PATIENTS ...a welcoming, healing and reassuring place
Converting patient pathways into the patient experience, from leaving their home to returning home.
• Accessibility and approachability - Is this facility to be somewhere that is part of their experience of the community structure; a familiar place they go past when shopping, maybe even pop into for information or coffee, or somewhere that is likely to be a special trip for a significant purpose?
Therefore how important is location in terms of prominence, links with public transport, parking space etc. Is it something that's an integral part of the built fabric of the community or a place apart from it? What should the initial impression be like? Can we say that drivers (other than those with a particular physical need or urgency) will not be given priority over those arriving by other means - that the facility will not face the world through a sea of car parking?
• Welcome and wayfinding - a place that doesn't stress you out just finding where you have to be.
A single entrance space from which you can see all secondary reception points has been achieved in a number of primary and acute care buildings- is this a non-negotiable for your project?
• The overall ethos and appearance of the facility.
A place that gives me confidence that I'll receive good care/treatment, and where I can retain some sense of myself rather than feel subsumed by the system - see also notes above on ethos.
• The patient environment - evidence based design links basic placemaking aspects such as views (positive distractions), control over your environment (noise, heat, ventilation and light etc), and a sense of privacy and human dignity to improved recovery. Can you pick a few key location types (reception/waiting areas, bedroom, and social space) and benchmark these?
• Will there be somewhere nearby I can escape to if there's an opportunity - a breath of fresh air on a difficult day.
PATIENTS ...a place that supports life
• For a children's hospital - a play space I can get to from my bed - an external space I can get to every day if I want - a place my family or friends can be with me.
• For a dementia unit - a place that doesn't add to my confusion, that is reassuring and somehow familiar. A place I can still do some things for myself.
• For many wards - a place I can rest, where I can think, where I can talk in confidence or be comforted in private. A place to get away for a moment to feel I've still some choices and control.
• For outpatient facilities - a place that doesn't depress me / stress me to go to and where those that have to come with me (a carer / a driver / my children ) can be kept occupied.
STAFF ...a place that supports the work
• What is the working model that is to be supported by the new/altered facility? Does it transpose current working practices or are new more integrated working methods to be used?
Can this be embodied in any specifics such as only one reception point (as opposed to one for NHS, one for social work etc) or a commonality of room specification to allow space to be used as a resource rather than a territory?
• Is it a stand-alone facility, or are links to other services/departments/community facilities critical?
This'll effect both the location and the facilities that'll be needed within the development.
• What do staff need to function effectively in terms of accessibility of the facility, functionality of working space and places to escape. Are there particular spaces you wish to benchmark?
e.g. deciding early days that there's a particular theatre design that you wish to benchmark (perhaps open plan with windows) will inform very early design approaches to ensure a view that cannot be reciprocated.
• What is the ethos of the facility? What messages is it trying to convey and what behaviours are you looking to engender? The physical nature of the building (imposing or friendly) both embodies and influences the staff/patient relationship and the types, places and modes of communication.
• What level of efficiency are you looking for and how will you approach it? Does 'lean design' mean concentrating solely on staff walking distances (and potentially making the building deep plan and artificially lit/ventilated) or are you really looking at making the briefing and design work harder so that you get more than one benefit from any space (internal and external) that you build?
e.g - Designing areas that have more than one use such as combined circulation/waiting spaces with something such as an atrium that assists with daylighting and ventilation: or, placing accessible external spaces (which may be need as lightwells etc) where they can have others uses such as formal and informal therapy, play space, additional waiting, respite and contribute to the biodiversity commitment?
• What are the additional benefits you're looking for from the development?
Are you looking for it to help with staff retention or event to attract new staff - if so which facilities does it have to beat to attract the skilled employees you want?
STAFF ...a place that'll not constrain future work
• How serious are you about future flexibility?
Will you require all consulting rooms to be the same, and a proportion of such rooms serviceable from more than one sub-reception to allow different users to occupy different areas as needs change? Will you require services to be routed such that walls can be removed/reconfigured more cheaply and the building refurbished on a floor by floor basis? What does flexibility mean in terms of your project?
• Is expansion space an absolute?
VISITORS ...a place to meet and discuss...a place that I can leave loved ones
• Do those accompanying, or visiting patients have a significant impact on the building function and the experience of patients?
Will they take residents for a walk, or need space to meet and chat with in-patients? Will they be waiting for loved ones to come out of treatment, and need information and reassurance? Will they be there for extended periods and need a breath of fresh air whilst not feeling too out of touch?
• How important are play and even crèche facilities to allow patients to attend and keep accompanying children occupied?
• Are there complimentary facilities or services that'd help meet broader objectives of community perception or accessibility of services / encouraging healthy lifestyles? Are there any other visitors you'd wish to encourage by facilities such as drop-in information point?
One of the community health facilities in Belfast has a cafe for use by those attending the GP, but it's so nice that it's popular with other locals and helps maintain the vibrancy and 'normality' of the place as it's a familiar part of the community structure rather than a place you go only when unwell.