Design Of Healthcare Facilities Research Articles

Implementing the model-based systems engineering (MBSE) approach to develop an assessment framework for healthcare facility design

AbstractThe global elderly population rises, increasing dementia cases. Built environment impact on dementia health outcomes is known, forming the basis for evidence-based design studies. There's a need for a comprehensive assessment framework due to the complexity of interactions among Architectural Variables (AVs) and Health and Care Outcomes (HCOs). This paper proposes using Model-Based Systems Engineering (MBSE) to create such a framework. It collects data from 105 studies on 40 AVs, 36 HCOs, and 396 interactions. MBSE offers a holistic understanding, aiding healthcare facility design decisions.

Nanotechnology applications in interior design of hospitals to enhance thermal comfort and decrease the infection spread for the occupants

Background In healthcare facilities, the significance of sensitive architecture cannot be overstated. In regions facing challenges such as Egypt, the healthcare sector is grappling with deteriorating conditions. The design of hospitals is crucial for addressing the needs of patients with varying illnesses and for creating an environment that fosters psychological well-being. The interior design process, especially the selection of materials, plays a pivotal role in ensuring a hygienic and safe environment within healthcare facilities. Walls, floors, ceilings, and furniture materials are key elements that contribute to the overall design. A study was conducted to investigate the application of nano materials in healthcare facility interior design in Egypt. Methods The study involved first a literature review on nano technology and its application in healthcare interior spaces. It culminated in a framework and guidelines for nano materials in different hospital zones. The analytical part of the study analysed successful international examples, leading to a checklist of nanomaterials categorized by hospital zones. The third part involved a base case study in Alexandria, Egypt, simulating the impact of nano coatings on air temperature, radiant temperature, and relative humidity using the DesignBuilder software. Results The results demonstrated a positive impact on patient health and thermal comfort with nano materials. The use of nano coatings in interior design finishes resulted in decreases in air temperature, radiant temperature, and relative humidity. There was an average decrease of 12.3%-16.7% in air temperature, 3%-4.2% in radiant temperature, and 7%-12% in relative humidity throughout the year. Conclusions The study highlighted the effectiveness of nano technology in enhancing the interior finishes of healthcare buildings, leading to improved patient health, thermal comfort, and decreased infection spread rate. We provide valuable recommendations for optimizing material selection in existing hospital buildings in emphasizing potential benefits of nano materials in healthcare facility design.

Exploring the impact of built environment design on oncology inpatient rooms: a single-based study of King Abdullah University Hospital

ABSTRACT The recognized impact of healthcare facility design on patient well-being prompted this investigation into the influence of design variables on patient satisfaction and length of stay (LOS) within a single-center oncology unit. A survey-based methodology was employed at King Abdullah University Hospital (KAUH) to gather data from 88 participants. The study focused on inpatient rooms on the 10th floor, comparing single and shared accommodations. Statistical analysis revealed a significant difference in LOS between the two room types, with patients in single rooms experiencing shorter stays and higher satisfaction. Privacy (PR) received the highest mean score in participant evaluations, followed by social support (SS) and physical support (PS) features. Visual appearance (VA) received the lowest mean score. The correlation analysis showed a significant negative correlation between privacy, visual appearance, and LOS (p < 0.01), indicating that greater privacy and better views (implicated by the visual appearance score) are associated with shorter LOS. Correlations between physical support, social support, and LOS were weak and not statistically significant. These findings underscore the importance of room configuration in shaping the patient experience within oncology units and highlight the pivotal role of design in influencing patient outcomes. They also stress the need for human-centric considerations in healthcare facility design. This knowledge can guide healthcare professionals, architects, and policymakers in optimizing spaces for oncology patients, illustrating how the interplay between the built environment and patient experiences can potentially reshape patient care.

The Impact of Design Factors on User Behavior in a Virtual Hospital Room to Explore Fall Prevention Strategies.

