Regardless of their location, size, or budget, all hospitals should have certain common attributes.
Efficiency and Cost-Effectiveness
An efficient hospital layout should:
Promote staff efficiency by minimizing distance of necessary travel between frequently used spaces
Allow easy visual supervision of patients by limited staff
Include all needed spaces, but no redundant ones. This requires careful pre-design programming.
Provide an efficient logistics system, which might include elevators, pneumatic tubes, box conveyors, manual or automated carts, and gravity or pneumatic chutes, for the efficient handling of food and clean supplies and the removal of waste, recyclables, and soiled material
Make efficient use of space by locating support spaces so that they may be shared by adjacent functional areas, and by making prudent use of multi-purpose spaces
Consolidate outpatient functions for more efficient operation—on first floor, if possible—for direct access by outpatients
Group or combine functional areas with similar system requirements
Provide optimal functional adjacencies, such as locating the surgical intensive care unit adjacent to the operating suite. These adjacencies should be based on a detailed functional program which describes the hospital’s intended operations from the standpoint of patients, staff, and supplies.
Flexibility and Expandability
Since medical needs and modes of treatment will continue to change, hospitals should:
Follow modular concepts of space planning and layout
Use generic room sizes and plans as much as possible, rather than highly specific ones
Be served by modular, easily accessed, and easily modified mechanical and electrical systems
Be open-ended, with well planned directions for future expansion; for instance positioning “soft spaces” such as administrative departments, adjacent to “hard spaces” such as clinical laboratories.
Cleanliness and Sanitation
Hospitals must be easy to clean and maintain. This is facilitated by:
Appropriate, durable finishes for each functional space
Careful detailing of such features as doorframes, casework, and finish transitions to avoid dirt-catching and hard-to-clean crevices and joints
Adequate and appropriately located housekeeping spaces
Special materials, finishes, and details for spaces which are to be kept sterile, such as integral cove base. The new antimicrobial surfaces might be considered for appropriate locations
A hospital is a complex system of interrelated functions requiring constant movement of people and goods. Much of this circulation should be controlled.
Outpatients visiting diagnostic and treatment areas should not travel through inpatient functional areas nor encounter severely ill inpatients
Typical outpatient routes should be simple and clearly defined
Visitors should have a simple and direct route to each patient nursing unit without penetrating other functional areas
Separate patients and visitors from industrial/logistical areas or floors
Outflow of trash, recyclables, and soiled materials should be separated from movement of food and clean supplies, and both should be separated from routes of patients and visitors
Transfer of cadavers to and from the morgue should be out of the sight of patients and visitors
Dedicated service elevators for deliveries, food and building maintenance services
Aesthetics is closely related to creating a therapeutic environment (homelike, attractive.) It is important in enhancing the hospital’s public image and is thus an important marketing tool. A better environment also contributes to better staff morale and patient care. Aesthetic considerations include:
Increased use of natural light, natural materials, and textures
Use of artwork
Attention to proportions, color, scale, and detail
Bright, open, generously-scaled public spaces
Homelike and intimate scale in patient rooms, day rooms, consultation rooms, and offices
Compatibility of exterior design with its physical surroundings
Security and Safety
In addition to the general safety concerns of all buildings, hospitals have several particular security concerns: