The growing need for sustainable hospitals
Funding has been pledged to build several new hospitals in the UK before 2030 in what promises to be the biggest programme of hospital building in a generation, according to the UK Government. Ruth Wozencroft of Q-Bital Healthcare Solutions outlines her ideas for the perfect hospital and why new buildings are needed.
This former hospital is now a university dormitory in London. The cost and upheaval of upgrading existing hospitals can outweigh the cost of building from scratch. Photo: Roger Utting|123rf
As healthcare needs and available technology evolve, work is ongoing throughout the world to repair, repurpose or replace healthcare environments in order to meet the ever-changing needs of patients. Hospitals that are housed within ‘heritage’ or older buildings often fall into disrepair and many face eye-wateringly steep bills for maintenance. The question is: How can new builds or rebuilds of existing acute hospitals be future-proofed to stop this becoming a recurrent problem for generations to come?
With such investment, the key is to make sure that healthcare providers achieve value for money and create environments that are sustainable and fit for purpose in both the short and long-term. The built environment influences health – none more so than the environments in which we deliver healthcare – and, arguably, there is room for improvement within most healthcare estates in the UK and overseas.
We’ve all heard of the creaking hospital buildings, which are an infection-control nurse’s nightmare, substandard infrastructure and aged buildings designed for large wards where privacy and dignity were not highly prioritised. It would have been impossible to foresee today’s levels of use and demand in such establishments. Neither were environmental controls much of a consideration in the past – the solution to being too hot on the ward was to open a window. Environmentally friendly buildings were not on the horizon a couple of hundred years ago;asbestos and lead were widely used in construction, their poisonous effects being unknown at the time.
The UK’s new build programme will allow for bespoke environments to be created which should, in theory, address all of the issues facing a hospital environment for the future. What makes the perfect, sustainable hospital?
Fit for purpose
We are now much better at predicting future need and we have far more data at our fingertips than previous generations; we know what the issues are – cancer, obesity and an ageing population, to name a few. In theory, this should allow us to build hospitals that have more resources available to deal with increasing numbers of patients in those areas of concern. An increase in the number of endoscopy suites that are better resourced, allowing for faster diagnosis; environments that are more bariatric-patient friendly; and more easily accessible environments for older people are some examples of recognising the issues are and where they are likely to come from. This should allow us to build the best healthcare environments to deal with them.
People’s expectations have risen over the years too – no longer are they prepared to wait in emergency rooms or accident and emergency departments for hours on end. With this in mind, many hospitals now offer minor injuries units to which patients can be decanted, reducing waiting times and freeing up valuable time and space for real emergencies. Rightly, patients expect to be treated in privacy, with their dignity protected, and to have choices about their care. The new built environments need to reflect these expectations.
Data tells us that things that were once predictable can change to become unpredictable. So a degree of flexibility is also required to make the perfect hospital. Many hospitals currently use mobile or temporary clinical environments to add theatre, ward, decontamination, minor injury or clinic space when they need to flex up in an area. Of course this will remain an option – but perhaps the modern hospital could also have flexible space built in, too.
It goes without saying that if building from scratch, we should do so in a way that helps protect the environment for future generations. There must no toxic materials such as lead or asbestos in the building. The hospital should be built so that it can operate in a carbon neutral way and reduce plastic and waste. It could be constructed in a bespoke way to suit the environment in which it sits (including being as climate-event proof as possible), and in a manner that protects and restores natural habitats and minimises the combined footprint of building, parking, roads and walks. The hospitals could harness solar and wind power and green roof systems.
Building from scratch allows planners to design hospitals that are laid out sensibly for patients and visitors; have environmental controls that support healing; and are places where patient comfort is at the forefront – from natural light and ventilation, to privacy and dignity. Implementing these factors into planning will help to facilitate patients’ recovery.
On the subject of temperature in particular, the environmental control of hospital buildings is vitally important. Appropriate temperatures and air flows are needed to protect vulnerable patients from potentially harmful extremes of temperature and the spread of airborne pathogens. Uncontrolled temperature variations can also negatively affect some pharmaceuticals and medical equipment.
Change cannot and will not happen overnight – and neither should it.
Globally, many hospitals are making improvements on a continuous basis by investing in upgraded facilities and equipment and improving the environments for patients. However, it is a slow process and one that needs careful thought, planning and strategic oversight to ensure that past mistakes are not repeated.
We see our colleagues in healthcare working hard in hospitals across the world, rightly taking pride in their work and in their own particular hospital. They and their patients deserve the best possible environment in which to work and be treated – one that is fit for purpose and fit for the future.
Q-bital Healthcare Solutions is a UK-based company that provides mobile healthcare facilities to national health services around the world. It has more than 20 years of expertise in the field with over 275,000 procedures having been performed in its manned facilities. Q-bital is a Key Network Partner of CRJ.