Falls in hospitals pose a significant safety risk, leading to injuries, prolonged hospitalization, and lasting complications. This study explores the potential of augmented reality (AR) technology in healthcare facility design to mitigate fall risk. Few studies have investigated the impact of hospital room layouts on falls due to the high cost of building physical prototypes. This study introduces an innovative approach using AR technology to advance methods for healthcare facility design efficiently. Ten healthy participants enrolled in this study to examine different hospital room designs in AR. Factors of interest included room configuration, door type, exit side of the bed, toilet placement, and the presence of IV equipment. AR trackers captured trajectories of the body as participants navigated through these AR hospital layouts, providing insights into user behavior and preferences. Door type influenced the degree of backward and sideways movement, with the presence of an IV pole intensifying the interaction between door and room type, leading to increased sideways and backward motion. Participants displayed varying patterns of backward and sideways travel depending on the specific room configurations they encountered. AR can be an efficient and cost-effective method to modify room configurations to identify important design factors before conducting physical testing. The results of this study provide valuable insights into the effect of environmental factors on movement patterns in simulated hospital rooms. These results highlight the importance of considering environmental factors, such as the type of door and bathroom location, when designing healthcare facilities.

Adaptive Architecture and Infection Prevention in Hospitals

In healthcare facility design, especially in hospitals, infection control is paramount due to the vulnerability of patients to nosocomial or healthcare-associated infections (HAIs). Despite advancements in medical practices and infection control measures, HAIs remain a significant challenge to patient safety and public health, particularly within hospital settings. Integrating adaptive architecture principles into hospital design and infrastructure presents a promising approach to addressing this issue. This paper examines the intersection of adaptive architecture and infection prevention in hospitals, with a focus on designing and constructing healthcare facilities to effectively curb the spread of infections. By incorporating adaptive architecture, hospitals can create environments that are responsive to the dynamic needs of patients, staff, and infection control protocols. Design elements such as flexible room layouts, easily adaptable ventilation systems, and antimicrobial surfaces can help minimize the risk of HAIs by reducing pathogen transmission and promoting cleanliness. Additionally, strategic placement of hand hygiene stations, isolation rooms, and patient flow pathways can optimize infection control practices and enhance patient safety. Strategically locating hand hygiene stations, isolation rooms, and patient flow pathways optimizes infection control practices and improves patient safety. By combining innovative design strategies and advanced technology, hospitals can better combat HAIs, fostering safer environments for patients and healthcare staff. This paper investigates how the collaboration of adaptive architecture and infection prevention can yield more robust and efficient healthcare facilities in the fight against HAIs. Keywords - HAIs, Adaptive Architecture, Infection, adaptable ventilation, flexible layouts, antimicrobial surfaces.

Impact of hospital design on the psychological well-being of geriatric patients

PurposeThe study investigates the relationship between hospital environmental factors and the well-being of geriatric in-patients. It aims to identify the impact of architectural design on comfort, safety, privacy and stress levels experienced by elderly patients during their hospital stays.Design/methodology/approachEmploying a mixed-methods approach, the research assesses the experiences of 100 geriatric in-patients across various hospital types through surveys, observational checklists and state anxiety measurements. The methodology involves examining architectural features, patient perceptions and correlations among environmental variables and patient experiences. Statistical analyses, including correlations and chi-square tests, were employed to discern associations between environmental variables and patient experiences.FindingsThe research identified key architectural features significantly impacting geriatric patients' experiences. Factors such as sturdy beds, furniture quantity, lighting conditions, proximity to facilities and ward occupancy levels were found to influence spatial, sensory and social comfort. Notably, proximity to facilities and control over the immediate environment were crucial for self-control and safety perceptions. Privacy, highly valued by patients, correlated with the presence of curtains and ward occupancy. Moreover, patient stress levels exhibited correlations with autonomy, privacy and ward occupancy.Originality/valueThis research offers significant insights into the criticality of specific architectural elements in enhancing comfort and reducing stress for geriatric in-patients. These findings hold substantial value for healthcare facility design, emphasizing the need to prioritize certain design aspects to promote the well-being of elderly patients during hospitalization.

Impact of the design of adult mental health inpatient facilities on healthcare staff: a mixed methods systematic review

ObjectivesMental health inpatient facilities are increasingly focusing on creating therapeutic, person-centred care environments. However, research shows that this focus may have unintended consequences for healthcare staff. Designs that do not...

