Tomorrow's hospitals - Anna Hjort on an evolving architecture

How will tomorrow's hospitals function - what are the architectural trends? Here, Anna Hjort, the architect responsible for the Healthcare competence area at FOJAB arkitekter, explains.

A big thing that is happening now is the conversion to single-patient rooms. This means less risk of infection, less risk of medication errors and you can easily examine the patient on the spot. Overall, the patient recovers faster. The chain of positive effects is so significant that this is now being implemented in Sweden, and indeed throughout Europe. In Sweden, it is also linked to a completely new concept - Patient Closer Care - which means that staff sit out in patient rooms rather than at the end of a corridor.
What is happening is that hospital stays are getting shorter. Whereas 20 years ago you were in hospital for 15 days, now you only need to stay for 3 days on average. This is of course also related to more effective medication, medical equipment and treatment.

Resilient outpatient clinics
Another new feature is that we are designing general outpatient clinics - not specially equipped clinics for orthopaedics, medicine or surgery. All rooms should look the same, so that you can grow and shrink over time. If a department needs more space, it can swell temporarily. Equipment such as ECG machines and the like are of course specific to the operation, but they are now usually on a rolling basis and can be retrieved from centrally located stores if necessary.

This is a prerequisite for the economic viability of healthcare. Co-use is based on designing premises that are as general, flexible and resilient as possible.

At the same time, home care is also being developed, making it possible, for example, to perform dialysis yourself instead of going to the hospital every day.

Robots take the plunge
Flows of pedestrians, patients, goods and staff, which should never cross each other, exist as an underlying structure supplying the different units of the hospital.

Often there is a logistics building on the periphery of the hospital area. This is where all food, goods and laundry are transported. To ensure that there is not too much running, either within the area or within the wards, transportation is managed by a system of culverts and elevators to each floor.

In some places, such as Norway, robots are used for transportation. They can be predestined to take, for example, medicine from the medicine store in the basement. Using a magnetic loop in the floor, the robot makes its way to the right elevator, which knows which floor it is going to. The door opens, the robot drives out and parks outside the entrance to the ward. This means that there is no need to have medication rooms on the wards. Instead, there are centrally located staff who administer the medication.

Such robots are also available for laundry and food transport, for example. You save staff and you save valuable space in the wards. There's less waste because, when it's that easy, you just order what you need. But it has to be in high-volume hospitals for this to work well and pay off.

Evidence Based Design
A key concept in this context is Evidence Based Design. The hospital should not just be a high-tech device where you put a sick person in and they come out healthy. It shouldn't just be management. The hospital stay should be an experience that is good for the soul as well. The soft values are very important. I'm thinking about views, daylight, beautiful colors and good materials.

It's also about not unnecessarily exposing things that can be intimidating. The staff are used to what it looks like, but for a patient who may already be tense and scared, the environment can be terribly intimidating. It could be the operating room, which you have time to see before you are put under anesthesia, the masks you have to put on for radiation treatment, or the MRI camera, which can frighten children in particular. Manufacturers are very aware of this and try to make medical devices as patient-friendly as possible. In short, it is important that the physical environment is a beautiful and friendly experience.