The most recent concept in hospital design enables the patient to remain in the same room throughout their stay, writes Bernard Potter
The latest concept in hospital design is the universal hospital room, now on trial in the US.
Designed to meet patient, family and staff needs, US hospital design consultant Doug Wignall, claims it has the potential to replace the traditional ward.
"Universal" is a term used to describe a patient care model which "enables the patient to remain in the same room for the duration of his or her stay and the staffing level to be adjusted according to the acuity of the patient," says Wignall.
"Technology and the inclusion of family and friends in the healthcare experience, are driving changes in hospital design in the US and it's inevitable that those changes will have broader international impact. Patient rooms need to be examined from the patient, staff, physician and family perspective. They all have needs - some different, some shared. And this is as true for Ireland, as it is for the US," says Wignall, of healthcare design consultancy, HDR Architecture.
He believes that where specific design concepts may not be immediately feasible in an Irish context, they can be identified as benchmarks to aim for, or act as catalysts to help find alternative solutions.
But can this concept, already a reality in the US, be adapted for Ireland? "In the first instance, it should be noted that the universal room concept arose as a practical solution to a specific problem. It was initially adopted in the US because of a shortage of nurses. This concept allowed hospitals to provide top-quality nursing care by cross-training nurses.
"The costs of using universal rooms can vary considerably, ranging anywhere from $280 to $350 per square foot in the US (approximately €207-€258). While these rooms do require an additional upfront cost, especially as they need to be about 10 per cent larger to accommodate the ICU level of care, there can be long-term savings, when hospitals require renovation for example, as universal rooms require little modification.
"It's important to remember that there are direct costs and associated risks every time a patient is moved. With the universal model, patients remain in the same room during their stay, thereby alleviating those direct costs and risks, and providing the hospital with a financial benefit as well," he adds.
He concedes that the adoption of the universal room concept has wide-ranging implications. "It calls for more private rooms and the decentralisation of workstations. Technology-wise, it requires sophisticated equipment for charting and communication, as well as the capability to meet the capital costs of equipping rooms for a higher level of care.
"But clinician productivity and satisfaction improves. Operational efficiency improves. There's an increase in patient, family and care-giver satisfaction and an overall improvement in healthcare quality."
He says that often staff have difficulty embracing the concept and they require a cultual change. "The most successful units are those where patients are grouped by specialty. Staff in cardiac care units have embraced this concept more readily. However, it is spreading to paediatric/PICUs."
Ultimately, Wignall poses the question: "Do patients, their families and staff in Ireland deserve lower standards of hospital design than their American counterparts?"
•Doug Wignall will speak on the topic "Envisioning Healthcare Paradigms in the 21st Century" at this year's Engineers Ireland Annual Conference which takes place in Croke Park on April 18th and 19th.
Bernard Potter is editor of The Engineers Journal