaz's constructivist paradigm, was developed to explore, construct, and interpret concepts and the interconnections between them. Six hundred seventeen interconnections between 146 factors, classified across 14 categories, were developed to explain the individual and combined impacts of all components of the design innovation ecosystem. This study provides hospital building designers, researchers, policy makers, and stakeholders with a systemic understanding of the innovation ecosystem and their potential role in this system. This knowledge suggests the need for interdisciplinary education to address complex and quickly evolving real-world building design problems.

Future Hospital Building Design Strategies Post COVID-19 Pandemic

The COVID-19 pandemic is regarded as a pivotal point in human history. The goal of architecture is to solve problems like the novel COVID-19 pandemic. As a result, new future methods to designing buildings and create environments emerged, with hospital design and infection control being prioritized as a key pillar of health care. Hospitals, like battlegrounds, require a future design that prioritizes speed and safety, not just during treatment but also during testing and follow-up care. The research aims to create an appealing, humane, and optimal therapeutic environment for dealing with the pandemic in order to raise the degree of safety that aids in the prevention of infection and illness spread. The research employs a deductive methodology, with the goal of discussing the evolution of the design of the future hospital environment through a set of design strategies based on social distancing policy, adaptability, flexibility, and engineering control of new preventive measures to deal with the current and potential future pandemics, while also considering humanistic aspects. The questionnaire was conducted to test the goals and strategies of this research through a group of specialists in order to reach the graphic results of the importance of these strategies in helping to design the hospital of the future, paving the way for future studies and research to develop building design and create environments of future hospitals.

The nature of innovation in hospital building design: a mixed grounded theory study

PurposeDespite the undeniable need for innovation in hospital building design, the literature highlights the disconnect between research and practice as the primary knowledge gap hindering such innovation. This study shows this focus to be an oversimplification, for the complex processes that trigger design innovations and impact their ecosystems need to be examined from a systemic perspective. This paper aims to conceptualise the evolution of hospital building design and identify and explain the main factors triggering design and construction innovations over the past 100 years.Design/methodology/approachA novel hybrid research design to mixed grounded theory (MGT) methodology, with Charmaz constructivist paradigm, is developed as a new systematic way of constructing and interpreting the concepts and interconnections among them that triggered design innovation.FindingsThis study represents a taxonomy of concepts and an explanatory innovation framework, containing 617 interconnections between 146 factors classified across 14 categories. The complex innovation ecosystem comprises multi-faceted processes between heterogenous factors with both individual and collective impacts on design innovations.Originality/valueThis research highlights the main components of the innovation ecosystem and its overall behaviour in this field, and the most influential and interrelated contextual factors, as well as representing and mapping generative interactions that support innovation processes. This knowledge can help hospital researchers, designers, policymakers and stakeholders adopt a multidimensional outlook to analyse the strength of all influential factors, introduce potential novel ways of collaborating, conceptualise an organisational approach, re-formulate research questions through transdisciplinary methods and introduce interdisciplinary courses and programs in architecture schools, thereby contributing to timely design innovation.

Spatial distribution of patient traffic volume in outpatient buildings of large general hospitals in China

ABSTRACT The spatial distribution of patient traffic is important for hospital building design, but there is still insufficient targeted discussion for Chinese outpatient buildings. To obtain reliable evidence, this study examined the outpatient traffic spatial distribution in a large Chinese general hospital by describing it as a set of inter-department patient traffic frequencies (q), which means the ratio of the number of patient trips within a pair of department units to the hospital’s total outpatient visits. Through three hospital samples and 2443 patient samples, three main findings were obtained: (1) The “q” value sets of each hospital sample and their average value set were obtained, and the idea of using them as evidence in outpatient building design was presented; (2) Outpatient traffic distribution was similar among hospitals and was characterized by clustering among certain departments: 38 out of 150 traffic sections created 90% of outpatient traffic, and four public departments’ outpatient traffic presented directivity; (3) There was an indicated slight variation among the samples; therefore, more precise evidence for specific cases required “q” values generated by themselves, which could be obtained conveniently through methods presented in this study. Subsequently, both evidence and methods are provided.

Healthcare Providers’ Perspective on Barriers to Patient Safety Incident Reporting in Lusaka District

Background: Many studies from a number of different nations around the world have consistently demonstrated unacceptably high rates of medical injury and preventable deaths. However, research shows that patient safety from developing countries is still infrequent and that frontline healthcare practitioners have concerns about patient safety which are yet to be looked at. Therefore, this study aimed at exploring concerns related to safety of patients receiving clinical care.Methods: In-depth, face to face interviews with 33 frontline healthcare practitioners and managers were conducted. The sample was collected at two largest hospitals in Lusaka, one offering mental health and the other one acute health services. Results: The findings were broadly categorized into staff-related and institutional-related challenges. Most incidents committed by them were going unreported. Challenges in maintaining patient safety were also attributed to lack of guidelines, standardized reporting system, patient overcrowding, poor hospital building design and staff shortages. These make it challenging in maintaining patient safety measures.Conclusion: In as much as patient safety is one of the priority areas in most healthcare systems of developing countries, incident reporting is not being done across the board. A number of factors are acting as barriers. There is a lot more that need to be done in order to improve the safety of patients in most developing countries and thus, with the current trend, patient safety incidents will continue harming patients receiving clinical care as long as these barriers exist.

