Graham McCorkindale: Better by design – how attention to detail is good for patients and hospital staff

Published on Monday 18 May 2009 18:49

OVER recent years, there has been considerable debate surrounding the financing of healthcare facilities.

Less well-documented is the debate about the quality of the design of these facilities, and the positive impact good design can have on the health and well-being of patients and staff.

Architects engaged in designing primary, community and acute healthcare environments are continually working to provide the best possible clinical solutions that also address the dignity and wellbeing of patients and their families.

For some time, we have championed the belief that good building design can have positive impact on patients.

The increasing acceptance of "evidence-based design" has brought scientific proof that validates previously assumed truisms.

Research undertaken in Scandinavia and North America has proven patient recovery will significantly improve when patients have a room with a pleasant view, can control their own environment and are able to have a good night's sleep. While not an exacting series of demands, it is surprising how difficult they are to achieve.

Standing between our desire to create an effective patient- focused design and the reality of the built form is a myriad of technical, regulatory and financial requirements and constraints that create a series of seemingly insurmountable hurdles.

It is also our experience that one of the real challenges we face in designing hospitals is that all of us, as potential patients, are physiologically and emotionally different and will respond in a variety of ways to the space around us.

The NHS and central government rightly dedicate considerable time and resource to the improvement of hospital cleanliness and the reduction of healthcare-acquired infection.

All initiatives that attempt to improve hospital environments should be welcomed, including the recent announcement to increase the number of hospital cleaners.

Equally important is the part we can play in the design of new buildings to ensure the right finishes and details are selected to make the cleaning and maintenance as easy and as effective as possible. Yet when we were asked recently to eliminate unnecessary ledges, by sloping window sills in bedrooms, it did beg the question of where the cards and flowers would sit.

Hospitals are a complicated building type, not only because they are highly technically serviced but also because they need to provide a huge variety of spaces in close proximity, where the full extremes of joy and grief are played out.

Further difficulties arise when considering the effectiveness of single-bed wards. While undoubtedly a positive response to patient dignity, and the limitation of spread of infection, for some patients, a single-bed ward can be a lonely place.

Patients quite rightly want an appropriately reassuring clinical environment for treatment, alongside a hotel environment for recovery. Staff quite rightly demand the best possible working environment for themselves and their patients.

The public deserves municipal health buildings of the highest design standards, which instil a civic pride and are easily accessible.

With such a wide range of design issues and aspirations, perhaps more time should be spent debating these more sensitive and tactile issues. After all, we all have a vested interest in good design.

&#149 Graham McCorkindale is the director of healthcare at architecture practice Keppie, the project architect for the new Forth Valley hospital.