Shared workspace design: elements of analysis for a healthy work experience

Purpose This paper aims to propose and provide an overview of a model analysis that considers the main spatial design attributes that influence and produce the most relevant salutogenic outcomes. These results are essential for a healthy work experience, especially in shared workspaces. Design/methodology/approach This study departs from the theoretical contributions of the salutogenic approach, principles from supportive design theory, psychosocial supportive design and the environmental demands and resources model. After a scoping literature review covering different fields of workspace design, environmental psychology and evidence-based design of health-care facilities, a conceptual analysis is done on a proposed understanding of work, health and environmental relations to overview spatial attributes that enhance specific salutogenic and well-being-promoting outcomes needed for a healthy work experience. Findings The model of analysis, as a theoretical element that helps create methodological tools, combined with the application of a post occupancy evaluation, is thought to assist architects, designers, workspace owners and stakeholders in their new designs or to evaluate existing ones. Originality/value Studies on defining spatial attributes and their intended salutogenic outcomes have been formally done in health-care facilities. However, applying this idea to shared workspaces is something new and is expected to contribute to their design and evaluation, especially if the notion of environmental demands and resources is complemented.

CO2 emission reduction, loads analysis, and strategies for new healthcare facilities design – Application on a case study

To understand the “Zero Emission Building” goal introduced by the Energy Performance of Buildings Directive (EPBD) revision, it is certainly important to define its scope, since different considerations must be made for buildings with different uses, characteristics and locations. In this paper, the case study of a new construction hospital building is analysed, bringing attention to two main aspects: the correct identification of energy needs of the Heating, Ventilation and Air Conditioning (HVAC) systems; Mechanical, Electrical and Plumbing (MEP) design strategies aimed at minimizing CO2 emissions. To pursue these objectives, the hourly trends of energy consumption are examined, focusing on the interpretation of their distribution, the main influencing variables and on the distribution of such energy consumption among the different utilities of the analysed system. It is opinion of the authors that this in-depth study is preparatory to the proper MEP design of the systems: in fact, by knowing the most energyconsuming users and the distribution of heating and cooling loads during the year, it is possible to identify the optimal design strategies and generation technologies to reduce the consumption of Primary Non-Renewable Energy. In this regard, the choice of an ap-propriate calculation model is highlighted as crucial. Possible design strategies related to the case study under consideration are analysed in this paper, ultimately exposing the general considerations regarding the ZEB issue in the hospital setting.

Developing Resilient Community Spaces in Healthcare Facilities: An Exploratory Study of a Public Health Crisis.

This exploratory study aimed to investigate the impact of the COVID-19 pandemic on the design of healthcare facilities, particularly those featuring communal spaces. It sought to identify strategies that were implemented, learned, or recognized when adapting to the limitations imposed by protective measures during the pandemic. Third places are social gathering places outside of home and work. Over time, these community-centric places evolved from free-standing getaways to more integrated niches in diverse contexts including healthcare. Their numerous advantages for users include enhancing community bonds and collaboration among healthcare workers. The onset of the COVID-19 pandemic resulted in a need to rethink the design of such spaces to make them more adaptable and resilient. An exploratory qualitative study was conducted through in-depth semi-structured interviews with sixteen practitioners involved in healthcare architecture and design projects during the pandemic. Data were analyzed using a thematic analysis approach. Findings indicate that the design of shared spaces in healthcare facilities for pandemic-like situations requires a special focus on modifiability and multifunctionality, achievable through strategies such as the use of movable, unconnected, and rearrangeable furniture or partitions that could swiftly change the function of a space. Other strategies include the capacity for compartmentalization of spaces, fostering indoor-outdoor connections, integrating advanced technology, and implementing effective infection control measures. Detailed emergent themes and examples of experienced constraints are discussed. Insights gained from our findings can be applied to new and ongoing healthcare design projects to ensure resiliency during normal and pandemic conditions.