The interdisciplinary conceptualization of future proofing in the context of hospital buildings

ABSTRACT Due to constantly changing requirements, future proofing is increasingly seen as an urgent need in hospital building design. However, as knowledge on future proofing hospital building design is yet to be consolidated, this study reviews the literature to clarify understanding of the concept in hospital building contexts. A scoping review methodology was considered appropriate to elucidate concepts in the literature. As future proofing has been developed in multiple industries, an interdisciplinary approach is taken to investigate the concept across three contexts: design (in general), the built environment and hospital buildings. Findings reveal that most studies adopted a crisis-driven approach to conceptualize future proofing – largely limited to consideration of adaptability and resilience. By synthesizing the data, the research provides a comprehensive definition of future proofing by answering the WHY, WHAT and HOW of its application to hospital building design. A future proofing model is proposed that is composed of passive–active and reactive–proactive dichotomies that identify four future proofing objectives. These objectives are addressed via six future proofing capabilities: maintainability, resilience, changeability, mitigation, improvement and transition. The study clarifies future proofing objectives in hospital building design and informs directions for further research and dialogue in policy, research, education and practice.

Hospital design features that optimise pandemic response

The COVID-19 pandemic has changed forever how we plan, respond to, and deliver health care. The lived experience of hospital infrastructure design to support a pandemic is currently not well described in the literature. Much of what is known covers generic elements of hospital design and/or assumptions about in-built disaster design features. The Central Adelaide Local Health Network became a key stakeholder in South Australia's response when the Royal Adelaide Hospital (RAH) became the designated receiving hospital for the state. Preparation for a pandemic commenced back in 2007 when a new build for the RAH was announced. Several disaster response infrastructure design features were incorporated into the RAH design specifications to provide a resilient facility that could respond to any type of disaster event while continuing to provide core clinical services. Key pandemic design elements included patient room design, pandemic air handling capability, and a 7-step scalability function. We describe these key elements based on real-time experience along with the key lessons learnt as the pandemic response evolved with the aim of guiding future hospital building design to not only support the more frequent time-limited disasters but, more specifically, a pandemic response. The RAH capitalised on its key design features to support its pandemic response and contributed to the overall success of South Australia's pandemic response.

Theoretical Issues and Conceptual Framework for Physical Facilities Design in Hospital Buildings

This study reviewed the theoretical issues relating to morphological and psychological design issues in hospital building design evaluation. The study of morphological configurations design issues, concentrates on the elements of building, shape/form, the structure of the environment, the structural efficiency and the architectural appearance of the hospital building forms. The psychological design issues focused on the essential issues relating to Proximity, Privacy and Wayfindings. Through the literature review of previous models such as, Khan (2012) Operational Efficiency Model, Haron, Hamid and Talib Usability Framework, (2012), Zhao, Mourshed &amp; Wright (2009) Model, Alalouch, Aspinall &amp; Smith Model (2016) and Hill &amp; Kitchen (2009). A conceptual framework for physical facilities design evaluation and satisfaction in hospital buildings was developed. The study, however, provides useful information for the development of a design framework that can inform policy on hospital buildings.

Two Generative Design Methods of Hospital Operating Department Layouts Based on Healthcare Systematic Layout Planning and Generative Adversarial Network

With the increasing demands of health care, the design of hospital buildings has become increasingly demanding and complicated. However, the traditional layout design method for hospital is labor intensive, time consuming and prone to errors. With the development of artificial intelligence (AI), the intelligent design method has become possible and is considered to be suitable for the layout design of hospital buildings. Two intelligent design processes based on healthcare systematic layout planning (HSLP) and generative adversarial network (GAN) are proposed in this paper, which aim to solve the generation problem of the plane functional layout of the operating departments (ODs) of general hospitals. The first design method that is more like a mathematical model with traditional optimization algorithm concerns the following two steps: developing the HSLP model based on the conventional systematic layout planning (SLP) theory, identifying the relationship and flows amongst various departments/units, and arriving at the preliminary plane layout design; establishing mathematical model to optimize the building layout by using the genetic algorithm (GA) to obtain the optimized scheme. The specific process of the second intelligent design based on more than 100 sets of collected OD drawings includes: labelling the corresponding functional layouts of each OD plan; building image-to-image translation with conditional adversarial network (pix2pix) for training OD plane layouts, which is one of the most representative GAN models. Finally, the functions and features of the results generated by the two methods are analyzed and compared from an architectural and algorithmic perspective. Comparison of the two design methods shows that the HSLP and GAN models can autonomously generate new OD plane functional layouts. The HSLP layouts have clear functional area adjacencies and optimization goals, but the layouts are relatively rigid and not specific enough. The GAN outputs are the most innovative layouts with strong applicability, but the dataset has strict constraints. The goal of this paper is to help release the heavy load of architects in the early design stage and present the effectiveness of these intelligent design methods in the field of medical architecture.

