We need to design hospitals to anticipate people’s future needs and deliver sustainable, inclusive, and resilient care.
Healthcare facilities have always played a significant role in society, seen as a refuge for the sick - and a place for help and healing. This is particularly true of hospitals.
While going to hospitals has seldom been seen as an enjoyable experience, they are nonetheless widely recognized as a crucial feature of any modern country.
A hospital, though, is much more than just a place to go for medical care.
From a sociological perspective, it is where people—patients, families, healthcare workers—spend time. This raises the importance of “place-making,” and notions of space, livability, and “lived experience.”
Political scientists view a hospital as a political project that cannot be untethered from its proponents, nor from the latter’s desire for visibility and popularity. An engineer would say a hospital is a piece of physical infrastructure that poses structural and logistical problems, and architects think it’s an object of design.
What these diverse perspectives have in common is that beyond their medical significance, hospitals are a product both of culture and technology, and are deeply rooted in their historical context.
If indeed healthcare facilities are products of their time, important questions emerge. Are they prepared for today’s challenges – and those of tomorrow? Are they able to tap into the latest technologies and knowledge? How will healthcare facilities of the future look? How should we design them?
At a recent expert meeting in Manila about smart healthcare facilities, participants discussed the 3 main components needed for “forward-looking” facilities” that deliver sustainable, inclusive, and resilient healthcare in Asia and the Pacific for decades to come.
First, tomorrow’s healthcare facilities should be people-centered, to put people’s needs, values, and experiences at the heart of their design, construction, and operation.
The drive toward this concept is informed firstly by a more open-ended view of what “health” is, beyond reductionist views that consider only the doctor and the interventions given. It recognizes that people have varying degrees of disability, and for a hospital to be truly inclusive it must provide ways for persons with disabilities to access care with ease and convenience.
Underscoring the importance of people-centered healthcare facilities is the fact that persons with disabilities are more likely to have negative healthcare experiences compared to others who have a similar illness but are not disabled. This approach is embodied at Singapore’s Khoo Teck Puat Hospital, which was designed and built to be a “hassle-free” hospital for its users.
Second, healthcare facilities must be green, to embrace the natural environment as integrated with it. This principle acknowledges trees as a resource, giving ventilation, thermal comfort, and enhancing the beauty of facilities’ physical environment.
The rationale is not just aesthetic but medical: studies show that natural greenery or views can help the therapeutic process. But green healthcare families not just tap into the benefits of the environment – they also ensure they don’t harm the environment.
Hospitals are big consumers of electricity, so designing them in a more energy-efficient manner is a crucial way to become “green.” Like the hospitals under the Yonsei University Health System, which was founded more than a century ago and established the Republic of Korea’s first modern hospital. The five hospitals under the system have a capacity of over 3,000 beds, and have become model green hospitals through the Green Severance Program.
Finally, it’s critical for healthcare facilities to be safe and resilient.
Although being prepared for any calamity is obviously more important in vulnerable areas, the long lifespan (50-100 years) of healthcare facilities means that even those in safe areas must be ready for the worst. This is likewise justified by the impacts of climate change, as changing weather patterns are leading to more severe storms and other adverse events. Hospitals also need to be resilient during earthquakes.
Beyond natural disasters, healthcare facilities should be secure from biomedical crises, including pandemics and bioterrorism. Pandemics like SARS and Ebola demonstrate how the global spread of illness can happen so quickly, further underscoring the importance of secure hospitals.
The World Health Organization is fully aware of these risks, noting in 2015 that hospitals and health workers are always severely impacted by emergencies, which undermine their capacity to provide care to affected communities when they need it the most.
Hospitals, like health problems, are here to stay. The challenge is to design them in ways that anticipate people’s needs in coming decades.
By pursuing these 3 components in an integrated way, healthcare systems will be in a better position to mitigate the threats of future - and make the most of the opportunities it presents.