Building Design for Service Redesign Susan Francis Senior Architectural Advisor, Future Healthcare...
-
Upload
leslie-horn -
Category
Documents
-
view
236 -
download
0
Transcript of Building Design for Service Redesign Susan Francis Senior Architectural Advisor, Future Healthcare...
Building Design for Service Redesign
Susan FrancisSenior Architectural Advisor, Future Healthcare Network and NHS Estates
Health and dis-ease
‘Health cannot be narrowly defined: it is not just about the absence of sickness, nor just about living longer, but about a better quality of life.
..Improving health is as much about employment, occupation, housing, transport and the environment, education and living standards- including poverty - as it as about treatment within the health service.’
Philipp R, Baum M, Mawson A, Calman K. Humanities in medicine: beyond the millennium. London: Nuffield Trust 2000
Integrated planning
pro
cure
me
nt
Changing workforce
New Clinical models
Building design
Impact of technology
inside hospitals
outsidehospitals Public Private Partnerships
Who
le s
yste
m c
onfig
urat
ion
Centralisation of decisions: historically unbalanced
Centralisation Decentralisation
Workforce
Patient safety
Patient experience
Affordability
Interface of care and design
Centralisation Decentralisation
Patient safety
Patient experie
nce
Service delivery
IT opportunities – remote diagnosis
High tech equipment
Afford- ability
Workforce
Role changes
Clinical networks
Service clusters and building types
New hospital components?
Children’s Services
ComplexSurgery
Theatres
A&E Majors: trauma
Short stay
ambulatory care Maternity &
neonatal care
Diagnostics
A&E Majors: surgery
A&E Minors
Critical Care
Stepdown
Primary care components?
HP &Children’s Services
IntermediateRehab Care
Primary CareUrgents
Short Stay
& Ambulatory Care
Assessment & CDM
Core services
Social Care
Complementary Medicine
A&EDiagnostic
Investigation
Critical Care
Acute Inpatient
Care Community Care Facilities
Ambulatory- 23 hr investigations & surgery
Outpatients- Generalised- Specialised- One Stop
–Rehabilitation–Low–Dependency–Respite–Shared Care–Home Care–Social Care
Co
mm
un
ity
+ P
rim
ary
Car
e
Patient Hotel
Chest Pain Elderly
Assessment
Medical Surgical
areas
Peri Acute Care
Graduated care processGraduated care process
Patient flows and adjacencies
-functionality and planning relationships
Redefine health and social care
SE Belfast PCT
Royal Hospital Belfast
Sperrin Lakeland
Whole system planning
Peterborough
Salford
Liverpool
FHN projects
FHN projects
Redevelop and Regenerate
Whipps Cross Hospital
Redesign
ACAD and BeCad
West Middlesex
Birmingham
Mid Essex
Therapeutic environment
‘The first requirement of a hospital should be that is should do the sick no harm.
Little as we know about the way in which we are affected by form, colour, by light, we do know this, that they have a physical effect.
Variety of form and brilliancy of colour in the objects presented to patients is the actual means of recovery.’
Florence Nightingale Notes on Hospitals 1885
Art, architecture and design
‘Architecture is also about the spiritual needs of people as well as their material needs. It has as much to do with optimism, joy, re-assurance; of order in a disordered world; of privacy in the midst of many; of space in a crowded site; of light on a dull day. It is about quality.’Sir Norman Foster. RIBA Gold Winner. Better by Design 1994
‘Creativity and imagination stimulate the spirit, and , in so doing, speed the recovery process. They are powerful medicine indeed.’Lord Richard Attenborough. President of Arts for Health
Scientific studies link patient outcomes
light
heat shielding
humidity
temperature
music
art
noise levels
Measuresreduced length of stay
incidents
physiological
Social studies link attitudes
Satisfaction
Patients more positive about treatment where they were more comfortable and rated staff treating them more highly Sheffield
Front line staff believed in the healing benefits of art and design Exeter
Staff recruitment and retention C&W
Experience
Perception of their hospital experience Leeds
Easing stress, taking mind off immediate worries and putting in a better mood C&W
Role not only in making a normalising experience but also making it special Bristol Children’s
Ask the Patient
Priorities Picker Connection to staff
Conducive to a sense of well being
Convenient and accessible
Confidentiality and privacy
Caring of the family
Considerate of impairments
Close to nature
Link to care culture MacmillanHolistic Inclusive Respectful Supportive
Control
Aedet Toolkit
FUNCTIONALITY• uses
• Access
• spaces
IMPACT• Character and innovation
• Form and materials
• Internal environment
• Urban and social integration
BUILD STANDARD• Performance
• Engineering
• Construction
Added value
Added value
Added value
Excellence
Fit for purpose
Access and location
Space standards, relationships and flows
Safety and security
Adaptability, elasticity, agility
Integrate art, architecture & design
Make coherent arrangements: human scale, proportion, balance
Delight the senses: light, views, colour, aroma, texture
Stimulate the mind, body and spirit
Adding value
1 1 Capital cost
5 2
Maintenance cost
200 10
Running cost of the business
Design fees 0.1
Business case for good design
New valuation methodsSocial and environmental performance
Modernisation of care
Patient safety
Design quality
Urban regeneration
Sustainability