An integral view of innovation in hospital building design: understanding the context of the research/practice gap

ABSTRACT Despite the undeniable need for enhancements in hospital building design, there remain issues in the transition of and translation from research to innovation. While the literature highlights the Research/Practice gap as the prime obstacle, the interplay between research and other variables impacting design innovation remains unclear. This paper aims to understand the innovation system in hospital building design by considering the wider context of design. In seventy-seven highly cited papers, the Integral Design Framework was adopted to examine interactions between research and innovation. This was then used to map variables impacting two innovative moments in hospital building design. The analyses suggest innovation occurs at the intersections of different knowledge domains and point to an oversimplified picture of innovation. It is shown innovations have been generated in relation to new knowledge that is influenced by several critical variables: social shifts, political decisions, architectural design trends, and medical and technological advancements. Analyses utilizing the Integral Design Framework indicates that research informing hospital building design has lacked holistic perspective, thus hampering design innovation. This points to the necessity of re-formulating research questions holistically to drive innovation and the narrowing of the Research/Practice gap.

Virtual Simulation Method in Hospital Design

The development of computing technology affords wide opportunities to apply the virtual reality in the building design process. Virtual reality not only promotes possibilities to explore architectural forms but also affords capability to learn the interaction of users and the design object as if they do in the real situation. User reaction toward design model can be learned and used to be effective information to develop a promoted preliminary design. The user satisfaction and suitability are indicated by their feedback of design object in virtual reality simulation. This paper aims to explain the application of the method on hospital building design. In this case the authors found that the method is very accurate to capture the user need and very valuable to support design process.

RUMAH SAKIT UMUM SWASTA KELAS C DENGAN FASILITAS TAMAN TERAPI DI KABUPATEN WONOGIRI

&lt;p&gt;&lt;em&gt;Designing Private General Hospital Class C in the Kabupaten Wonogiri motivated by needs of society to have better health services, the increased of population growth was offset by increasing the number of health facilities, the spread of hospital in Wonogiri is unequal, &lt;/em&gt;&lt;em&gt;Kabupaten&lt;/em&gt;&lt;em&gt; Wonogiri is lack of 283 beds, the rumors about reduction of hospitals grade with facilities of B&lt;/em&gt;&lt;em&gt;adan &lt;/em&gt;&lt;em&gt;P&lt;/em&gt;&lt;em&gt;enyelenggara &lt;/em&gt;&lt;em&gt;J&lt;/em&gt;&lt;em&gt;aminan &lt;/em&gt;&lt;em&gt;S&lt;/em&gt;&lt;em&gt;osial&lt;/em&gt;&lt;em&gt;. The purpose of this design is to generate design of hospital buildings as a place for people of Wonogiri and communities outside Wonogiri, to obtain health facilities as the main reference with the capability of service that are adjusted to the regulation standard of Class C Hospital by using a healing garden as a healing facility or therapy. So far, the existing paradigm regarding hospital is the patients often feel uncomfortable when receiving medical and treatment due to the circumstances of the hospital which is seemed creepy and claustrophobic for patients&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;S&lt;/em&gt;&lt;em&gt;o it can trigger stress of them which can cause patient's immune system becomes depressed so that the process of recovery and healing the patient became obstructed. The method used is a method of designing the architecture, applied to the hospital building with characteristics of physical environment of a hospital facility must be designed by emphasizing the comfortability and safety for patients, with healing garden facilities aims to reduce stress levels of patients who will be treated at the hospital&lt;/em&gt;.&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;

Towards a building typology and terminology for Irish hospitals

The physical form of the hospital environment shapes the care setting and influences the relationship of the hospital to the community. Due to ongoing demographic change, evolving public health needs, and advancing medical practice, typical hospitals are frequently redeveloped, retrofitted, or expanded. It is argued that multi-disciplinary and multi-stakeholder approaches are required to ensure that hospital design matches these increasingly complex needs. To facilitate such a conversation across different disciplines, experts, and community stakeholders, it is helpful to establish a hospital typology and associated terminology as part of any collaborative process. Examine the literature around hospital design, and review the layout and overall form of a range of typical Irish acute public hospitals, to outline an associated building typology, and to establish the terminology associated with the planning and design of these hospitals in Ireland. Searches in 'Academic Search Complete', 'Compendex', 'Google', 'Google Scholar', 'JSTOR', 'PADDI', 'Science Direct', 'Scopus', 'Web of Science', and Trinity College Dublin Library. The search terms included: 'hospital design history'; 'hospital typology'; 'hospital design terminology'; and 'hospital design Ireland'. Typical hospitals are composed of different layouts due to development over time; however, various discrete building typologies can still be determined within many hospitals. This paper presents a typology illustrating distinct layout, circulation, and physical form characteristics, along with a hospital planning and design terminology of key terms and definitions. This typology and terminology define the main components of Irish hospital building design to create a shared understanding around design, and support stakeholder engagement, as part of any collaborative design process.