Sadly, hospitals have been a big point of discussion lately. How they function and how they adapt to unknown challenges are major talking points. What will hospitals look like in the near future? What changes need to be made to the way they are designed?

Specialized Yet Flexible

When designing hospitals, architects and engineers have to deal with two very different issues. On the one hand, we want them to be specialized enough to adequately handle medical procedures. Hospitals provide highly specialized medical functions. The proper equipment and configuration of the space is necessary for hospital staff to do their job.

Many buildings, like offices and commercial buildings, can have a loose fit since the exact use of that space isn’t known at the time of construction. Whether you run an architecture firm or a marketing firm, in general, you will be able to use any office you rent. Hospitals aren’t like that.

We never know when something like COVID-19 will hit again in the future. What we do know is we need to be prepared to adapt. It’s not just potential disasters we need to be prepared for. Changes in medical technology also demand changes in the way hospitals are used.

To account for this, hospitals need to be able to evolve and deal with change of functions.

How Can Architectural Design Help?

A study published in June 2020 in the Health Environments Research and Design Journal studied two hospitals – one designed for a specific use and the other designed for flexibility. The overall configuration of the hospital and the services each provided were similar.

By looking at the differences in “design strategy, planning, design process, and construction by phases” and comparing how the hospitals changed in a twelve-year period, the researchers hoped to understand how the initial design decisions impacted the long-term development plans.

The hospital that was designed for flexibility ended up being a monolithic cube with horizontal shell floors inside. The other hospital was designed to be a cluster of two separate vertical medical centers.

By building vertical instead of horizontal, the architects limited the size of the units within each wing. If two different programs share a floor and one shrinks, that space can only be used by the other program on that floor.

Horizontal building allows for the different units to grow or shrink without losing that space.

In the hospital that wasn’t designed with flexibility in mind, the only flexible area was the large floor area that connected the two vertical stacks. In this space, the oncology and cardiology units on the same floor were able to negotiate and share similar areas.

The researchers concluded, “Architectural design strategies developed in an early stage of the design process has a major impact on the future evolution of the hospital facility.”

A second study published in the Journal of Perinatology looked at how flexibility could be adopted in Neonatal Intensive Care Units (NICUs) as a core value during design. The quick and economical adaption to unknown events and changing demographics was identified as one of the core benefits of flexibility. Several NICUs have already been designed with flexibility in mind, at great benefit to the child and family.