Hospital Planning: Patient Care Units

In the final blog of our Hospital Planning series, we discuss designing patient care units. The safety and comfort of the patient, as well as the ease of care for the staff are the primary drivers for design.

In this blog, I’ll focus on planning patient care units in a hospital. With that in mind, Design Collaborative’s mission – to improve people’s worlds – is the first thing our healthcare team would think about when we begin to design. To achieve our mission, we focus on how we can:
  • Reduce stress for patients, family, and staff
  • Maximize infection prevention and safety
  • Promote efficient and timely care
  • Accommodate current and future technology
  • Provide a healing environment for patients
  • Minimizing the transfer of patient information, including sound controls, in accordance with HIPAA laws

This diagram illustrates the key departments in a hospital, the primary and secondary relationships that each department has to each other, as well as key entry points for patients. Using this diagram, it’s easy to see how each department is positioned in relationship to others. For a typical patient care unit, you’ll need separate access for both patients and family, as well as staff and service personnel. Patient care units need to be located in a semi-isolated area so that unnecessary traffic is prevented or avoided. Rooms are positioned on the exterior for views of the outdoors and for maximum daylight exposure. This promotes the healing process, and meets code requirements and design guidelines.

Patient Care Units Are Positioned For Ease of Staff and Privacy of Patients

Patient care units typically are directly accessed by the lab and pharmacy departments so that staff from those departments can efficiently access patients throughout the day as they care for them. The units need to be organized in a way that promotes efficient travel for staff to minimize walking distances so they can increase the time they are caring for patients.
There are many different types of patient care units. In smaller hospitals, all units might be located together. In larger hospitals, they are typically separated by the type of care that’s required.

 

To determine the number of beds needed, our design team works with hospital personnel to calculate the total number of patients that are anticipated for their market area. This diagram is an example of the process we would follow to help identify total bed need.

 

 
This diagram gives a preliminary total departmental gross square foot estimate for the most common patient care units.

 

 
Even though we would use this process to give our best estimate for the total bed need, there is no guarantee that we can accurately predict how many patients any given hospital will see at once.
When planning a patient room, our team must consider many variables: who will use the room besides the patient? What environment are they in? What procedures will happen here? What issues, like safety and privacy, are there to consider? It’s easy to see how many things must be considered when planning a patient care unit.
There are many different types of patient care unit departmental configurations that have been over the past 50 years. The design used most often in current design is the racetrack configuration (lower right). This puts the care team and other support spaces in the center of the patient care units, allowing the care team more direct access into the patient rooms with less walking distance. This also puts the patients in individual spaces for care and privacy issues, and positioned where they can easily get the attention of care staff when necessary.

Intentional Design Creates a Lasting Impression

Aside from departmental unit efficiencies, the primary opportunity for a hospital to leave an impression with their patients comes through the intentional design of patient rooms. A patient should feel a sense of security, such as safety from falling or feeling attended to by the care staff. They should also have a good sense of privacy for the duration of their stay, and a sense of dignity from the manner of care that they receive. Amenities play a big role in providing these perceptions, such as the position of the restroom and designated family zones for accommodating loved ones.

 

There are three standard patient room layouts that can accomplish these goals and they are primarily driven by the location of the restroom. The first option positions the restroom inboard near the main hallway. The second positions it outboard, along the exterior wall furthest from the hallway. A third positions the restroom midboard or nested. As designers, we guide our client through these three variations to pinpoint their biggest concerns with how care is delivered from their staff and what their expectations are with how the patients use their rooms during their stay.

 

The headwall is the wall at the patient’s head where medical gases, power, over-bed lighting, and nurse call are located. There could be monitors or computers here, too. With all of these different services and devices, our challenge is to design them in a way that they are accessible to staff but at the same time are done in an aesthetically pleasing way so the room doesn’t look intimidating or clinical.

Planning a Healthcare Space?

We've spent the last four weeks detailing how our healthcare team plans the various spaces within a hospital. We stay on top of trends and consistently seek out ways to educate our team on updates in technology and code requirements for healthcare spaces. Patients value healthcare spaces where they feel safe, cared for, clean, and up-to-date. If you'd like to explore options for your space, please contact us.

Bill Ledger AIA, ACHA, NCARB, EDAC, LEED AP
Associate, Architect