It’s time to rethink hospital design for the healthcare needs of tomorrow

In just 20 years our way of life is likely to have changed significantly in response to the impact of developing technologies, climate change and evolving demographic shifts.

Gavin Thompson is cities global chair at Buro Happold

But one key group of facilities in our cities that have not undergone a major conceptual design change in the last century are our hospitals. It’s time to make a fresh start and rethink hospital design for the healthcare needs of tomorrow. But what does that look like?

As part of an international design team with architect OMA, we at Buro Happold have explored this complex question for one of the leading hospital providers in the Middle East. This extensive research project has given us the rare opportunity to develop a prototype design of the Hospital of the Future, exploring the evolution of the hospital in detail that every healthcare market, including the UK’s, can learn from.

So, what are some of the major changes we’ve envisaged?

Engineered to adapt

We identified the importance of adaptability and agility for the hospitals of the future. To think about the future, you have to clearly understand the demands on current hospitals. Where is the stretch on those demands and where may they go in the future?

The structure and services within the hospital of today are highly rigid and hard to adapt. Inspired by field hospitals, the Hospital of the Future adopts a horizontal configuration rather than the traditional multi-storey stacked configuration of many hospitals that exist today. This is achieved by relocating hospitals out of city centres, to areas of lower land value.

Embracing modularity is also essential to building in adaptability. Each module can function independently as well as part of the whole. Many other spaces, such as bed wards, are designed to a highly efficient level of standardisation, with plug-and-play MEP systems, water and district energy supplies, data, and air and medical gases.

This approach ensures that facilities within a hospital never become obsolete.

Closer to nature

A growing body of evidence has shown that a healthy environment goes beyond offering patients a view from their beds. Creating the best possible surrounding for the recovery of patients has many physical aspects and they can be applied in building layouts, integration of natural elements, lighting, scents, and acoustics.

The prototype hospital inverts the traditional 20th century hospital. It places the bed wards on the ground floor. A key benefit of the low, horizontal hospital is that each bed ward has a direct connection to nature-rich courtyards at ground level.

Courtyards are created naturally through the combining of crosses that the modular structure facilitates. It returns the hospital of tomorrow to the aesthetics of the cloisters, where hospitals were first born within a monastic setting.

By realising a more comfortable patient and staff experience, hospitals can become more effective in their ultimate goal to heal.

Sustainable and resilient

Construction needs to adapt to live with climate change and new hospitals will be no exception. We identified the importance of “treading the earth lightly” and building resilience against future shocks. As our hospital is less constrained than the typical inner-city hospital of today, it’s afforded the opportunity to incorporate infrastructure that reduces vulnerability through increasing site self-sufficiency.

The horizontal plane creates significant roof space for the integration of solar photovoltaics. A battery storage system and thermal storage could be deployed to balance demands between day and night.

To support the development of a prototype that is capable of riding out a significant shock event, a critical function area has been tested based on its potential to operate self-sufficiently. We developed this concept of an island mode of operation, which would allow operation in the event of being cut-off from supplies. We found the hospital could operate self-sufficiently for almost a week, far beyond what sites are currently capable of.

The importance of resilient supply chains was vividly demonstrated as hospitals around the world faced life-threatening shortages in oxygen supplies for Covid-19 patients.

Building in automation

The hospital of today is reliant on manual labour and the operation of lifts for the vertical distribution of goods and waste.

Our prototype facility includes a layer sitting beneath the hospital where robots can move around and deliver items across facilities on demand. The hospital’s structural design will incorporate this hidden technical layer, devoted to a faster, smarter distribution system.

One of the key things we’re also doing with this automation is trying to free up staff time from moving boxes to caring for patients – the sort of things a robot can’t do.

All of the ideas and technologies we’ve explored here and incorporated into our prototype design may sound radical, but the technology exists, and much of it is already being utilised successfully in other types of buildings.

It’s important now that as engineers we bring everything together for healthcare and share a vision of what’s possible, to meet with healthcare providers’ ambitions to transform how they deliver care. By moving this conversation forward I believe we’re making meaningful steps to unlocking a new generation of hospitals.

  • Gavin Thompson is cities global chair at Buro Happold

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