Enhancing Fiscal Outcomes through Human-Centered Design: The Economic Benefits of Salutogenic Architecture in Public Health Care Facilities

The study aims to investigate the economic benefits of salutogenic architecture in public healthcare facilities. The research design involves a quantitative approach that will utilize a survey to gather pertinent data. The survey comprises a meticulously designed set of questions aimed at investigating the economic benefits of salutogenic architecture in public healthcare facilities across Algeria. For comprehensive coverage, the study will encompass a sample size of 60 healthcare facilities, representing approximately 10% of the total establishments distributed across various provinces (wilayas). It aims to assess the economic advantages resulting from incorporating salutogenic design principles, such as natural light, access to nature, and a sense of environmental control, into the construction and renovation of public healthcare facilities. This research underscores the significance of salutogenic architectural principles in healthcare facility design, highlighting the importance of fostering positive atmospheres, providing access to natural elements, ensuring flexibility, and nurturing community connections to enhance patient and staff well-being by providing valuable insights into public healthcare sorting based on salutogenic architectural criteria and the demographic characteristics of the sample population. The findings highlighted the need for improvement in certain criteria such as flexibility and adaptability, a positive and healing atmosphere, and access to nature. The study also emphasized the significance of salutogenic architectural principles in healthcare facility design and suggested incorporating strategies that enhance patient and staff well-being.

HYGIENIC ASPECTS OF ARCHITECTURAL AND PLANNING SOLUTIONS FOR THE CONSTRUCTION OF MENTAL HEALTH FACILITIES

In order to take into account the hygienic aspects of architectural and planning solutions in the construction of new mental health facilities (general hospitals, crisis units, hospices, psychological care centers, etc.), multidisciplinary groups should be involved – architectural and planning, urban planning units, the public, medical representatives of medical institutions, relatives, patients, to take into account all the necessary in-hospital factors. To conduct a hygienic assessment of architectural and planning solutions for buildings of psychiatric health care institutions in Ukraine that were built in the eighteenth and nineteenth centuries and to provide a comparative description of the hygienic standards of psychiatric health care institutions in different countries. The study was conducted on the basis of the analysis of the DBN B.2.2-10:2022 "Health Care Facilities", scientific sources of domestic and foreign scientists. A survey was conducted among chief physicians of psychiatric hospitals in Ukraine on safe sanitary and hygienic, anti-epidemic conditions of psychiatric health care facilities. There were 55 psychiatric hospitals in Ukraine before the outbreak of full-scale war: 28.6% of them were built in the eighteenth and nineteenth centuries (from 1786 to 1945), 28.6% after the Great Patriotic War (from 1945–1991), and 42.8% during the period of Ukraine's independence (from 1991–2013). Only 25% of psychiatric institutions have playgrounds for outdoor games equipped with tennis tables and volleyball nets (for table tennis and volleyball), 25% of hospitals have playgrounds for quiet recreation (chess, dominoes), and 12.5% have playgrounds for physical education and recreation (sports and play areas). At the same time, 41.6% of these sites are in satisfactory condition. Ukraine has adopted the State Construction Standards of Ukraine DBN B.2.2-10:2022 "Healthcare Facilities. Basic Provisions". It provides basic provisions for the design of health care facilities (buildings and structures of all types of health care facilities) during new construction and reconstruction or during major repairs in health care facilities. However, there is currently no formal sanitary legislation containing sanitary, epidemiological and hygienic requirements for the decoration, equipment and operation of health care facilities with inpatient units.

Investigating the application of lean tools in the design of healthcare facilities

ABSTRACT Lean methods and tools are increasingly being implemented globally in the design of healthcare facilities, to eliminate waste and improve processes. The study of the implementation of Lean in the design of healthcare facilities in India is essential to identify the challenges in the Indian context and its benefits to the Indian healthcare industry. In this study, the methodology of Action Research was employed to optimize the design of outpatient units within the gynaecology departments of two hospitals in India. The methodology involved diagnosis, action planning, action taking, evaluating, and specifying learning. The research process began with a comprehensive literature review, which was followed by interviews conducted with various stakeholders to identify the existing problems. Based on the identified issues, the Lean tools of mistake-proofing, spaghetti diagram, BIM, and visual management were selected for implementation in the study. The intervention studies were performed in collaboration with firms that designed the two healthcare facilities. Mistake-proofing suggestions were made using tools like BIM and visual management to propose solutions that ensure safety, privacy, and efficient movement within outpatient departments. Spaghetti diagrams created using the software VisTABLE, were used to study user movements and quantitative analyses were performed to arrive at alternative layouts. Reduction in distance travelled, and avoidance of repeated movements over a path was achieved in these alternate layouts. The feedback from the design firms showed that these tools could be implemented during the design process and would minimize wasted efforts while enhancing the effectiveness of space.

Stroke Inpatient Rehabilitation Environments: Aligning Building Construction and Clinical Practice Guidelines Through Care Process Mapping.

Stroke inpatient rehabilitation is a complex process involving stroke survivors, staff, and family utilizing a common space for a shared purpose: to optimize recovery. This complex pathway is rarely fully described. Stroke care is ideally guided by Clinical Practice Guidelines, and the rehabilitation built environment should serve to optimize care delivery, patient and staff experience. We aimed to articulate the inpatient stroke rehabilitation process of care in a series of process maps, and to understand the degree to which current stroke clinical and building construction (ie, design) guidelines align to support inpatient stroke rehabilitation. We used the Value-Focused Process Engineering methodology to create maps describing the events and activities that typically occur in the current stroke inpatient rehabilitation service model. These maps were completed through individual and group session consultations with stroke survivors, architects, policy makers, and clinical experts. We then determined which sections of the Australian Stroke Rehabilitation Guidelines and the Australasian Health Facility Design Guidelines could be aligned and applied to the process maps. We present a summary process map for stroke inpatient rehabilitation, alongside detailed process maps for 4 different phases of rehabilitation (admission, a normal weekday, a weekend day, and discharge) using Value-Focused Process Engineering notation. The integration of design and clinical guidelines with care pathway maps revealed where guidelines lack detail to be readily linked to current stroke inpatient care practice, providing an opportunity to design stroke inpatient rehabilitation spaces based on the activities occurring within them. Our findings highlight gaps where clinical and design experts should work together to use guidelines to their full potential; and to improve the process of planning for future stroke rehabilitation units.

Considerations for mental healthcare facility design in Indian context

With time, there has been a shift in the approach towards location and design of mental health establishments across the globe. In India, the situation changed significantly after the establishment of the Mental Healthcare Act, 2017. The nature of change has been affected by the history, cultural norms, and climatic conditions of the country as well. However, today, India follows a generalized design guideline that is devoid of country-specific considerations. Moreover, there is a dearth of recent research work based on contextual design and site location considerations for a mental health establishment in India. This paper presents a study on the current policies of India, the existing design and location theories of mental health care facilities and contextualization of those theories on two primary case studies and two possible site locations. The findings are then applied to an academic design project with a discussion on the possible design and location considerations that need to be addressed in country or state-specific guidelines. It is concluded by highlighting the relevance of case-specific, rather than generalized, fit-for-every-place approach, today.

Understanding the interplay of light, color, and interior design in healthcare spaces

Healthcare facilities have evolved from strictly functional to therapeutic places, integrating spiritual and psychological components of health. Design issues must be given specific attention to establish a therapeutic atmosphere that promotes successful therapy and stress alleviation. Color and light have a tremendous influence on the human mind and body, according to extensive studies, making them critical aspects of healthcare facility design. This study’s approach is to contribute to the construction of more effective therapeutic settings by investigating the effects of color and light on human wellness and providing design alternatives. So, it tries to provide a complete design paradigm that combines the strategic use of color and light in healthcare facility interior design. Because healthcare institutions play an important role in improving general well-being, this approach can help to create more effective healing settings. To provide the theoretical framework and collect data, this study uses a combination of library studies and descriptive research. The research initially investigates the notion of color and light, then explains their impact on physical and mental health disorders, as well as their use in therapeutic settings. The study concludes with the creation of a conceptual model and recommended design solutions for healthcare facilities.

Hazard Assessment and Remediation Tool for Simulation-Based Healthcare Facility Design Testing.

To develop an objective, structured observational tool to enable identification and measurement of hazards in the built environment when applied to audiovisual recordings of simulations by trained raters. Simulation-based facility design testing is increasingly used to optimize safety of healthcare environments, often relying on participant debriefing or direct observation by human factors experts. Hazard categories were defined through participant debriefing and detailed review of pediatric intensive care unit in situ simulation videos. Categories were refined and operational definitions developed through iterative coding and review. Hazard detection was optimized through the use of structured coding protocols and optimized camera angles. Six hazard categories were defined: (1) slip/trip/fall/injury risk, impaired access to (2) patient or (3) equipment, (4) obstructed path, (5) poor visibility, and (6) infection risk. Analysis of paired and individual coding demonstrated strong overall reliability (0.89 and 0.85, Gwet's AC1). Reliability coefficients for each hazard category were >0.8 for all except obstructed path (0.76) for paired raters. Among individual raters, reliability coefficients were >0.8, except for slip/trip/fall/injury risk (0.68) and impaired access to equipment (0.77). Hazard Assessment and Remediation Tool (HART) provides a framework to identify and quantify hazards in the built environment. The tool is highly reliable when applied to direct video review of simulations by either paired raters or trained single clinical raters. Subsequent work will (1) assess the tool's ability to discriminate between rooms with different physical attributes, (2) develop strategies to apply HART to improve facility design, and (3) assess transferability to non-ICU acute care environments.

Adaptability in healthcare buildings: a perspective through Joseph Bracops Hospital.

The healthcare sector has to face changes happening fast and often in an unpredictable way, such as epidemiological trends, the advancements of medical technology and processes or evolving social and economic needs. This results in a frequent need for infrastructures' retrofitting, with an increasing focus on the environmental impact of buildings, which have one of the highest embodied carbon footprints per square meter in the construction sector. As result, interest in healthcare buildings' adaptability is growing among researchers and practitioners. After an introduction on the research topic, a focus on the definition of adaptability and the existing assessment models is provided to address the following research question: to what extent are adaptability models effective to evaluate and orient the design of healthcare buildings? A quite varied use of the term adaptability has been found in the literature, as well as a new research trend aiming to establish a link with circularity. Moreover, most of the assessment models do not have a focus and have never been tested on the healthcare sector. An approach to circular and adaptable design is presented through the case study of the Joseph Bracops Hospital (Belgium), which has been submitted for evaluation by the Reversible Building Design protocol developed by Dr. Durmisevic. The evaluation highlights some of the current barriers in the design of adaptable healthcare facilities. Insights for future research are provided to encourage data-collection about the service life of healthcare buildings, so to understand if the adaptability of these infrastructures should be mainly monofuntional or transfunctional.

Hospital design principles implementation: Reflections from practitioners in Thailand

ABSTRACT Due to the inherent complexity of medical service procedures, safety standards, and functional requirements in healthcare facilities, numerous design principles have been advocated for more systematic and straightforward design practices. However, most of them are established in developed economies. There is a scarcity of practitioners’ perspectives on their implementation process, difficulties, and outcomes in other socio-cultural conditions. Therefore, this research reflects the realization of these principles in Thailand. It does so by literature review, hosting four public discussion forums in Bangkok, thematic analysis, and data triangulation with case studies. Despite many hospital design principles established, this research shows that it is still a chaotic task to execute them in different contexts. As some may conflict with the national health system, practitioners have to both scrutinize the principles and acquaint themselves with the existing system before balancing, prioritizing, and deciding whether to follow, adjust, or deny the principles. This decision-making process also varies from hospital to hospital due to health disparities, site constraints, local culture, and laws and regulations. This research forms an understanding of healthcare facility design in developing economies and reveals some dilemmas. It also paves the way for future research on hospital design principles localization.

Standard precautions should include 'safe ventilation' to minimise far-afield airborne transmission in health and social care settings.

Standard precautions should include 'safe ventilation' to minimise far-afield airborne transmission in health and social care settings.